Re: Questions about surgery

[Guest guest]

ne,

I am going to meet with Dr. Schmalzried in L.A. about either hemi-surface on both my hips or Conserve Plus metal-metal surface replacement. I have AVN in both hips. Only you can answer whether you want to take this route.

I will definitely have him preform which ever procedure he recommends. Yes, the long term results are unknown, but I look at it as a time buying procedure. I am 40 and I don't want to have my bone amputated with all of the medical research going on. I want to be able to take advantage of the newest technologies if and when it comes time for the next surgery. In addition, I want to be able to be as active as possible for the mental and health benefits.

If it makes you feel any better, my orthopedic surgeon knows Dr. Schmalzried. He holds him in the highest regard. He is a highly recognized surgeon and considered one of the best in his field. Ask him how many hemi-surface procedures he has performed-a very similar surgery. In addition, ask for a copy of the materials on hemi-surface that they send to doctors, so you can see how similar the procedures are. I hope this helps.

Lucinda

Questions about surgeryHi all, I just got back from LA and the Joint Replacement Institute - I met with Dr Schmalzried, who took me a little by surprise by emphasizing the unknown aspects of surface replacement as compared to THR, in terms of longevity and other potential problems that he didn't specify.I'm still feeling like I want to go that route, however, I was a little concerned when he told me that he has only performed one surface replacement surgery thus far. His colleague, Dr Armultz, has done 300 but has a long waiting list.So, I'm a little nervous considering the idea of the surgery with him having so little experience. I'm thinking of maybe going to the UK instead. Anyone have any thoughts or suggestions... I'm left feeling a little shaken and unsure now.Thanks,ne

[Guest guest]

ne,

I see you are considering coming to the UK and I know others in the US have looked into the possibility but it seems that the waiting list at Birmingham is quite long to see McMinn or Treacy. Can I suggest another UK alternative.

I had BHR on my left hip at the Nuffield Orthopaedic Hospital in Oxford performed by Gundle. I first saw him last December and had the operation on May 17th - at the time I was under the impression that he could have done it sooner had it been convenient for me. While he may not have performed as many operations as the Birmingham pair he has certainly done many more then Dr Amstutz - several hundred when he did me and I dare say plenty more since then. The entire procedure cost around 11,000 pounds (reduced somewhat because I was discharged from hospital in less than 4 days!)

Since then I have enjoyed pain free mobility and frankly were it not for the scar I would forget that I had had the operation at all.

I was driving a manual shift car (left hip remember) within 2 weeks and back on a golf course within a month!

To all those investigating the possibility of a UK based operation do check the options elsewhere than Birmingham.

Best of Luck to you

Steve Christie

Questions about surgeryHi all, I just got back from LA and the Joint Replacement Institute - I met with Dr Schmalzried, who took me a little by surprise by emphasizing the unknown aspects of surface replacement as compared to THR, in terms of longevity and other potential problems that he didn't specify.I'm still feeling like I want to go that route, however, I was a little concerned when he told me that he has only performed one surface replacement surgery thus far. His colleague, Dr Armultz, has done 300 but has a long waiting list.So, I'm a little nervous considering the idea of the surgery with him having so little experience. I'm thinking of maybe going to the UK instead. Anyone have any thoughts or suggestions... I'm left feeling a little shaken and unsure now.Thanks,ne

[Guest guest]

> Since then I have enjoyed pain free mobility and frankly were it not for the

> scar I would forget that I had had the operation at all.

> I was driving a manual shift car (left hip remember) within 2 weeks and back

> on a golf course within a month!

> To all those investigating the possibility of a UK based operation do check

> the options elsewhere than Birmingham.

> Best of Luck to you

> Steve Christie

Hey, are you the same Steve Christie who is the placekicker for

the Buffalo Bills (NFL -American Football)? Now THAT would be something!

http://sports.nfl.com/2000/playerhighlights?id=408

Seriously, thanks for the info, I've been meaning to update my page

with more links to more UK hospitals. Someone had sent me the Nuffield

link before. Anyway, real life keeps getting in the way...

-

[Guest guest]

ne,

On July 11, I had a hemiarthroplasty of the left hip, due to AVN. The acetabular cartilage was OK. After reading the articles on the JRI website, I wrote to Chuck at JRI with the following questions. He referred my inquiry to Dr. Beaule, whose reply follows my original e-mail to him. This might be something you want to factor into your decision, if you have a choice.

Don

Revision of Conserve hip deviceMr. , I have a question about the Conserve device as it relates to the possible need for a revision in the future. The JRI website article on precision fit hemiarthroplasty says " For those requiring reoperation, revision to either full surface or total hip replacement was easier than revision of stem-type conventional devises and much like a primary replacement..... " It appears that the Conserve device is identical to the femoral component of the Conserve Plus. In situations where the patient has a received the Conserve hip and the acetabular cartilage subsequently fails, would it be possible to add the acetabular component and retain the femoral device? Is that what is referred to by the " revision to full surface " in the article? The JRI article also says " Evidence implicates that with Ti alloy heads the acetabular cartilage is worn through which is evident by the burnished and roughened surface of the component seen at revision as compared to the smooth glistening surface of cobalt-chrome. " This seems to indicate that the Conserve hip is not expected to cause much wear of the acetabular cartilage. I imagine it is too early to determine the extent of the wear caused by the cobalt chrome hip. What do the doctors at JRI anticipate in this area?My thanks in advance for your help in getting answers to these questions.Don Cassell

Dr. Beaule replied:

" The difficulty in revising a Conserve to a Conserve Plus is that the femoral component finish for the former is not adequate for a metal on metal bearing and also in order to better fit the acetabulum in some cases the component size for the Conserve will be an odd number and all Conserve Plus are even number. Thus making impossible to keep the same femoral component. Dr Amstutz has revised some hemiresurfacing of earlier designs to a Conserve Plus thus it is feasible but the more you loose proximal femoral bone stock the more you compromise the fixation. So the decision to revise a Conserve to a Conserve Plus versus to a total hip would be based on patient age and quality of the remaining bone after removal on Conserve component.Regarding the wear of cobalt chrome on the cartilage, the material is probably not that critical compared to correct sizing and early intervention to preserve the acetabular cartilage.Sincerely Yours, E. Beaule, MD, FRCSCAssociate JRI

[Guest guest]

Steve,

Thanks for your reply. Do you have contact info for Dr Gundle?

ne

Reply-To: surfacehippyegroups

Date: Wed, 1 Nov 2000 17:08:57 -0000

To: " 'surfacehippyegroups' " <surfacehippyegroups>

Subject: RE: Questions about surgery

ne,

I see you are considering coming to the UK and I know others in the US have looked into the possibility but it seems that the waiting list at Birmingham is quite long to see McMinn or Treacy. Can I suggest another UK alternative.

I had BHR on my left hip at the Nuffield Orthopaedic Hospital in Oxford performed by Gundle. I first saw him last December and had the operation on May 17th - at the time I was under the impression that he could have done it sooner had it been convenient for me. While he may not have performed as many operations as the Birmingham pair he has certainly done many more then Dr Amstutz - several hundred when he did me and I dare say plenty more since then. The entire procedure cost around 11,000 pounds (reduced somewhat because I was discharged from hospital in less than 4 days!)

Since then I have enjoyed pain free mobility and frankly were it not for the scar I would forget that I had had the operation at all.

I was driving a manual shift car (left hip remember) within 2 weeks and back on a golf course within a month!

To all those investigating the possibility of a UK based operation do check the options elsewhere than Birmingham.

Best of Luck to you

Steve Christie

Questions about surgery

Hi all,

I just got back from LA and the Joint Replacement Institute - I met with Dr Schmalzried, who took me a little by surprise by emphasizing the unknown aspects of surface replacement as compared to THR, in terms of longevity and other potential problems that he didn't specify.

I'm still feeling like I want to go that route, however, I was a little concerned when he told me that he has only performed one surface replacement surgery thus far. His colleague, Dr Armultz, has done 300 but has a long waiting list.

So, I'm a little nervous considering the idea of the surgery with him having so little experience. I'm thinking of maybe going to the UK instead. Anyone have any thoughts or suggestions... I'm left feeling a little shaken and unsure now.

Thanks,

ne

[Guest guest]

Concerning hemi-arthroplasty and the need for revision. I recently read an article and sorry I did not keep it(i need thr/resurfacing) but what it said was that although the cartilage may look in good shape almost always(I believe it said "always") there are microscopic changes and that in time the cartilage will go regardless of implant and revision will be required. If I find the literature I will post it. Sorry,

[Guest guest]

ne,

Gundle can be found at:

Nuffield Orthopaedic Hospital

Windmill Road

Headington

Oxford

OX3 7LD

His secretary is Prior, her number is +44 1865 227717

Good Luck

Steve

p.s. Sorry to disappoint but I am not the Steve Christie who was part of the losing Bills side in 3 Superbowls in the early 90's.

Questions about surgeryHi all, I just got back from LA and the Joint Replacement Institute - I met with Dr Schmalzried, who took me a little by surprise by emphasizing the unknown aspects of surface replacement as compared to THR, in terms of longevity and other potential problems that he didn't specify.I'm still feeling like I want to go that route, however, I was a little concerned when he told me that he has only performed one surface replacement surgery thus far. His colleague, Dr Armultz, has done 300 but has a long waiting list.So, I'm a little nervous considering the idea of the surgery with him having so little experience. I'm thinking of maybe going to the UK instead. Anyone have any thoughts or suggestions... I'm left feeling a little shaken and unsure now.Thanks,ne