Re: so, info gained over the last few months...

[Guest guest]

you are not going to

wear out a stainless steel implant, but it can loosen.

Jeanne,

Your m/m Conserve Plus Implant is made of Cobalt Chrome NOT Stainless Steel ...

[Guest guest]

Richie,

From my own experience I can answer about returning to work at a desk job. I

started working from home about 8 days post-op for about 2 to 3 hours a day.

I returned to my office 13 days post-op for about 5-6 hours a day. I

returned to a full 8 hour a day about 17 post-op. I won't comment on how I

get to the office since your not suppose to drive until at least 3 weeks. I

hope this helps.

Duane

[Guest guest]

Richie,

Nice post, not at all boring...

At 12:06 PM 3/6/01, you wrote:

>Ok guys,

>Appologies if this is boring:

.....

>8. Where would one find info on strengthening / flexibility exercises on

>the net? without going to a physiotherapist.

Have you seen this site?: http://www.onbeinghip.com/

Although it's a commercial site - he's selling his book there so the

detailed exercise information is not included (and I have not seen his

book) - he claims to have been able to cope with his arthritic hip problem,

and delay surgery for about 10 years by using an aggressive exercise

program to counteract the muscle wasting that develops with the arthritis

and worsens the pain and disability. Makes sense perhaps as a stalling

tactic. Rather than order his book I started seeing a physiotherapist, and

feel that I have made some useful gains, although it's a lot of work, one

needs to be very motivated. 43 years old, and a very " reluctant " patient,

my plan at this point it to find a way to tough it out until resurfacing

surgery becomes available in Canada...or until I win the lottery!

>Is it better to get these muscles strong before surgery or leave them with

>atrophy and strengthen them after surgery?(doesn't make sense to strengthen

>them if they are cut)

>

I don't think it's a good idea to leave a muscle to atrophy if you can find

a way to preserve it instead - the atrophied state is surprisingly hard to

" undo. "

Cheers,

Debbie

[Guest guest]

Hi Richie:

The meeting is the American Academy of Orthopedic Surgeons being held

in San Francisco. Mr. McMinn is presenting an outcome study of 1000

patients over 10 years. The data will be helpful in making decisions.

I think the schedule is at www.aaos.org under " annual meeting " .

I have a friend who is a US Olympic coach who turned me on to Swiss

Ball Training. I can do it even when my hips hurt and it has added

increadible conditioning to my legs, hips, butt, and lower back. You

don't need much space to get a workout either. You can get info at

www.chekinstitute.com on both the ball and video learning.

I sent x-ray copies of my actual x-rays because on comparison with

scanned copies I found the quality was better. It only cost $30 and

can usually be done at any place x-rays are taken.

As far as I know, the metal ion issue is blood born not genetic.

Women share their blood supply with their baby during pregnancy, but I

have not heard of sperm being able to carry the metal. But hey, I'm

not a doctor either.

Hope that helps!

BTW - I trained with the Royal Marine Commandos in 1989 while I was

with 75th Ranger. Don't remember the group off hand, but had a great

time playing aggressor against them.

Thought they had the strongest officer & NCO corp I'd ever seen. Also

thought those bullpup guns sucked pond water though. Kept falling

apart in the field.

[Guest guest]

Hi Richie,

Here's my perspective on some of your questions. Keep in mind I am only 5

weeks post op. (Left hip resurfaced by Dr. Amstutuz on 1/30/01)

>1. So, the implants can be expected to last 15 years or more, possibly

>life. It seems that the limiting factor is not the implant but the actual

>cement / screws / bone wearing loose.

>

>AGREE?

I don't think anyone can quote an average lifetime for these implants,

because they haven't been around long enough. Rught, you are not going to

wear out a stainless steel implant, but it can loosen.

>

>2. Metal / poly implants cause osteorosis (forgive spelling). which could

>loosen the fitting faster.

>

>AGREE?>

Your body tries to attack the polyethylene debris and in the process tears

up some of your bone. The new cross-linked poly implants are supposed to

create less debris.

>

>5. On average (obviously everyone is different), the time before one can

>return to a desk job would be 6-8 weeks?

>

>AGREE?

I just went back to work this week, five weeks after, and feel I could have

gone back sooner, but after accruing sick leave for 20 years, I felt

entitled to stay home for a while! I moved a couch into my office before

surgery so I could lie down elevate my leg from time to time.

>7. (depending on the answer to #7)

>Is it better to get these muscles strong before surgery or leave them with

>atrophy and strengthen them after surgery?(doesn't make sense to strengthen

>them if they are cut)

>8. Where would one find info on strengthening / flexibility exercises on

>the net? without going to a physiotherapist.

I think the more fit you are overall, before surgery, the better your

recovery will be. Any leg strengthening you do before surgery will pay

off. You will be putting 50% of your weight on your operated leg the first

time you get up. And the more flexible you are before surgery, the better

off you will be afterward. Here are two flexibilty exercises that I did

for about 15 years, (I have been considering surgery for at least that

long!) right up until surgery:

1. Lie on your back and bend your leg till your thigh is perpendicular to

the floor. Grab your knee with your hands and try to make little circles.

2. As above, bend leg and try to move it to the left and right as far as

possible while keeping knee bent.

I learned these exercises from the Center for Self-Healing in San

Francisco, run by a PT name Meir Schneider. They have a web site

http://www.self-healing.org/

If you can tolerate it, you might try using small ankle weights. From a

seated position, you can strengthen you quadriceps by extending

(staightening) you leg. For hamstrings, get down on all fours and curl

your leg up with knee bent. Or from this position, you can do

" fire-hydrants " . Bend your knee and raise your leg out to the side. I

guess you could also do all of these without weights as well.

If you have access to a pool, there are a bunch of simple exercises you can

do. Hang on to the side and extend your leg out to the side, keeping it

straight. Or swing your leg back and forth from the hip, keeping it

straight. Or use a flotation belt and move your legs like you are pedaling

a bicycle.

I hope some of these work for you...

>

>9. any advise on how to scan xrays for emailing? because i have tried it

>and it does not work in a conventional way...lol

>

Hmm, good question. Maybe take your Xrays to a copy center and get a

photocopy made first.

>

>The main worry is the danger from being under anesthesia, but i see some

>people have it under epidural. How safe is an epidural?

This is what I had, and I am still here.

Good luck Richie,

Jeanne

>

>

>_________________________________________________________________________

>Get Your Private, Free E-mail from MSN Hotmail at http://www.hotmail.com.

>

>

>

[Guest guest]

> snip snip <

> 1. So, the implants can be expected to last 15 years or more,

possibly

> life. It seems that the limiting factor is not the implant but the

actual

> cement / screws / bone wearing loose.

>

> AGREE?

They no longer use screws or glue on socket. Loosening due to bone

decay or infection is the likely limiting factor

> 2. Metal / poly implants cause osteorosis (forgive spelling). which

could

> loosen the fitting faster.

>

> AGREE?

YES

>

> 3. With metal / metal there is no risk of osteorosis?

>

> AGREE?

Don't know for sure. Data appears to show no osteolysis with m/m.

> 4. The debris from the metal/ metal implant could cause possible

toxicology

> problems for women planing on having children and the risk to the

fetus is

> under debate, lack of long term results being the obvious problem.

>

> WHAT ARE YOUR OPINIONS OF METAL TOXICOLOGY IN MENS SPERM?

> AND THE RISK TO BABIES PRODUCED MY MEN AFTER RESURFACING?

If concerned, have your sperm frozen for later use. You could always

run before and after tests to confirm. If sperm contains excess

metal ions, perhaps accelerated production could be a treatment for

metal ion removal (lol)

> 4. For me, it would seem that metal on metal is a better

alternative for my

> situation, lower risk of Osteorosis than metal/poly, and

therefore a lower

> probability of the fitting wearing loose/ taking longer to work

loose

> (taking other factors in to consideration).

>

> AGREE?

YES

> 5. On average (obviously everyone is different), the time before

one can

> return to a desk job would be 6-8 weeks?

>

> AGREE?

Answered by others with experience.

> 6. When the surgery is taking place, are the thigh & pelvic muscles

> stretched out of the way or are they cut?

I believe some detatched, some retracted.

> 7. (depending on the answer to #7)

> Is it better to get these muscles strong before surgery or leave

them with

> atrophy and strengthen them after surgery?(doesn't make sense to

strengthen

> them if they are cut)

The stronger you are, the quicker the recovery.

> 8. Where would one find info on strengthening / flexibility

exercises on

> the net? without going to a physiotherapist.

Use common sense. I have found that I need to be very careful and

slow when exercising, otherwise the pain gets worse and I do less

exercise.

> 9. any advise on how to scan xrays for emailing? because i have

tried it

> and it does not work in a conventional way...lol

No advise

> The main worry is the danger from being under anesthesia, but i see

some

> people have it under epidural. How safe is an epidural?

This is a concern of mine as well. There are good recent posts in

this regard. I will use that info to query Dr. S at JRI next week.

OOh Rah

[Guest guest]

,

Thanks for your post. very helpful indeed. i was under the impression

though that they use cement or screws to secure the pelvic side of the

implant. if not, then what do they use?

You might be right about the accelerated production of sperm, i shall have

to start practising at the earliest oportunity in order to build up a faster

recouperation time...

cheers matey i will keep you informed.

richie

_________________________________________________________________________

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[Guest guest]

>

>(ps. i just called BHR in the UK, and a few surgeries, and it seems that all

>the docs and munufacturers are over in San Fransisco for a big resurfacing

>conference. does anybody have any info on that?)

I know my Dr. is there!

>3. With metal / metal there is no risk of osteorosis?

Osteolysis is the word you're looking for

>

>WHAT ARE YOUR OPINIONS OF METAL TOXICOLOGY IN MENS SPERM?

My guess is that the risk would be minimal. With a baby, we are talking

about 9 months of possible in utero exposure to the metal ions, with

possibility of metal ions crossing the placental barrier and getting into

the baby's bloodstream. Obviously sperm has a much smaller exposure time.

>AND THE RISK TO BABIES PRODUCED MY MEN AFTER RESURFACING?

I'm sure no one has a clue at this point. The R & D folks are working on

creating the best, longest lasting prosthesis for the patient. I'm pretty

sure next generation exposure is only remotely in the back recesses of

their minds.

>

>5. On average (obviously everyone is different), the time before one can

>return to a desk job would be 6-8 weeks?

I was told possibly within 2 weeks!

>

>6. When the surgery is taking place, are the thigh & pelvic muscles

>stretched out of the way or are they cut?

Yes :-)!

>Is it better to get these muscles strong before surgery or leave them with

>atrophy and strengthen them after surgery?

A strong muscle heals faster and " learns " its new job quicker, so

definitely strengthen as much as you can before surgery.

>

>8. Where would one find info on strengthening / flexibility exercises on

>the net? without going to a physiotherapist.

Get the " Heal Your Hips " book.

>

[Guest guest]

Richie

I will address the issue that you raised regarding pre-op exercise as it related

to muscle tone,

based on my personal experience.

I indicated in a post to the list in late January that I was scheduled to have a

Birminham Hip

Resurfacing here in Australia on Jan 30. I will provide some details of my

experience in another

post.

As it transpired I underwent surgery on Feb 13, 2001 at Sydney Adventist

Hospital, under the

skilled hand of Dr Sullivan who was trained by and uses the same procedure

and

prosthesis as McMinn, Treacy and others in the UK.

I am just 3 weeks post-op and I am truly quite amazed at the rapid progress I

have made. I

have not required any pain relief for several days now, have been driving (with

surgeon's

permission) for a week and I am quite comfortable using one crutch. Dr Sullivan

is quite happy

for me to discard the crutches altogether when I can walk without a limp and I

am getting closer to

that point every day.

I believe I owe this to the preparation I undertook prior to the operation. To

put this preparation

into context, I had been following a regular stretching and weight program at a

gym for some

years following spinal fusion surgery, to try to regain and maintain

flexibility. As my hip

problems increased during the latter half of 2000 my gym visits became very

irregular. When a

date for my surgery was set however I resolved to make every day count and

visited the gym

almost daily in the final four weeks. I worked on strengthening all muscle

groups in both legs and

upper body. I am convinced (as were the physiotherapists at the hospital) that

this conditioning

enabled me to commence doing exercises in the first week post-op that were not

usually

attempted until the second week.

Surprisingly I have not seen any mention on this list of the use of hydrotherapy

in accelerating

rehabilitation after hip resurfacing. Dr sullivan insists that all his patients

undertake hydrotherapy

while in hospital and encourages the continued use of same after leaving

hospital if it is available.

In addition to my " land " exercises at home, I have been spending an hour a day

in a

hydrotherapy pool since coming home from hospital. Once again I have been able

to progress

through the exercise levels at a faster rate than normal, due, I believe, to

pre-op conditioning.

Believe me, the day you have your surgery is just the beginning of a long hard

grind to full

recovery and the better prepared you are both physically and mentally the easier

it will be. By

the way, I'm no spring chicken - 59 in June.

Good luck,

[Guest guest]

-

I believe that the event that just completed in San Francisco is the AAOS

Anual Meeting of which resurfacing was just a small part.

Re: so, info gained over the last few months...

>

>(ps. i just called BHR in the UK, and a few surgeries, and it seems that

all

>the docs and munufacturers are over in San Fransisco for a big resurfacing

>conference. does anybody have any info on that?)

I know my Dr. is there!

>3. With metal / metal there is no risk of osteorosis?

Osteolysis is the word you're looking for

>

>WHAT ARE YOUR OPINIONS OF METAL TOXICOLOGY IN MENS SPERM?

My guess is that the risk would be minimal. With a baby, we are talking

about 9 months of possible in utero exposure to the metal ions, with

possibility of metal ions crossing the placental barrier and getting into

the baby's bloodstream. Obviously sperm has a much smaller exposure time.

>AND THE RISK TO BABIES PRODUCED MY MEN AFTER RESURFACING?

I'm sure no one has a clue at this point. The R & D folks are working on

creating the best, longest lasting prosthesis for the patient. I'm pretty

sure next generation exposure is only remotely in the back recesses of

their minds.

>

>5. On average (obviously everyone is different), the time before one can

>return to a desk job would be 6-8 weeks?

I was told possibly within 2 weeks!

>

>6. When the surgery is taking place, are the thigh & pelvic muscles

>stretched out of the way or are they cut?

Yes :-)!

>Is it better to get these muscles strong before surgery or leave them with

>atrophy and strengthen them after surgery?

A strong muscle heals faster and " learns " its new job quicker, so

definitely strengthen as much as you can before surgery.

>

>8. Where would one find info on strengthening / flexibility exercises on

>the net? without going to a physiotherapist.

Get the " Heal Your Hips " book.

>

[Guest guest]

At Sydney Adventist Hospital, Dr Sullivan's resurfacing patients commence

hydrotherapy on

day 3. The hydrotherapy pool, located within the hospital has a hydraulically

operated seat

which is used to lower the patients into and out of the water.

The water is warm, approx. 35 degrees C and therefore quite relaxing and pain

relieving. The

buoyancy of the water reduces the effect of gravity acting on the body and

exercises are a lot

less stressful. By moving towards the shallow end of the pool the effect of

gravity can be

increased as strength is gained. Additionally the resistance of the water can be

used to exercise

quite hard.

The initial exercise program however is quite gentle and consists walking

forwards, backwards

and sideways, holding the pool rail and working the involved leg with flexion

(lifting knee so that

the thigh is horizontal), abduction (moving leg out to the side) and extension

(moving leg

backwards) exercises. Finally with a flotation aid, gentle cycling.

For me, there has also been a psychological benefit. The abitiy to do the

exercises comfortably

in the water provides a sense of achievement and engenders a positive attitude

which I think is a

very important aspect in the healing and recovery process.

Good luck with your strengthening program and your resurfacing in April. If you

would like further

details please feel fee to e-mail me.

> ,

> Thanks for the motivating words. I am hoping to have

> hip resurfacing in April and have just started a strengthening

> program. I am 59 also and look forward to being back in shape

> again. Could you give some more details about hydrotherapy

> after the operation? When were you allowed to start this?

> Good luck with continued recuperation.

[Guest guest]

>>clip clip<< i was under the impression

> though that they use cement or screws to secure the pelvic side of

the

> implant. if not, then what do they use?

It is my understanding that the acetabular component is " hammered " in

after the socket is shaped with a reaming tool. The backside of the

devise has a porous coating to facilitate ingrowth of bone. Screws

are only used if you have a structural problem of the pelvis. I

think glues were found to inhibit bone ingrowth and is no longer used

in most cases.

Cheers

[Guest guest]

> 9. any advise on how to scan xrays for emailing? because i have

tried it

> and it does not work in a conventional way...lol

Any X-ray department is able to make copies of your films for you to

send to a physician for review. I suspect they may be able to do a

better job than most of us can do.

>

>

> The main worry is the danger from being under anesthesia, but i see

some

> people have it under epidural. How safe is an epidural?

>

Epidurals are very safe, and provide excellent pain control. They can

be continued after the surgery for a day or two, and will continue to

provide good pain control during that time. An epidural narcotic is

the only pain medicine that I used after surgery, I didn't have

significant pain after it was removed.

When an epidural is used for the primary agent for anesthesia during

surgery, the patient often receives a sedative during the case, so

that you'll rest. There is quite a bit of manipulation of the leg

with hip surgery, as well as the boring and hammering <G> that goes

along with it. I suspect most patients prefer not to be awake.

Jack son 6 weeks post op Rt C+ with Dr. A

[Guest guest]

>

> At Sydney Adventist Hospital, Dr Sullivan's resurfacing patients commence

hydrotherapy on

> day 3. The hydrotherapy pool, located within the hospital has a hydraulically

operated seat

> which is used to lower the patients into and out of the water.

This sounds great, and I, myself, benefitted by PT workouts in the pool

after week 6, but on day 3 aren't they concerned about getting the incision

infected?? Yikes, when I think about what the incision looked like

at day 3.

-

[Guest guest]

Hydrotherapy is excellent.

I had both hips done 7 days apart. Being a little unwell for 48 hours

post-second hip set me back. To catch up I was sent for hydrotherapy,

about 20 minutes sessions for 3 days only, walking into the pool on

crutches. Walking in water plus knee lift exercises in warm water and

being partially weight-unloaded transformed my progress.

Now at 15 months. Just finished playing squash!!

Roy.

In message , Brewster

writes

>>

>> At Sydney Adventist Hospital, Dr Sullivan's resurfacing patients commence

>hydrotherapy on

>> day 3. The hydrotherapy pool, located within the hospital has a hydraulically

>operated seat

>> which is used to lower the patients into and out of the water.

>

>This sounds great, and I, myself, benefitted by PT workouts in the pool

>after week 6, but on day 3 aren't they concerned about getting the incision

>infected?? Yikes, when I think about what the incision looked like

>at day 3.

>

>-

>

>

>

[Guest guest]

,

The incision is covered with a waterproof dressing called a Tegaderm Pad made by

3M in US -

it does not need to be changed after showering or exercising in the pool. Also

the pool water is

treated to reduce bacteria to extremely low levels. Having said that, should the

incision be

showing any " oozing " (through the absorbant pad under the waterproof transparent

outer skin of

the dressing) hydrotherapy is delayed.

> >

> > At Sydney Adventist Hospital, Dr Sullivan's resurfacing patients commence

hydrotherapy

on

> > day 3. The hydrotherapy pool, located within the hospital has a

hydraulically operated seat

> > which is used to lower the patients into and out of the water.

>

> This sounds great, and I, myself, benefitted by PT workouts in the pool

> after week 6, but on day 3 aren't they concerned about getting the incision

> infected?? Yikes, when I think about what the incision looked like

> at day 3.

>

> -