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Re: ConsPl revision

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If I have the

ConservePlus now at age 48, and if it lasts for 20 years or so, I worry that

a full revision at age 70 could be hard to withstand.

I am sure that 20 years from now the advancement in technology for a 'revision' of resurfacing (if needed) would be a piece of cake ... I have been resurfaced and have no worries what the future will bring ... Technology is moving along so fast that I am sure everything will be covered ... I know that this still will be a 'vague' answer to your questions about revisions, but I don't think many resurfaced 'hippies' have been 'revised' (which is a GOOD thing) ...

P.J.

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I will answer your hypothetical question but I do not think it is a

reasonable scenario. There is no reason to think at the end of 20 years a

revision to a thr will require only a bearing surface revision. All of the

numbers indicate you will need a new stem with a longer distal end for

fixation. There will be more bone removal involved with this.

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Dear Cate:

Truly a question such as yours should be left up to the professionals. I

speak only for myself and not for others you have addressed, but I firmly

would suggest you seek professional orthopedic advice as to your worry. I do

not know where you live but I would gladly give you references to the

surgeons that I saw in regard to making my decision. Once again I have

chosen the Implex ceramic-on-ceramic, surgery date for January 30, 2001.

Yes, I must say we all consider the revisions and that is why I've chosen the

ceramic device. I'm hoping for the 30 years plus from the odds I've been

quoted. Who knows what types of procedures they will have in 20 or 30 years

for revisions. You must feel comfortable with your choice and your surgeon.

I strongly suggest you, like us all to do your homework. It's great to ask

us hippies out there our opinions but I for one don't have a medical degree

and a strong leg to stand on, if you pardon the pun. Good luck and I hope

this is of some help.

Jana Escher

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Cate: Like everyone else, I have no unique knowledge of the subject.

However, it seems logical to believe that if it ever became necessary to

remove the acetabular component of your Conserve Plus implant, its removal

would be no easier nor more difficult than the removal of the acetabular

component in a THR device. The scenario you present of possibly not having

to remove but only to reline the THR device may not be a realistic one.

After 20-30 years or more, there's no certainty that the THR device would

not require replacement, to the same extent as the CP device. In any case,

given all the speculation and uncertainty, I don't think this consideration

should be the deciding factor in choosing one over the other. But, like the

others, I would suggest that you discuss this with Dr. Mont and other

professionals.

Hal

> ConsPl revision

>

> Dear , , , Jana, and anyone else out there who can

> comment,

>

> I've asked the following question of a number of people but am still

> looking

> for more info - what I've gotten is too vague to set my mind at ease. The

> question: If a ConservePlus has to be revised what are the implications

> for

> removing a well-embedded acetabular implant? I've been told that

> revisions

> to THR are very easy, but have never heard that from someone who had one

> or

> someone who did one! It all sounds too theoretical to me. If I have the

> ConservePlus now at age 48, and if it lasts for 20 years or so, I worry

> that

> a full revision at age 70 could be hard to withstand. In contrast, if I

> get

> a THR cup and stem that remain well-embedded I might only have to have the

> liner or ball replaced. Please forgive me all of you who have already

> read

> my scenario on the discussion board, but I just feel the need to dig at

> this. I will be grateful to hear responses as I am feeling the pressure

> to

> make a decision soon. Thanks all and Happy Holidays - it's great to know

> there is a community out there!

>

>

>

>

>

> _______________________________________________________

> Send a cool gift with your E-Card

> http://www.bluemountain.com/giftcenter/

>

>

>

>

>

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>

> Cate: Like everyone else, I have no unique knowledge of the subject.

> However, it seems logical to believe that if it ever became necessary to

> remove the acetabular component of your Conserve Plus implant, its removal

> would be no easier nor more difficult than the removal of the acetabular

> component in a THR device. The scenario you present of possibly not having

> to remove but only to reline the THR device may not be a realistic one.

> After 20-30 years or more, there's no certainty that the THR device would

> not require replacement, to the same extent as the CP device. In any case,

I have to echo this and 's comments as well. There are 3 possbile

points of failure (liner wear, loosening of femoral or acetabular part)

and I think its optimistic to count on only liner to be the point

of failure. Also, will parts (or even the manufacturer) be around in

20-30 years? At the time of revision will the liner that fits your

socket be the best available? Who knows? Ask someone who does revisions

about the percentage of revisions that require only the " relining " .

One advantage of the Conserve Plus is the bone from the femur will be

there to harvest and can be used for grafting, should that be needed.

That said I don't think " ease of revision " is the strongest advantage

of the CP. There are others.

> given all the speculation and uncertainty, I don't think this consideration

> should be the deciding factor in choosing one over the other. But, like the

> others, I would suggest that you discuss this with Dr. Mont and other

> professionals.

Agree on that as well. If you have asked and you are getting vague

answers its because there are a lot of uncertainties, its a difficult

choice for all due to that.

Happy Holidays and good luck in your decision.

-

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Dear Jana,

Thanks so much for your reply. I am definitely taking your advice. I have

been told by one OS I've been seeing that there is a new Howmedica Osteonics

implant that is cer/cer - called Trident. A year ago he was extremely wary

of ceramic (concerns re shattering), now he seems inclined. It's been very

hard to get internet info on this - although I keep trying. In addition,

I'd like to explore the Implex ceramic devise as well. Do you have an

internet address? Also, I live in Milwaukee. My thanks!

Cate

_______________________________________________________

Send a cool gift with your E-Card

http://www.bluemountain.com/giftcenter/

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, ,

Thanks very much for your feedback. I find your comments thoughtful,

balanced and very helpful - as always. I will definitely take up my

questions w/Dr. Livermore in Sheboygan in 5 days. One thing I notice

happening is that my ability to question more directly has grown over the

past year. The whole medical scene can be so overwhelming & intimidating -

I think I spent the first several months of getting OS opinions just

acclimating!

Cate

_______________________________________________________

Send a cool gift with your E-Card

http://www.bluemountain.com/giftcenter/

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> One advantage of the Conserve Plus is the bone from the femur will

>be there to harvest and can be used for grafting, should that be

>needed.

> -

Just curious, would that be a free vascularised graft, in which the

bone with blood vessels need to be kept alive? Are you speaking of

two concurrent operations at some point, where bone is harvested on

one side to graft into other hip? The harvest, it seems to me, would

only become available from ones own failed resurfacing, revising to a

full stem implant, right? I've heard of free vascularized fibular

grafts, but never of a revision to THR and a vascularised graft being

done during the same surgery...If so, who has done such an

operation?

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