Hip Replacement/Resurfacing..?

General Discussion
1

Close now to having to face the process, and with it becoming more and more common for an aging surfer tribe, would like to refresh the forum dialogue on those who have had or are contemplating hip replacement or resurfacing.  And would value feedback from those who have had the process, the results of their respective procedure, who their surgeon was, and any reccomendations for same. 

 

Like Rodney Dangerfield used to say, “If I knew I was going to last this long, I would have taken beter care of myself”

 

Cheers!

2

hey LCC

i am sort of in your shoes, pre-resurfacing phase.

i am 41 and though i have some pretty serious deterioration of my hip joint, no doctor has come out and told me i need this procedure now.

The orthoped. surgeon i was referred to uses a different procedure than the “Birmingham” method, which seems to be the most common.

I am in the PacNW and hope to find someone local who had a resurfacing procedure done.

I am extremely torn on the subject, for now it is all about Palliative care of my hip and soft tissue around it.

wish i could be more help, but have you checked out:

http://www.surfacehippy.info/

it seems to be one of the main online sources of studies, reviews and doctors-it is geared toward resurfacing rather than replacements.

hopefully someone else on here has more knowledge on the subject

3

hi

 

i had no hip replacement right now and i hope i never need one.

 

i am a medical ingenieer, and i just can say, try to stay as long as you can with your human hip. the replacement will normally become loose after 10-15 years, and it will never be the same. try to strenthen your muskels etc, but if there is no other way i wish you the very best.

 

 

 

klaus

4

Up in the NW myself, transplanted from the bay area 4 years ago…61, however, and non-stop since 1963…over two decades of snowboarding with a fondness for out of bounds certainly didn’t help the wear and tear either, which I finally had to walk away from…have thoroughly checked out the surfacehippy spot, which is both inspiring and informative…first trashed my right hip back in the late 70’s at Hanalei during a wooly wipeout, hobbled around for months unknowingly until getting thru it… then years later when getting a work up for a back issue, was shown on the x-rays that I had apparently fractured the hip…which was causing the back issue…LOL

Have battled this since then, keeping my weight lean, swimming and spinning when not surfing…they gave me a steroid shot in the hip 3 years ago during a paticular bad episode, and it took them 20 minutes of poking the needle around, even with the use of the imaging device, before they could find a space in the joint big enough just to slip the needle thru…big fun, that…

Scheduled next month with an ortho surgeon here in Oregon for a workup consult who has done almost 900 resurfacing procedures, and many more replacements…only for something like this, I would travel to where ever to get the treatment done by the best doctor possible…I plan on surfing as long as I can walk, so want to get this done right…

 

 

5

sent you a PM LCC

 

but the basic gist of it is:

found my other info. The Resurfacing method the surgeon I spoke with is called Cormet/Stryker.

i think it is the same basic procedure as Birmingham. The surgeon told me i would be walking out of the hospital (2-3 days in hospital) and be load bearing within the week. I find this hard to believe as any other info i have read, most are down(not walking) for 2 or so weeks and do not even return to work for about 3 weeks. Maybe i did not hear him right.

During 2010, I have met with 2 orthopeds and 1 orthopedic surgeon. 2 of 3 of these guys told me to keep my hip strong and healthy and get as much as i can out of my human hip, and call them when i cannot deal anymore. the 3rd said i am a candidate but see if i can go longer in my current situation. Basically when i cannot stand it anymore.

I have seen all kinds of other specialists and treatments:

Acupunturists, Physical Therapists, Doc of Naturapathy, and Doc of Chiropracty. All of which are not convinced that resurfacing/replacement is right for me. I went through a series of injections directly into my joint to stimulate some muscle growth, did not respond to it, but at least it made me get used to large needles, not sure it was as intense as your needle, but was not pleasant by any means and was usually 5 injections per session through a lot of tissue.

I am pretty open to whatever might make things feel better, but cannot seem to pull the trigger on a major operation yet. Which brings me to keeping it healthy, flexible and tissue/muscle as strong as i can. I do not have the same flow in many physical activities, but i try to treat it like a post operation rehab, but without the operation.  Stretching everyday but do not really have the discipline and proper flex for yoga. Frustrating and tiring indeed.

I have modified some of my activities accordingly, surfing will be a huge gauge for me. Right now i can feel a loss of flex and flow in my movements, but can still function.

6

You might check with these guys  http://www.stoneclinic.com/  even if you don’t go to them as they do pretty leading edge work and a lot of research. Their main patient demographic is aging athletes and their goal it to keep them playing their games of choice.

7

I had a full replacement around 5 years ago. It is all good so far. Mine was a stryker device. Not sure what you called the procedure but it was done from the front (anterior) with a very small 6 inch or so incision.It was done on an insane looking table designed for this surgery.  I was walking with just a cane in two weeks. I spent two nights in the hospital. I was evaluated for resurfacing but I was too far gone for it. Technology for this stuff changes every day so do you homework. I heard some of the best surgeons in the world for this are actually in India.

    Mine was done by a very good surgeon in Savannah,GA who learned the procedure from a Doc in California.

   I used to limp around and could not even put a sock on. I am 62 years old/young.

8

Sounds like it was done on the Pro-FX table, which allows the surgeon to manipulate the body to get to the hip without cutting thru muscles or tendons…your story certainly supports what they say about this technique - less damage, faster recovery.

 

thanks for sharing…

9

http://www.completept.com/pages/cpt.html

http://www.hiphelp.com/

call me if you like

 

 

10

http://www.nytimes.com/2010/12/17/business/17hip.html?_r=1&scp=1&sq=Hip%20replacement%20problems&st=cse

 

 

The Implants Loophole

By BARRY MEIER
Published: December 16, 2010
New York Times

 

11

 

Exactly why doing the front end research, and using a thoroughly vetted product and surgeon is so vitally important.  When Warren Bolster, the well respected surfing photographer, killed himself in 2006 at the age of 59, a lot was said about the constant hip pain and mobility issues he was struggling with due to a faulty hip replacement…working in the islands last year, I talked to a local surfer in his early 50’s, hobbling with a cane above the Cliffs lookout…recovering from his second hip replacement operation, as the first one had failed within 2 years…hadn’t been in the water for almost three years, had a poor prognosis on the second implant due to the damage from the first implant, and was literally in tears talking about how much he missed surfing…

Hence this thread, trying to learn from those who’ve already been there, and realhy feeling it for brothers in the tribe who have had less then desirable outcomes.,

12

Aloha,

Google up  DR. HARLAN AMSTUTZ,  he's the guy that did my hip.     He trains Doc's from all over the world.

13

thanks for starting this thread. it has got me thinking in a more serious way about resurfacing again.

another site i ran across is:

http://www.hipresurfacingsite.com

 

thanks to all who have experience and are sharing

14

Rich,

 

Hope you get well soon !

 

 

15

Thanks to EasternPacific for mentioning the site with Dr Klapper. I feel like I saw some one else mention that doctor in another thread. I picked up his book called Heal Your Hips: How to prevent surgery and what to do if you need it.

While it is only a book, I found it to have some good info, good stretches/exercises and some rehab and pool work.

Might not be useful to everyone, but so far I feel like it has gotten me some extra flex and target weak muscles.

I have my normal stretches I do daily, but a couple of these seem to help more.

Eventually, I will need to take it farther, but feel like it helps me prepare my hip a little more for the surgery step

16

Have now seen several hip surgeons, and some info to share.

Projected useful lifetime for current hip devices is 30 years, so hip resurfacing is the first choice for those under the age of 50 or so, as once the resurfacing devices wear out, total hip replacement will then see the patient thru the rest of their life.  So an important key for those younger is to get an early diagnosis for serious hip issues, and not reach the point of athritic degradation that hip resurfacing has been removed as an option.  And progress continues to be made on techniques to replace existing hip replacements with new, so having a full hip replacement when younger doesn’t mean out of luck when still alive 30 years later.

For a total hip replacement, the anterior approach is certaily the way to go.  A process that has been used in Europe since the 60’s, and becoming the new gold standard here in the US, it not only dramatically reduces recovery time (walking immediately after surgery, sports in two months or so), it equally reduces post-op dislocations, as the major muscles groups have been left intact, firmly holding the implant in place.

As potential dislocaton problems are an obvious serious issue for surfers, both for long term health and immediate survival if dislocaton occurs while out in heavy conditons, the Big Femoral Head device is the go to solution for the more strenous sports athletes such as surfers.  Since the BFH devices also are thought to have a higher wear rate, however,  it requires the surgeon to balance the device selection between dislocation prevention and minimal wear.

I went through a workup with an orthopedic surgeon in San Francisco I really like, Dr. Nichaolas Mast with the SOAR clinic, who has studied extensivey with some of the best ortho surgeons in the US and Europe, including the highly regarded Dr. Joel Matta in Santa Monica, and several other notables in Europe.  He has done hundreds of hip replacements, is fully versed on the latest tecniques for best outcoms, and very importantly to me, he is a dedicated surfer who understands how important is is for a surfer to keep surfing.

On a personal basis, turns out I will need both hips replaced due to the advanced athritis in both.  Having been assured this is strictly a pain related decison and waiting will not change the outcome, I’ll just deal with the current come and go discomfort and keep on surfing until my body let’s me know it’s time to get it done…

17

I have a birmingham replacement which is 5 years old now and it has been excellent from the start, and feels like it will last another 20 years, I could not surf(because of the pain) before i had the op and at the age of 46 i was not going to ride a body board. My advice to anyone would be if it affects your surfing life, get a re-surface before the bone is too worn out.

18

It doesn’t go smooth for everyone. The ball at the top of my femur was not entirely inside its pelvic socket so I had much pain and very limited mobility.

My surgery with the so calledfull hip replacement, gold standard anterior approach was done here in Santa Cruz at Dominican 10-16-08.

I was able to surf in about 10 months after the operation but I have had many complicatons.

The tip of the rod wiggled around in the my femur which then produced a medial femur fracture.

I spent the end of '09 and 9 months of '10 waiting for the bone to knit up. Bone pain doesn’t go away. The bone pain has been gone for about 10 weeks.

I’m doing physical therapy now but iwith many nerve channels flaring up. because of imbalance in function. I can climb a few stairs but not a thenth of what I want to.

I’m in good health so I’m hoping my process will carry me to a point of being able to surf again, but I’m not going out and be a liability to myself and my fellow surfers.

It’s been several years since I’ve been able to use my hip in any way approaching normality,

the two or three preceding the operation and the two plus following it,

so I have to get the muscles, legiments and tendons to work properly.

It’s a crooked road and I seldom know what’ll come up next. For now It very light stuff, like short beach walks, a few stairs, a little swimming. Ti Chi, and stretching as directed by my physical therapist.

Am I complaining? No! If I hadn’t had the proceedure I wouldn’t  be walking or doing a lot of normal everyday activities.

Aloha,. Rich

19

hal - if you want to talk, get a hold of me.

I understand the pain

 

==ep

 

 

20

your last paragraph is well stated. I too was in your shoes , and knowing that it is an elective procedure,  only you can say when it’s time. You will know. 

when I had my fist hip done (Dr, Robert C. Klapper at Cedars Sinai in LA) I waited as long as I could. The objective there after was to get as much distance in between the two surgeries as possible, give yourself at least one good bearing surface to walk on. The objective was one year, I got eight months, but I wanted to get the second one done knowing how much better I would be. Living in chronic pain is stressful. Over a prolonged period of time is unhealthy. You realize it right away,post op. 

Your choice of surgeon is key. You have one shot at this for a first time. I’m 8 years out, doing pretty well, and continue to work at getting better and learning more about this evolving field. As of late, resurfacing has shown some of the unknowns, but if I was a candidate for resurfacing I’d find the best Dr’s available like Bill did.

Feel free to PM for any reference links or info. Good Luck!

==ep