Alternative to Total Hip Replacement (THR)

[mbd]

Wanted to share with fellow horsemen: I was born with severe bi-lateral dysplasia, in a cast til 3-1/2, seemed to turn out okay, but was warned my whole life I was living on borrowed hips. Made it to 47 years old as a competitive horseman (eventing, pleasure, ranch work, backcountry packing, rehabbing projects, etc.), marathon runner (pavement and mountain races), serious hiker, avid hunter, xc skier, yada yada yada with zero issues.

About age 47 started having issues with hips while trying to qualify for Boston. Ortho doc shook his head, told me to stop running and when the pain got bad enough, he’d do a THR. He said I had about a year left before I couldn’t tie my shoes.

Oh HELL no that wasn’t an acceptable answer! Spent almost 3 years doing what I could to manage the pain, quit running on pavement, took up yoga and biking, plus lots of weight lifting.

Finally hit the wall this past winter when a couple mile run was miserable for days and getting on and off my draft-cross mare resulted in awful grinding noises and a lot of pain. Started on researching my options and found hip resurfacing. Liked the information and statistics, applied to the doctor in the US who does the most and has been doing them the longest, Dr. Gross of Midlands Orthopaedic in Columbia SC. There are others, but that’s who I chose.

Have never been so happy in my life! One hip done, one to go after the first one heals (6 months.) ZERO joint pain, and I can feel it coming back nicely. After both are done I fully anticipate returning to everything I’ve always done and loved, so wanted to share. The recovery time kind of sucks, but it’s worth it to me for the long term return.

Google hip-resurfacing, look up www.grossortho.com, or www.surface-hippy.com for lots of information. If I can answer any questions, I will try.

[hosspuller]

I had a similar experience… When the surgeon only does THR … all the people get THR’s Thanks to the internet, I learned about Birmingham resurfacing. Went to another doc that does both… got a resurfacing 6 years ago. Sprained a hamstring 3 weeks post surgery taking stairs two at a time! Learn from my mistake… Take your time to heal after the surgery …

Able to ride for hours again without hip pain .

[pony_alter]

Re-surfaced @ 42 and couldn’t be happier. Biggest regret was waiting 2 years before having it done.

[wendy]

6 months healing is actually longer than the healing time after a THR? what is the advantage? I know several people who have had minimally invasive THR and they were walking without pain within 2 weeks and back to full function in 6 weeks.

[pony_alter]

My recovery wasn’t that long, I was suppose to stay off it for 6 weeks because I was an extreme case with cysts in bone that they filled w/ cement…I was handling horses and driving @ 2 weeks. The benefit is it doesn’t dislocate easily like traditional THRs (good for riders), it’s meant for active people AND it leave the femur in place for any future revisions as hardware can wear out. I don’t jog, as I’ve been told that makes it wear out faster…just my personal choice to try to make it last longer.

[AnotherRound]

Great information! I had heard of it, and these are great testimonies. I think I would opt out of running afterwards, too. Just too hard on the bones and tendons to begin with, and there are alot of other kinds of strengthening work you can do without banging and heavy impact. Yoga. Man, I’m getting strong with Yoga. Anyway, good news.

[hosspuller]

[QUOTE=wendy;7205194]
6 months healing is actually longer than the healing time after a THR? what is the advantage? I know several people who have had minimally invasive THR and they were walking without pain within 2 weeks and back to full function in 6 weeks.[/QUOTE]

A resurfacing saves the bone. The larger bearing of a resurfacing resists dislocation better. Bottom line… a THR is two replacements. A resurfacing is three replacements. A Resurfacing is only done to the younger folks since the surgery is much more involved. Sawing off the leg bone for a THR gives the surgeon working room a resurfacing does not.

[pony_alter]

[QUOTE=hosspuller;7205708]
A resurfacing saves the bone. The larger bearing of a resurfacing resists dislocation better. Bottom line… a THR is two replacements. A resurfacing is three replacements. A Resurfacing is only done to the younger folks since the surgery is much more involved. Sawing off the leg bone for a THR gives the surgeon working room a resurfacing does not.[/QUOTE]

Actually a THR is much more involved and traumatic to the body, you are talking amputation. Not sure what you are talking about with “replacement”, as far as the research has gone the resurface may last our entire lives, even for those of us operated on in our 40s. There are 2 pieces of hardware in each surgery, the receiving end in the pelvis pretty much the same in both surgeries. There is plenty of good info on resurfacing if you Google it. yahoo has a wonderful group “surface hippies”, you can reach folks in your area and get DR reviews.

[dm]

What hosspuller is probably meaning is that it is my understanding that it is more difficult for the surgeon to perform a hip resurfacing than a hip replacement because there isn’t as much room to work (and therefore the incision is usually a bit longer than what the same patient would need for a replacement) and it’s technically more challenging because there is little room for error when placing the hardware components.

I’ve had both of my hips replaced (not resurfaced), but my surgeon is also a well known hip resurfacer. I have a metal allergy, and the cobalt chrome prosthesis would not have worked well for me. Instead, I have titanium/ceramic/highly cross linked poly in me.

I would have gone for the resurfacing if I had been a good candidate, though, primarily for the bone conserving nature of it. I’m very likely going to have to have a revision of both at least once in my lifetime, and it would have been easier to do them if it had been from a resurfacing to a replacement, rather than a revision of a replacement. But, even with my replacements my surgeon doesn’t expect it will be a problem to do a revision on me when/if it becomes necessary.

I don’t worry about dislocation of my hip replacements because I have a pretty sizable ball/socket in there. Yes, the resurfacing components are larger and more the size of the natural hip, but I’ve bent my hips at pretty sharp angles and nothing feels like it’s going to dislocate. My surgeon hasn’t told me about anything I shouldn’t do, other than running because that kind of higher impact activity can wear out the prosthesis sooner. But, I don’t run anyway. Riding was fine with him, as well as hiking, or whatever else I wanted to do. Whether it’s a resurfacing or a replacement, new hips are a beautiful thing when you’ve been suffering with pain for a while before the surgery.

Glad you are so happy with your resurfacing. I know Dr. Gross does a lot of them, so it’s good that you went to someone experienced. That’s very important. Mine has done over 1000, so he’s also pretty experienced with it as well.

[mbd]

To clarify why I chose resurfacing rather than THR, I really didn’t like the statistics on THR: dislocations, never again any high impact, and they wear out. I probably won’t go back to pavement marathon running but I wanted the option to run again in some form. Interestingly, Dr. Gross views horseback riding in general as high impact.

I’m on the slow recovery plan due to how much damage and bone spurs there were in the sockets, plus the fact he did a lot of excavating to form a new more ‘normal’ hip socket; I was fortunate I had the bone to do that but it was a lot of trauma in the pelvis. He wants the one totally healed before doing the second so my total recovery time will be close to a year.

The mare needs to learn to drive anyway … and the gelding drives beautifully so I may become that crazy horse lady in the forecart bombing around the neighborhood

My incision is 4" overall; I was shocked he could do that much work in that small of an incision. He said it was 1) because he’s good (excellent surgeons are SO modest…) and 2) he didn’t have much to go through to get in there. I’m 5’5" and about 125 lbs in good muscle tone. Pre-op I consciously dropped 10 lbs and about 8% BMI to get in shape for surgery and I think it paid off.