This is what my surgeon is proposing for me to deal with osteoarthritis. He said that though I'm 67 my bone density is high, I'm physically very active, and that resurfacing would be better than a hip replacement. The risks of fracture and dislocation are significantly lower than with replacement, there's a much better chance of returning to full activity after the operation though revision rates are slightly higher. If it all goes pear shaped I can have a replacement anyway.
But has anyone here had a hip resurfaced? What's been your post op experience?
My first post-op report, after three weeks, after eight weeks.
But has anyone here had a hip resurfaced? What's been your post op experience?
My first post-op report, after three weeks, after eight weeks.
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Cost here in India is about US $2500 and up for a hip replacement, and goes up to nearly $7500 if an imported ceramic face joint is used.
The wear surface is metal on the cheapest ones, a special hard wearing material called UHMW-HDPE is standard, ceramic coated is the latest I have heard of.
Ask another doctor, basically how do they do it.
Resurfacing implies separating the joint, polishing the matching faces (means a gap will be created), and putting it all back together agaiin.
And it will be repeated at the time the joint is worn out, and needs replacement, and that will be when you are older.
It does not add up in my opinion.
Best get it replaced when needed, and your recovery will be better after the first surgery at a comparatively young age.
Alignment is a problem, also porous bones when you get older.
Poorer results for surgery then.
A friend got his done recently, cost him 800K Rupees for both, about
US$10,000, the surgeon used American joints, and had a really good setup.
He was back home in about a week.
My mother also had a byepass done at 63 years, the doctor said I can put 3 stents, but she is diabetic, so after 5 years there will be chance of blockage, she will need byepass then in any case, so best do grafts...she was going for knee replacement, and the heart issue showed up, she had not had an attack then.
That was in 2005, 18 years back, she is still OK for cardiac issues, no problem.
The thing is that it is a pretty big wound, so the theatre and wards have to be really clean.
Septic infections after such surgeries are more frequent than after relatively minor procedures, as the bones are cut.
The other thing is that the surgeon has about 4 minutes during surgery for the bone cement to set, so alignment better be good first time out, repeating for correcting the mistake is an even bigger problem.
Like I said, find another doctor.
Where are you?
Edinburgh is far away?
Joint team there at the Royal Infirmary is good.
It is the top hospital in Scotland.
The wear surface is metal on the cheapest ones, a special hard wearing material called UHMW-HDPE is standard, ceramic coated is the latest I have heard of.
Ask another doctor, basically how do they do it.
Resurfacing implies separating the joint, polishing the matching faces (means a gap will be created), and putting it all back together agaiin.
And it will be repeated at the time the joint is worn out, and needs replacement, and that will be when you are older.
It does not add up in my opinion.
Best get it replaced when needed, and your recovery will be better after the first surgery at a comparatively young age.
Alignment is a problem, also porous bones when you get older.
Poorer results for surgery then.
A friend got his done recently, cost him 800K Rupees for both, about
US$10,000, the surgeon used American joints, and had a really good setup.
He was back home in about a week.
My mother also had a byepass done at 63 years, the doctor said I can put 3 stents, but she is diabetic, so after 5 years there will be chance of blockage, she will need byepass then in any case, so best do grafts...she was going for knee replacement, and the heart issue showed up, she had not had an attack then.
That was in 2005, 18 years back, she is still OK for cardiac issues, no problem.
The thing is that it is a pretty big wound, so the theatre and wards have to be really clean.
Septic infections after such surgeries are more frequent than after relatively minor procedures, as the bones are cut.
The other thing is that the surgeon has about 4 minutes during surgery for the bone cement to set, so alignment better be good first time out, repeating for correcting the mistake is an even bigger problem.
Like I said, find another doctor.
Where are you?
Edinburgh is far away?
Joint team there at the Royal Infirmary is good.
It is the top hospital in Scotland.
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I'm happy with the surgeon, technology etc, but was curious about recovery experiences. Also happy it's the right thing for me.
The important is that I keep the head of the femur and that it keeps it's shape and size. Which minimizes the risks of breaks and dislocations. There's also no risk of leg length changes.
It's not a common op in the UK because it's normally used on people under 60 where hip problems are much rarer.
I know people with new hips, but other than Andy Murray don't know, or know of, anyone with a resurfaced hip.
So it was post op experience I was curious about.
FWIW in the UK this and hip replacements are ~£15k. One or two days in hospital, mine will be done with an epidural anaesthetic others use general anaesthetic.
The important is that I keep the head of the femur and that it keeps it's shape and size. Which minimizes the risks of breaks and dislocations. There's also no risk of leg length changes.
It's not a common op in the UK because it's normally used on people under 60 where hip problems are much rarer.
I know people with new hips, but other than Andy Murray don't know, or know of, anyone with a resurfaced hip.
So it was post op experience I was curious about.
FWIW in the UK this and hip replacements are ~£15k. One or two days in hospital, mine will be done with an epidural anaesthetic others use general anaesthetic.
Epidural is normal practice for aged patients needing hip or knee replacemnt.
Steel is stronger than porous bones.
Friend's Mom had a fall, broke the femoral head, it was repaired with bolts, so I think the replacement has a better long term result, my Mom had both knees replaced in 2006, no issues so far.
Bones do get porous with age.
I have also seen that the patient's mental strength and positive mental outlook are important for a good result.
It is your body, and without access to your medical records, I can only give a general opinion.
But I still think you should take a second opinion from an experienced surgeon.
Alignment is done with sophiticated equipment if needed, here a surgeon (trained in Germany by Zimmer) says that is needed only for trauma, bow leg or other abnormal cases, not for regular people.
There are dummy joints provided by the joint supplier, the three parts of the knee joint are kept in place, and then the final combination is handed over to the surgeon for fixing.
That takes care of alignment and length issues.
Knee joint is femoral and tibial implants, and a wear plate.
There are a series of sizes for them, and oddly enough the male and female implants are different.
Here the surgeons prepare the top and bottom bones, insert the dummies, work the leg, look for torsion etc, the fix the real joint in place, with cement or screws.
They have it down to less than an hour for knees, < 2 for a hip replacement.
Zimmer, DePuy, Stryker and Smith + Nephew are well known knee joint makers, and many designs exist, that is the choice of the surgeon to choose the type of joint after consulting the patient.
I have no connection with any joint maker named above.
The area around my city is a big center for orthopedic implants, the cheapest hip is about $125, steel ball and socket, cement fixing, no I am not kidding.
Steel is stronger than porous bones.
Friend's Mom had a fall, broke the femoral head, it was repaired with bolts, so I think the replacement has a better long term result, my Mom had both knees replaced in 2006, no issues so far.
Bones do get porous with age.
I have also seen that the patient's mental strength and positive mental outlook are important for a good result.
It is your body, and without access to your medical records, I can only give a general opinion.
But I still think you should take a second opinion from an experienced surgeon.
Alignment is done with sophiticated equipment if needed, here a surgeon (trained in Germany by Zimmer) says that is needed only for trauma, bow leg or other abnormal cases, not for regular people.
There are dummy joints provided by the joint supplier, the three parts of the knee joint are kept in place, and then the final combination is handed over to the surgeon for fixing.
That takes care of alignment and length issues.
Knee joint is femoral and tibial implants, and a wear plate.
There are a series of sizes for them, and oddly enough the male and female implants are different.
Here the surgeons prepare the top and bottom bones, insert the dummies, work the leg, look for torsion etc, the fix the real joint in place, with cement or screws.
They have it down to less than an hour for knees, < 2 for a hip replacement.
Zimmer, DePuy, Stryker and Smith + Nephew are well known knee joint makers, and many designs exist, that is the choice of the surgeon to choose the type of joint after consulting the patient.
I have no connection with any joint maker named above.
The area around my city is a big center for orthopedic implants, the cheapest hip is about $125, steel ball and socket, cement fixing, no I am not kidding.
True, but I don't have osteoporosis. The surgeons say I have excellent bone density.
In a replacement the stem of the prosthesis is, generally, cemented into the femur. When you fall there's an increased risk of the bone surrounding the stem fracturing.
If you're active and doing things that could involve you falling (like riding a bike or hiking on rough mountain trails), a replacement can be vulnerable to dislocation, femur shattering or the stem loosening. Not with resurfacing.
It's the reason resurfacing is the preferred approach for younger people.
Have seen two surgeons. One says ceramic on polymer full replacement, the other said resurfacing though he'd have been ok to do a full replacement if that was what I decided I wanted .
Revision rates for replacement/resurface are similar, as are lifetimes of the prosthesis themselves. However, on the evidence to date people with resurfacing are more likely to be able to return to full activity after surgery.
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How is the cost of treatment in India relavant? And you discuss costs.
Do you have different classes of cleanliness in your operating theatres?
“It is your body, and without access to your medical records, I can only give a general opinion.
But I still think you should take a second opinion from an experienced surgeon.”
Are you medically qualified Mr(?) NareshBrd to give an opinion?
A little bit of knowledge can be dangerous
Surgery is surgery, and no matter what they say, this is major surgery.
Some doctors and surgeons avoid offending their patients at all costs.
So, allow me to emphasize something they won’t:
Lastly, arthritis and osteoarthritis are quite common in anyone past the age of 40. Doctors deliver these diagnoses as positive abnormalities, but in reality, they often are normal abnormalities, in the sense that they are common, even in people who have no symptoms whatsoever.
So, if you are in a great deal of pain frequently, are not overweight and have no comorbidity factors, consider surgery as a valid approach to fixing your problem. Otherwise, seek a couple more opinions.
Again, my goal here is not to offend, but to help.
Some doctors and surgeons avoid offending their patients at all costs.
So, allow me to emphasize something they won’t:
- If you are obese or very overweight or even just overweight, please do something about that first. It will not only make recovery from such procedures possible, but a lot faster as well.
- Be sure that you are able and willing to undertake the physical therapy regimen you should undertake after surgery. It will speed up recovery and bring you back to full function.
Lastly, arthritis and osteoarthritis are quite common in anyone past the age of 40. Doctors deliver these diagnoses as positive abnormalities, but in reality, they often are normal abnormalities, in the sense that they are common, even in people who have no symptoms whatsoever.
So, if you are in a great deal of pain frequently, are not overweight and have no comorbidity factors, consider surgery as a valid approach to fixing your problem. Otherwise, seek a couple more opinions.
Again, my goal here is not to offend, but to help.
How is the cost of treatment in India relavant? And you discuss costs.
Do you have different classes of cleanliness in your operating theatres?
My father contracted MRSA at a major, top rated hospital in Chicago.
My wife just had her hip replaced in June of 22. It is now done as outpatient surgery here in the US. Anterior (instead of posterior) procedure, pretty small incision on the front side of the hip, so minimal to no cutting of muscles, etc. She was up walking less than 2 hrs. after the procedure, no issues.
For the sake of clarity. I'm 67, 183cm tall and weigh 74kg. I lift weights at the gym, cycle 150km per week and when in Spain have been doing day hikes of 30km. My blood pressure is normal and I have a resting heart rate in the high 50s.
I have very painful bone on bone contact in the hip, largely caused by a narrow pelvis around the head of the femur. A birth defect that's quite common. It causes excessive cartilage wear & at some point, arthritis.
Surgery is the ONLY option. Two surgeons agree on it, and I've opted for resurfacing for reasons explained in the head post.
I'm interested the post op experience of anyone who's had resurfacing...
I have very painful bone on bone contact in the hip, largely caused by a narrow pelvis around the head of the femur. A birth defect that's quite common. It causes excessive cartilage wear & at some point, arthritis.
Surgery is the ONLY option. Two surgeons agree on it, and I've opted for resurfacing for reasons explained in the head post.
I'm interested the post op experience of anyone who's had resurfacing...
Sad for your father.
It obviously wasn't very clean, or were their clinical regimes weren't very good then? If that was a top rated hospital.....
My wife had cortisone injections in her foot recently at a local NHS community hospital, the pre infection control was very thorough leading up to and during the procedure, even for such a minor event.
And it went very well.
Good luck with your procedure
https://www.dchft.nhs.uk/service/hip-resurfacing/
Perhaps more useful than Dr naresh's expertise
You are in good shape, the cartilage is worn out.
It will not grow back.
Resurfacing can be compared to polishing a rough surface, the surgeon is going to remove a small amount of bone and cartilage, and a small gap will be created. That will increase as you age.
And as you grow older, a slip in the bathroom is enough to cause damage to the hip.
Your bones will lose density sooner or later, it is a natural process.
One doctor did say replacement, the other says your choice.
So be it, it is your body, and your activity level.
Also, there are companies apart from the big ones who make joints with a greater degree of freedom. The surgeon will be aware of that, this somtimes borders on sports medicine.
And cementing / screwing / combination is a normal procedure in orthopedic surgery.
My mother has had falls due to her Parkinson's issues, no damage to the knees.
I again emphasise that if the bone ends are properly prepared for the insert, without excessive gap, and the prosthesis properly bonded, it is a safe and durable option.
There are many websites in the USA / Canada, dedicated to older people and their problems.
Be aware that some are funded by device suppliers.
Go through them, there will be posts from patients who have undergone these procedures, and shared their experience.
I think this procedure can be put off for a short time, while you think it over.
The doctors in India say that there is no point in doing major surgery twice, better replace the joint, and be done with it.
I do deal with medical devices, some of my friends are nationally reputed doctors, with many decades of individual experience, unlike some canine hecklers on this site.
Can you pour turpentine or petrol on dogs, as you can do that with cats, who then take off?
It will not grow back.
Resurfacing can be compared to polishing a rough surface, the surgeon is going to remove a small amount of bone and cartilage, and a small gap will be created. That will increase as you age.
And as you grow older, a slip in the bathroom is enough to cause damage to the hip.
Your bones will lose density sooner or later, it is a natural process.
One doctor did say replacement, the other says your choice.
So be it, it is your body, and your activity level.
Also, there are companies apart from the big ones who make joints with a greater degree of freedom. The surgeon will be aware of that, this somtimes borders on sports medicine.
And cementing / screwing / combination is a normal procedure in orthopedic surgery.
My mother has had falls due to her Parkinson's issues, no damage to the knees.
I again emphasise that if the bone ends are properly prepared for the insert, without excessive gap, and the prosthesis properly bonded, it is a safe and durable option.
There are many websites in the USA / Canada, dedicated to older people and their problems.
Be aware that some are funded by device suppliers.
Go through them, there will be posts from patients who have undergone these procedures, and shared their experience.
I think this procedure can be put off for a short time, while you think it over.
The doctors in India say that there is no point in doing major surgery twice, better replace the joint, and be done with it.
I do deal with medical devices, some of my friends are nationally reputed doctors, with many decades of individual experience, unlike some canine hecklers on this site.
Can you pour turpentine or petrol on dogs, as you can do that with cats, who then take off?
It is possible that new systems, which can rebuild worn surfaces, have been introduced, which I am not aware about.
So do ask the doctor in detail, the old procedure would increase the gap between mating surfaces, increasing the wear of the joint.
The biggest cause of post operative infections are secondary airborne infections in the recovery units, and those are difficult to curb, the most at risk patients are those who have had open heart surgery and orthopedic surgery .
Like above, MRSA after surgery, at a reputed hospital in a First World country...these things happen.
Be aware, talk and find out the time to finally replace the joint after resurfacing, which is a time buying procedure in my opinion.
Then decide.
So do ask the doctor in detail, the old procedure would increase the gap between mating surfaces, increasing the wear of the joint.
The biggest cause of post operative infections are secondary airborne infections in the recovery units, and those are difficult to curb, the most at risk patients are those who have had open heart surgery and orthopedic surgery .
Like above, MRSA after surgery, at a reputed hospital in a First World country...these things happen.
Be aware, talk and find out the time to finally replace the joint after resurfacing, which is a time buying procedure in my opinion.
Then decide.
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I think not. The pain is having a significant impact on my life, I'm 67 and only have so many fully active years ahead of me, I don't want to spend some of them hobbling around on a cane munching painkillers. There has been enough delay.
If the resurfacing doesn't work out I can still have a full prosthetic.
Contrary to what you describe, resurfacing involves removing remaining cartilage, putting a metal/polymer 'cup' into the pelvis and a metal/ceramic cap onto the head of the femur. So the joint is metal on metal, or ceramic on polymer, similar to current full prosthesis. I believe there are currently trials of ceramic on ceramic (hopefully they don't squeak like the full prosthesis do). There are ~1.5k resurfacing operations a year in the UK compared to 85k replacements.
A potential problem with resurfacing could be a reaction to metal particles released by wear of a metal on metal joint. Not common, but if you have it, the resurfacing has to come out.
Short of a custom hip prosthesis resurfacing is the only way to preserve hip geometry...
Survival and functional outcome of the Birmingham Hip Resurfacing system in patients aged 65 and older at up to ten years of follow-up
They certainly do, but can be controlled. In the UK we had 15 and 57 MRSA and Cdif infections per 100k hospital days. In the following couple of decades this has been in steady decline to be 0.9 and 22.6. But it's a reminder that we all should continue to use handwash in hospitals regardless of COVID.
If you want a 'laugh' have a read of the biography of Ignac Semmelweis, a true pioneer and much derided in his own time.
The hospital is where you go to get the real bad infections. It can be as clean as can be and there is still a great risk for infection.
There's two aspects to getting an infection: the presence of the pathogen, and your ability to fight it off. My father was unable to fight off infection. I was almost 100% certain to have been exposed to the MRSA pathogen; I was at the hospital 4 to 6 days a week for months and I didn't get infected.
I 100% guarantee you that when you go to the hospital, the most dreadful pathogens imaginable are lurking. My father was at Northwestern Memorial Hospital on Lake Shore Drive, about as prestigious as it gets.
Many people come in with Staph Aureus that they've been carrying around for ages, but it's (mostly) harmless outside the body. I read on the CDC site that testing has shown that, roughly 33% of the population is carrying Staph Aureus with no ill effect and <2% carry MRSA.
All it takes is one touch near a wound, so it's bad news, of that there's no doubt. Gives us a glimpse of what the world was like before antibiotics...
This is so true. The doctors wouldn't even repair my bulging hernia until I lost 50 lbs. I lost 67 lbs before I had the surgery.
Physical therapy, before and after, is vital to a good outcome. I walked 4-6 miles a day for a year before the surgery, and now it's 9 months since I had it and I still walk 4-6 miles a day. So many of my ailments have been mitigated or eliminated. My knee was causing me so much pain and debilitation, and the doctors said they wouldn't fix that unless I lost weight as well. Now my knee is so much better. My diabetes is gone - normal blood sugar almost every day. My blood pressure is almost normal; when I started it was 170/137! Little wonder I didn't have a heart attack or major stroke (doctors now say they think I has several small strokes and I had a life threatening pulmonary embolism and many small ones). No more blood thinners, reduced blood pressure medication.
I walked through excruciating pain for months. It was worth it. I never would have regained my health if I had been lazy about this.
My neighbor had an emergency bypass done. She refused to walk or exercise after the procedure. She was diabetic and her husband had to hide food from her. I remember her husband trying to get her to walk around the block but she wasn't having it. The TV was her life. Sadly, she passed away shortly after the procedure.
Being a physiotherapist for 30 years, yet to see a resurface. Lots of replacements with excellent results. I've seen it holding together on old ladies with osteoporosis. I think the key world is durability. How many years of continuous use it will take. There is a problem with the femoral head. It gets blood supply both from the femur and a ligament to the pelvis. I guess this ligament is cut in resurfacing as with replacement. And then whatever happens to the neck of the femur will lead to avascular necrosis. Just a possibility.