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THR Should I Cancel My Left Hip Replacement?

CatchAll

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I just found this site last week. I'm glad you all are here.

I had my right hip replaced in February, 2021. I'm 45. It had gotten to the point where I couldn't walk two blocks without looking for a place to rest. The surgeon used the anterior approach and installed a Depuy Corail stem, ceramic ball, and Pinnacle cup with a polyethylene liner. We didn't discuss the parts and pieces before the surgery, but I guess those are pretty good components. Recovery has been pretty easy. I went home that day, used a walker for a few days, and used a cane for a week or so after that. It took a long time for a numb spot on my leg to go away and I still get a little bit of weird tenderness in my quad, but overall I treat my right hip like normal except I don't run, jump, or abuse it.

So ... my left hip is junk too. It is not near as bad as the right used to be. There is always some pain, but not enough to eat advil for breakfast. Range of motion is a problem and I can often feel some clicking in there, but I can usually walk or hike and it doesn't feel too terrible as long as I keep moving; after I stop the left hip pain starts. For example, I did a 45 minute steep uphill hike a couple of weeks ago. When I stopped my left hip started to feel bad and the whole downhill trek was very painful. I'm not sure if this is bad enough to require a replacement just yet. I think I could squeeze a few more years out of it, but why should I?

I'm scheduled to have a total replacement of my left hip later this month and I am having second thoughts for a few reasons. A friend of mine recently talked to someone who had a hip resurfaced and he does not have any restrictions. His surgeon told him that the hip might last the rest of his life. I don't know who the surgeon was, but I'm working on finding out. My surgeon told me to expect 20 years from my replacement hip and I'm not supposed to do anything high impact. I just started reading the work that James Pritchett is doing in Seattle with resurfacing and I'm wondering if I should go that route instead. I don't know enough about resurfacing to really make a decision on that point yet. On the other hand, if my right hip is a total replacement what difference would it make if get the left resurfaced? The right one will still be subject to limitations. Finally, if I keep my appointment, I will be in the same insurance year as my first surgery, so I will not have to pay anything out of pocket for the second hip (buy one get one free).

For background, I played rugby into my early 30's, then did cross-fit three or four days per week until just about 40. I have always lifted weights and been pretty active, but never a lean/light person. My hips started to go when I turned 40 and I pretty much stopped all physical activities by 44.
 

58hippain

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I had my second hip done less then three weeks ago finally have no hip pain. I would get it done and get back to all your physical activity.
 

djklaugh

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@CatchAll " My surgeon told me to expect 20 years from my replacement hip and I'm not supposed to do anything high impact." I think your surgeon is a bit old school with this statement. Now a days implants are expected to last 30+ years - and some of the original ones lasted 40+ years. And as for no "high impact" activities - well I was significantly older than you with no history of - and no interest in - "high impact" sports activities - and when my surgeon discharged me - after having both hips replaced at the same time - he said my only life time restriction was "no bungie cord jumping".

Here at BoneSmart we have seen quite a few people your age and younger getting hip replacements and returning to physically demanding jobs (police officers, firefighters, construction work, etc) and high impact activities with very few problems.

I don't know too much about hip resurfacing but what I've seen here is that such a procedure has just as painful and lengthy a recovery time as a hip replacement and chances are you would need a hip replacement any way with in 10 years. You can use the search function here to look for other threads related to hip resurfacing.
 

Pumpkin

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@CatchAll
Welcome to BoneSmart, :welome:

Link to a list of members who had Hip Resurfacing .

I think I could squeeze a few more years out of it, but why should I?
In the reading below you will find a score chart, score how your hip is doing to get a better idea of just how limited your life has become.

New BoneSmart members like you are in various stages of their journey to joint replacement. Making the decision whether or not to have surgery and preparing for surgery can be easier once you have done your research and know what lies ahead. Here are some tools that can help you decide what is best for you.

If you are at the stage where you have joint pain but don't know for sure if you are ready to have surgery, these links may help:
Score Chart: How bad is my arthritic hip?
Choosing a surgeon and a prosthesis
BMI Calculator - What to do if your surgeon says you're too heavy for joint replacement surgery
Longevity of implants and revisions: How long will my new joint last?

If you are at the stage where you are planning to have surgery but are looking for information so you can be better prepared for what is to come, take a look at these links:
Recovery Aids: A comprehensive list for hospital and home
Recliner Chairs: Things you need to know if buying one for your recovery
Pre-Op Interviews: What's involved?

And if you want to picture what your life might be like with a replaced hip, take a look at the posts and threads from other BoneSmarties provided in this link:
Stories of amazing hip recoveries
 

Eman85

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Your hip, your decision. I've had 2 done and as soon as they started hurting I waited about 50 years before I had them replaced. I was signed in at the hospital and still thinking of cancelling. As you said you have had one replacement so what's to gain by resurfacing? You hear all different times for how long a replacement hip will last, it's all an educated guess. Many factors including size of the person and how much it's abused, then in some cases the factors don't seem to matter. Are you wanting to run and do high impact things? I figure the biggest risk for my hips is me doing something dumb like falling off of a ladder.
 

Schaargi

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Hi @CatchAll

Yeah, I understand your dilemma.

I'm 5 weeks out from my second THR, and my new surgeon just installed a Depuy Corail stem, ceramic ball, and Pinnacle cup with a polyethylene liner. What a coincidence!

My first THR is a different product and I worry that this one (the Depuy) will be so much better. I did a lot of research before having this hip done and have a lot of confidence in it.

I hope your research helps you make the right decision. Yes, the resurfacing could last the rest of your life, but so could the Depuy, right?

Best of luck.
 

Jaycey

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@CatchAll Welcome to BoneSmart! From what you describe in terms of the condition of that left hip you may not be a candidate for resurfacing. But only your surgeon can determine this.

In my experience waiting is just a waste of time. Getting the hip done before it has an impact on the rest of your body means an easier recovery.
 
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CatchAll

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I finally tracked down a guy that had his hip resurfaced. He had his right one done last March and is having his left one done this month. He went with resurfacing because a friend of his had both hips resurfaced when he was in his thirties (over 20 years ago) and both of them are still going strong. He was not advised to avoid any type of activity after recovery. He also knows a couple of other guys that had it done. They all go to Dr. Pritchett in Seattle.

I guess it doesn't matter at this point since I had a full replacement of my right hip, but I would have liked to continue doing crossfit (sprinting, jumping on and off of boxes, high intensity weightlifting), occasionally play rugby, soccer, or flag football, and do some jogging. My son is only 8, so I don't know what sports I might want to continue to do. I understand that some surgeons are telling their patients to do whatever they want, but it seems that they give that advice to older patients who are less likely to put as much stress on the joints and who are unlikely to outlive the device even if they subject it to some abuse.

I have not seen data to support the conclusion that you can expect a hip replacement to last 30 or 40 years. There's a chance they will last that long, but there are a lot of factors that could come into play. The studies I have seen commonly look at 5, 10, and 15 year time frames. Some reference 20 and 25 year follow-ups. In those longer periods the studies I looked at reference between 60% and 80% survival of the implants, but they also noted that younger age was a negative risk factor.
 

ljpviper

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Hello, I had a hip resurfacing that I had to remove . I will tell you that a dual mobility hip replacement felt more natural to me. You make a good point of already have a hip replacement on one side.

If it were me I would just get another hip replacement. Dr. Pritchett is an awesome surgeon if you decide to resurface the other hip. I asked my surgeon what I can do on my dual mobility he said basically anything that I could do on the resurfaced hip. Hope that helps.
 

Schaargi

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I understand that some surgeons are telling their patients to do whatever they want, but it seems that they give that advice to older patients who are less likely to put as much stress on the joints and who are unlikely to outlive the device even if they subject it to some abuse.
I agree with you. My first surgeon told me I had no restrictions, and then I think he realized I was more active than he originally thought and backed off his previous recommendation. It was disheartening, to say the least. My second surgeon is more optimistic, but I'm going to try to pin him down at my 3-month follow-up in January.

You seem like you are doing some excellent research. I hope you can find a solution that doesn't make you feel hindered.
 
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Autumn01

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I havnt read much about resurfacing to know anything.

but seems to me that you cant go back to try resurfacing after a hip replacement…but you can go forward to a hip replacement if you find resurfacing inadequate?

if thats the case….then do resurfacing. Maybe your hip wont need anything further.

get all your info, get docs opinions.
 
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CatchAll

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It is looking like I will just go forward with the total replacement for my left hip. There's no way I can get enough information before my scheduled surgery to determine whether there is a chance that resurfacing would be a better option. Since I'm already missing a femoral head on one side, saving the other isn't going to make much difference in my lifestyle.

I finally got a call back from the surgeon's office who does resurfacing. They want me to get all of my medical records and all prior xrays mailed to them then schedule an appointment at their office 2 hours away. That appointment would probably be just days before my scheduled replacement. I tried to explain that I just need to talk with someone in the office who can tell me about the procedure, what implants they are using, and what data they have collected regarding revision rates so that I can decide if I should cancel my scheduled operation. If I cancel and do a replacement or resurfacing next year, I start from scratch on insurance deductibles. I'm ok with doing that if I think there is a good reason, but I have already met my out of pocket maximum this year. If I go forward with the total replacement this month it is free.

The whole business of health care is pretty frustrating. It is impossible to ask a doctor a simple question unless you schedule an appointment and burn half of a day so that you can your 30 minutes of Q&A. If you think of a follow-up question after you have walked out the door, you have to schedule another appointment.
 

Going4fun

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Most surgeons don't like giving out the data you requested on the phone. They feel more comfortable telling you that information in person with all the nuances that they think are important. Not all surgeons systematically track things.

Sometimes revisions are done by different surgeons, so the original surgeon doesn't know about this.

A larger point though is I don't think it's good to greenlight surgery before meeting the surgeon. There's a huge amount of trust involved in surgery, even if on paper the surgeon has a great record or a great reputation. You really do want to meet the surgeon in person (maybe this can be done online too) and assess them. Trust is huge for comfortably going forward with surgery. Some people will give you the creeps even if others like them.

Sounds like going forward with a total hip is good for you. Good luck.
 
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CatchAll

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@Going4fun Thanks for your comments. I wouldn't want a surgeon to schedule a surgery without meeting him. What I am wanting is for a surgeon to tell me about his work so that I can decide for myself whether I should redlight a surgery that I already have scheduled with a different surgeon. Maybe I would end up rescheduling the total replacement with my current surgeon next year after an in-depth evaluation of resurfacing with this other surgeon, but I just need to decide whether to hit the brakes right now. You do mention something that is key... they want to tell you information that they think is important. I'm trying to remember if a doctor has asked me what is important to me.

If I were to cancel my scheduled surgery and start over next year, it would cost me between $7,000 and $8,000 because I have met my out of pocket maximum for insurance this year. I would be willing to do that if I believed there is a possibility that I might choose the other surgery. Right now I am weighing an unknown potential benefit against a known cost and there is a clock counting down. T minus 11 days.
 

Schaargi

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@CatchAll

I wish I could help more with your decision. The deadline is intensifying everything for you.

I sense that you are wondering if it would be worth the $$ to step back and put it on hold. That's a LOT of money, but it's hard to make a life decision without the information you feel you need. I guess I'm just reiterating what you are already feeling, but I hear so much angst in your posts I wanted to let you know that.

I'm so sorry you are in this dilemma and I know it's stressful with the clock ticking.
 

Going4fun

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So what do you think of your present surgeon? Are you ambivalent about them?
 
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CatchAll

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My present surgeon is awesome. For a total hip replacement I doubt there is anyone better in the state.
 
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CatchAll

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I have a couple of new things to consider.

About 6 weeks ago I started taking fluoxetine (prozac) for mild depression that I attribute to my hip problems. I didn't think of doing any research about it until today. I found one study that said there is an increased risk of bleeding during/after surgery for people who take these types of drugs. I'm not too concerned about that because I think the risk is still pretty small. Then I found another study done on mice that pretty clearly showed that it inhibits bone growth. That's not good. I have calls into my doctors to see if they have any comments.

I also talked to another guy who had his hips resurfaced at about my age. He's convinced that it is way better than replacement. At that time the surgeon said he had been doing resurfacing for almost 30 years and had not had a failure yet. I have some buyer's remorse now.
 

ljpviper

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I would not worry about buyers remorse. Hip replacements have come along way in the last 10 years. Unless you were getting your hip resurfaced with Dr. Prichett as he uses poly and metal. All other hip resurfacing surgeons utilize a metal on metal component.

That can lead to complications in the future.
 
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CatchAll

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@ljpviper Dr. Pritchett is who these resurfacing patients have all used. After calling some friends, and friends of friends, I now know of 5 or 6 guys who have had resurfacing done by Dr. Pritchett. Pritchett's office is 10 or 15 miles from my surgeon's office. When I met with my surgeon about hip replacement I asked him about resurfacing since I had read something about younger active patients going that route. He said that nobody really does it anymore because of metal on metal leading to metallosis problems, so I gave up on that topic right away.
 

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