Re: THA Long Term Restrictions

May 12, 2009

Juju, this isn't correct. I was post menopausal when I got my two resurfacings

and everything went fine. If anyone doesn't have good bone density it only

means they have to spend 6 weeks on crutches in their recovery.

Here the choice of surgeon is REALLY important. If one has low bone density or

any complications they should be using only the top docs. But resurfacing can

be work well with low bone density too.

Hollie

> A post yesterday indicated a failure in a resurfacing in a post-

> menopausal woman. How sad that someone on this site might feel that

> the choice is between resurfacing which is conceded to be higher risk

> in post menopausal women and a replacement that will leave one

> crippled. I was aware of greater failure in post menopausal women and

> therefore deliberated opted for a procedure that was almost guaranteed

> to get me at least 15 or 20 years without another operation --

> >

> > > > > > > > > > > > >

> > > > > > > > > > > > > [Non-text portions of this message have been

> > removed]

> > > > > > > > > > > > >

> > > > > > > > > > > >

> > > > > > > > > > >

> > > > > > > > > >

May 12, 2009

I don't know what you mean by " incorrect " . Incorrect means my

information was wrong. I stated that there is greater risk for post

menopausal women.

There is in fact elevated risk in post menopausal women. By elevated

risk, it means that a statistically higher number of post menopausal

women will undergo problems with this surgery and some surgeons will

not do it on post menopausal women.

It's fine that your surgery went well -- there was a post yesterday

about a woman who DID experience complications.

People need to know all options regarding any medical procedure and

then make their own decisions based on what they think is best for

themselves.

My personal decision was that since resurfacing is contra-indicated in

post menopausal woman there was no reason why I shouldn't opt for a

THR which provided me with a completely satisfactory result -- with no

restrictions (LOL -- I stress this since it went into my personal risk

benefit analysis).

Someone else might weigh the factors and come up with a different

conclusion which is fine.

However, to not know that there are elevated risk factors for post

menopausal women serves no purpose.

Begin forwarded message:

> From: Hollie <rosey9932000@...>

> Date: May 12, 2009 11:47:13 AM PDT

> Joint Replacement

> Subject: Re: THA Long Term Restrictions

> Reply-Joint Replacement

>

> Juju, this isn't correct. I was post menopausal when I got my two

> resurfacings and everything went fine. If anyone doesn't have good

> bone density it only means they have to spend 6 weeks on crutches in

> their recovery.

>

> Here the choice of surgeon is REALLY important. If one has low bone

> density or any complications they should be using only the top docs.

> But resurfacing can be work well with low bone density too.

>

> Hollie

>

> > A post yesterday indicated a failure in a resurfacing in a post-

> > menopausal woman. How sad that someone on this site might feel that

> > the choice is between resurfacing which is conceded to be higher

> risk

> > in post menopausal women and a replacement that will leave one

> > crippled. I was aware of greater failure in post menopausal women

> and

> > therefore deliberated opted for a procedure that was almost

> guaranteed

> > to get me at least 15 or 20 years without another operation --

>

> > >

> > > > > > > > > > > > > >

> > > > > > > > > > > > > > [Non-text portions of this message have been

> > > removed]

> > > > > > > > > > > > > >

> > > > > > > > > > > > >

> > > > > > > > > > > >

> > > > > > > > > > >

> > > > > > > > > > > [Non-text portions of this message have been

> removed]

> > > > > > > > > > >

> > > > > > > > > >

> > > > > > > > >

> > > > > > > >

> > > > > > >

> > > > > >

> > > > >

May 12, 2009

Show me the peer reviewed study where you are getting your information.

Hollie

> I don't know what you mean by " incorrect " . Incorrect means my

> information was wrong. I stated that there is greater risk for post

> menopausal women.

>

> There is in fact elevated risk in post menopausal women. By elevated

> risk, it means that a statistically higher number of post menopausal

> women will undergo problems with this surgery and some surgeons will

> not do it on post menopausal women.

>

> It's fine that your surgery went well -- there was a post yesterday

> about a woman who DID experience complications.

>

> People need to know all options regarding any medical procedure and

> then make their own decisions based on what they think is best for

> themselves.

>

> My personal decision was that since resurfacing is contra-indicated in

> post menopausal woman there was no reason why I shouldn't opt for a

> THR which provided me with a completely satisfactory result -- with no

> restrictions (LOL -- I stress this since it went into my personal risk

> benefit analysis).

>

> Someone else might weigh the factors and come up with a different

> conclusion which is fine.

>

> However, to not know that there are elevated risk factors for post

> menopausal women serves no purpose.

>

> Begin forwarded message:

>

> > From: Hollie <rosey9932000@...>

> > Date: May 12, 2009 11:47:13 AM PDT

> > Joint Replacement

> > Subject: Re: THA Long Term Restrictions

> > Reply-Joint Replacement

> >

> > Juju, this isn't correct. I was post menopausal when I got my two

> > resurfacings and everything went fine. If anyone doesn't have good

> > bone density it only means they have to spend 6 weeks on crutches in

> > their recovery.

> >

> > Here the choice of surgeon is REALLY important. If one has low bone

> > density or any complications they should be using only the top docs.

> > But resurfacing can be work well with low bone density too.

> >

> > Hollie

> >

> > > A post yesterday indicated a failure in a resurfacing in a post-

> > > menopausal woman. How sad that someone on this site might feel that

> > > the choice is between resurfacing which is conceded to be higher

> > risk

> > > in post menopausal women and a replacement that will leave one

> > > crippled. I was aware of greater failure in post menopausal women

> > and

> > > therefore deliberated opted for a procedure that was almost

> > guaranteed

> > > to get me at least 15 or 20 years without another operation --

> >

> > > >

> > > > > > > > > > > > > > >

> > > > > > > > > > > > > > > [Non-text portions of this message have been

> > > > removed]

> > > > > > > > > > > > > > >

> > > > > > > > > > > > > >

> > > > > > > > > > > > >

> > > > > > > > > > > >

> > > > > > > > > > > > [Non-text portions of this message have been

> > removed]

> > > > > > > > > > > >

> > > > > > > > > > >

> > > > > > > > > >

> > > > > > > > >

> > > > > > > >

> > > > > > >

> > > > > >

May 12, 2009

Are you serious? It is so universally acknowledged that post

menopausal woman are outside the parameters of being the ideal

patient. I haven't read anything regarding resurfacing that has stated

anything differently. In dealing with statistical studies, not every

post menopausal women will have complications nor will everyone under

60 (or fitting criteria for ideal patient) NOT have complications --

but that is true of any procedure because medicine is an art as well

as a science.

Again, if one elects for hip resurfacing, fine. However, there are

rational reasons why someone might weigh the cost/benefits and come

out on the other side.

As for " peer reviewed " , all any lay person can do is to read

everything available, ask medical professionals probing questions and

then come to an educated decision.

For what it's worth, here's a statement by Dr. Schmalzreid as well as

other doctors. Schmalzreid has been performing resurfacings for years

so his bias is certainly not against THR. I am not presenting this as

the be all and all -- however, for you to treat this universally

accepted data -- i.e. post menopausal women being statistically more

likely to have a poorer outcome than others is quite odd.

Again, someone over 60 can have a perfectly satisfactory outcome.

However, for someone to not acknowledge information is not logical.

One can then decide that the benefit of a resurfacing outweigh risks

-- or that other factors besides being post-menopausal factor into the

equation.

Hip Resurfacing Information

Again, I am not arguing against resurfacing -- merely pointing out

that there are logical rational reasons why someone might opt for a

THR -- and that such a choice is not tantamount to accepting a life of

limitations.

WHat I think is wrong is painting a negative picture of a procedure

based on outdated techniques and prothesis -- because it does an

extreme intellectual disservice to people researching -- If one thinks

that a THR MUST result in restrictions, then one is more likely to

accept restrictions from an OS rather than either challenging the OS

and/or seeking an OS who can provide a better outcome.

On May 12, 2009, at 3:14 PM, Hollie wrote:

>

> Show me the peer reviewed study where you are getting your

> information.

>

> Hollie

>

> > I don't know what you mean by " incorrect " . Incorrect means my

> > information was wrong. I stated that there is greater risk for post

> > menopausal women.

> >

> > There is in fact elevated risk in post menopausal women. By elevated

> > risk, it means that a statistically higher number of post menopausal

> > women will undergo problems with this surgery and some surgeons will

> > not do it on post menopausal women.

> >

> > It's fine that your surgery went well -- there was a post yesterday

> > about a woman who DID experience complications.

> >

> > People need to know all options regarding any medical procedure and

> > then make their own decisions based on what they think is best for

> > themselves.

> >

> > My personal decision was that since resurfacing is contra-

> indicated in

> > post menopausal woman there was no reason why I shouldn't opt for a

> > THR which provided me with a completely satisfactory result --

> with no

> > restrictions (LOL -- I stress this since it went into my personal

> risk

> > benefit analysis).

> >

> > Someone else might weigh the factors and come up with a different

> > conclusion which is fine.

> >

> > However, to not know that there are elevated risk factors for post

> > menopausal women serves no purpose.

> >

> > Begin forwarded message:

> >

> > > From: Hollie <rosey9932000@...>

> > > Date: May 12, 2009 11:47:13 AM PDT

> > > Joint Replacement

> > > Subject: Re: THA Long Term Restrictions

> > > Reply-Joint Replacement

> > >

> > > Juju, this isn't correct. I was post menopausal when I got my two

> > > resurfacings and everything went fine. If anyone doesn't have good

> > > bone density it only means they have to spend 6 weeks on

> crutches in

> > > their recovery.

> > >

> > > Here the choice of surgeon is REALLY important. If one has low

> bone

> > > density or any complications they should be using only the top

> docs.

> > > But resurfacing can be work well with low bone density too.

> > >

> > > Hollie

> > >

> > > > A post yesterday indicated a failure in a resurfacing in a post-

> > > > menopausal woman. How sad that someone on this site might feel

> that

> > > > the choice is between resurfacing which is conceded to be higher

> > > risk

> > > > in post menopausal women and a replacement that will leave one

> > > > crippled. I was aware of greater failure in post menopausal

> women

> > > and

> > > > therefore deliberated opted for a procedure that was almost

> > > guaranteed

> > > > to get me at least 15 or 20 years without another operation --

> > >

> > > > >

> > > > > > > > > > > > > > > >

> > > > > > > > > > > > > > > > [Non-text portions of this message

> have been

> > > > > removed]

> > > > > > > > > > > > > > > >

> > > > > > > > > > > > > > >

> > > > > > > > > > > > > >

> > > > > > > > > > > > >

> > > > > > > > > > > > > [Non-text portions of this message have been

> > > removed]

> > > > > > > > > > > > >

> > > > > > > > > > > >

> > > > > > > > > > >

> > > > > > > > > >

> > > > > > > > >

> > > > > > > >

> > > > > > >

May 12, 2009

Juju, so you have no studies or any support for your opinion that resurfacing is

dicey for post menopausal women.

Your statement that this is univerally acknowledged is specious. I really keep

up with resurfacing studies and I've never heard about it.

Without studies to back up your opinion, you have nothing.

Hollie

> Are you serious? It is so universally acknowledged that post

> menopausal woman are outside the parameters of being the ideal

> patient. I haven't read anything regarding resurfacing that has stated

> anything differently. In dealing with statistical studies, not every

> post menopausal women will have complications nor will everyone under

> 60 (or fitting criteria for ideal patient) NOT have complications --

> but that is true of any procedure because medicine is an art as well

> as a science.

>

> Again, if one elects for hip resurfacing, fine. However, there are

> rational reasons why someone might weigh the cost/benefits and come

> out on the other side.

>

> As for " peer reviewed " , all any lay person can do is to read

> everything available, ask medical professionals probing questions and

> then come to an educated decision.

>

> For what it's worth, here's a statement by Dr. Schmalzreid as well as

> other doctors. Schmalzreid has been performing resurfacings for years

> so his bias is certainly not against THR. I am not presenting this as

> the be all and all -- however, for you to treat this universally

> accepted data -- i.e. post menopausal women being statistically more

> likely to have a poorer outcome than others is quite odd.

>

> Again, someone over 60 can have a perfectly satisfactory outcome.

> However, for someone to not acknowledge information is not logical.

> One can then decide that the benefit of a resurfacing outweigh risks

> -- or that other factors besides being post-menopausal factor into the

> equation.

>

> Hip Resurfacing Information

>

> Again, I am not arguing against resurfacing -- merely pointing out

> that there are logical rational reasons why someone might opt for a

> THR -- and that such a choice is not tantamount to accepting a life of

> limitations.

>

> WHat I think is wrong is painting a negative picture of a procedure

> based on outdated techniques and prothesis -- because it does an

> extreme intellectual disservice to people researching -- If one thinks

> that a THR MUST result in restrictions, then one is more likely to

> accept restrictions from an OS rather than either challenging the OS

> and/or seeking an OS who can provide a better outcome.

>

> On May 12, 2009, at 3:14 PM, Hollie wrote:

>

> >

> > Show me the peer reviewed study where you are getting your

> > information.

> >

> > Hollie

May 12, 2009

I emailed several which have been commented on. Unlike others LOL I do

have a life which purpose isn't to provide medical research for people

on the internet since I have no vested emotional (or other) interest

in what strangers do with their bodies.

There are certainly generally accepted guidelines -- a guideline is

just that for both doctors and patients.

I assume anyone with enough intelligence to find this list will also

google medical procedures -- read the literature and discuss it with

actual medical professionals in terms of what this means for

themselves as individuals.

outside the parameters of IDEAL patient -- that's a continuum or bell

curve which doctors or patients may or may not take into account in

making decisions.

On May 12, 2009, at 7:06 PM, Hollie wrote:

>

> Juju, so you have no studies or any support for your opinion that

> resurfacing is dicey for post menopausal women.

>

> Your statement that this is univerally acknowledged is specious. I

> really keep up with resurfacing studies and I've never heard about it.

>

> Without studies to back up your opinion, you have nothing.

>

> Hollie

>

> > Are you serious? It is so universally acknowledged that post

> > menopausal woman are outside the parameters of being the ideal

> > patient. I haven't read anything regarding resurfacing that has

> stated

> > anything differently. In dealing with statistical studies, not every

> > post menopausal women will have complications nor will everyone

> under

> > 60 (or fitting criteria for ideal patient) NOT have complications --

> > but that is true of any procedure because medicine is an art as well

> > as a science.

> >

> > Again, if one elects for hip resurfacing, fine. However, there are

> > rational reasons why someone might weigh the cost/benefits and come

> > out on the other side.

> >

> > As for " peer reviewed " , all any lay person can do is to read

> > everything available, ask medical professionals probing questions

> and

> > then come to an educated decision.

> >

> > For what it's worth, here's a statement by Dr. Schmalzreid as well

> as

> > other doctors. Schmalzreid has been performing resurfacings for

> years

> > so his bias is certainly not against THR. I am not presenting this

> as

> > the be all and all -- however, for you to treat this universally

> > accepted data -- i.e. post menopausal women being statistically more

> > likely to have a poorer outcome than others is quite odd.

> >

> > Again, someone over 60 can have a perfectly satisfactory outcome.

> > However, for someone to not acknowledge information is not logical.

> > One can then decide that the benefit of a resurfacing outweigh risks

> > -- or that other factors besides being post-menopausal factor into

> the

> > equation.

> >

> > Hip Resurfacing Information

> >

> > Again, I am not arguing against resurfacing -- merely pointing out

> > that there are logical rational reasons why someone might opt for a

> > THR -- and that such a choice is not tantamount to accepting a

> life of

> > limitations.

> >

> > WHat I think is wrong is painting a negative picture of a procedure

> > based on outdated techniques and prothesis -- because it does an

> > extreme intellectual disservice to people researching -- If one

> thinks

> > that a THR MUST result in restrictions, then one is more likely to

> > accept restrictions from an OS rather than either challenging the OS

> > and/or seeking an OS who can provide a better outcome.

> >

> > On May 12, 2009, at 3:14 PM, Hollie wrote:

> >

> > >

> > > Show me the peer reviewed study where you are getting your

> > > information.

> > >

> > > Hollie

>

May 12, 2009

From the NY Times article -- people should obviously further research.

Notice that the article doesn't condemn resurfacing but merely

questions whether it is riskier for certain patients -- i.e. post

menopausal women - this is an excerpt. Presumably intellectually

curious people can track down the original research which is cited.

Red Flags About Hip Resurfacing for Women - NYTimes.com

But studies from some countries where resurfacing has been used longer

than in the United States, including Sweden and Australia, have

repeatedly shown a higher failure rate for women who undergo the

procedure than for men. Such women are more likely to need a second

corrective operation soon after the first, compared with women who get

a conventional full replacement hip, a recent British study found.

And earlier this week, researchers released a study of resurfacing

patients in the United States that raised similar cautions. The study,

conducted by researchers at Rush University Medical Center in Chicago,

indicated that complications from hip resurfacing were more frequent

in women — of all ages — and in men over 55.

“This procedure is not ideal for everyone,” said Dr. Craig J. Della

Valle, who led the Rush University study. Dr. Della Valle noted that

data showed that resurfacing worked very well in men under 55.

The potential problems with resurfacing reflect a drawback of which

doctors have been long aware. Although hip resurfacing has the

advantage of retaining more of a patient’s thigh bone, that bone must

remain strong for years.

That is the reason the procedure already is not advised for patients

in their 60s, male or female. But the drawback may also be potentially

significant for even younger women, because of the bone weakening that

accompanies menopause. Meanwhile, even advocates of resurfacing

acknowledge that they have yet to agree on how best to screen women

for the procedure.

On May 12, 2009, at 7:06 PM, Hollie wrote:

>

> Juju, so you have no studies or any support for your opinion that

> resurfacing is dicey for post menopausal women.

>

> Your statement that this is univerally acknowledged is specious. I

> really keep up with resurfacing studies and I've never heard about it.

>

> Without studies to back up your opinion, you have nothing.

>

May 12, 2009

Here is a link to the entire article, again Kathy (Bird) is the patient I got

Barry Maier in touch with, the writer of the article.

http://www.nytimes.com/2008/11/08/business/08hip.html?fta=y

Her failure occured due to surgeon error, she was within the first 50 procedures

for her surgeon. Here is another excerpt from that same article:

" A company spokesman also said recently that & Nephew believed that the

size of a patient's femur was a better indicator than gender of whether

resurfacing would benefit a patient, with the best results seen in patients with

bigger femurs.

Experts say that hip resurfacing is more difficult to perform than a traditional

implant, in part because reshaping the top of the femur is an exacting process.

Some doctors express concern that American surgeons, eager to cash in on patient

demand, are performing hip resurfacings after only scant training in the

technique from the device makers.

The Rush study found that most complications occurred with surgeons trained by

& Nephew during the first procedures they performed. Dr. Della Valle said

he found that data reassuring because it indicated that physicians learned

quickly how to perform the procedure successfully.

When a resurfacing fails, it is then necessary to have a full hip replacement —

the very procedure that the resurfacing surgery is supposed to defer for a

decade or more. That is what happened with Kathy Bird, 53, a part-time academic

adviser who lives near Denver. "

If anyone would like to get in touch with Kathy, I would be happy to give you

her contact info, she will be the first to tell you her failure was due to the

learning curve and that her doctor made a mistake in her surgery, it had NOTHING

to do with her being a female.

Vicky

>

> >

> > Juju, so you have no studies or any support for your opinion that

> > resurfacing is dicey for post menopausal women.

> >

> > Your statement that this is univerally acknowledged is specious. I

> > really keep up with resurfacing studies and I've never heard about it.

> >

> > Without studies to back up your opinion, you have nothing.

> >

>

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