Guest guest Posted October 31, 2000 Report Share Posted October 31, 2000 I meant to say, " The one thing that bothers me just a bit is the fact that I have NOT read any testimonials from surface replacement recipients that speak to the procedure as having been a negative experience for them " . Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 1, 2000 Report Share Posted November 1, 2000 Mark, I had my left hip resurfaced on 01/26/00, and I am enjoying my new life. I have had absolutely no pain or discomfort since the surgery. Oops, I forgot about physical therapy, but even that was a positive experience: I was able to regain my original flexibility. I'm 41, and I feel like a teenager. I cannot thank Dr. Amstutz enough. Don H sivartkram@... wrote: > Hip resurfacing appears to be an excellent procedure! > > I am personally sold on the technique and hope to be able to toss the > phrase, " total hip replacement " completely out of my > vocabulary, except when I tell folks that I didn't have to go > the THP route when I had my hip repaired. > > The one thing that bothers me just a bit is the fact that I have found > read any testimonials from surface replacement recipients that speak > to the procedure as having been a negative experience for them. > > Given, there are a very limited number of resurfacing recipients when > compared to THR recipients, but I am still surprised that I have not > seen a few testimonials regarding the negative side of surface > replacement. > > Please understand that I am not complaining, only asking a lot of > questions as I move forward with what I feel is the RIGHT procedure > for me. > > Mark > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 3, 2000 Report Share Posted November 3, 2000 > > I meant to say, " The one thing that bothers me just a bit is the fact > that I have NOT read any testimonials from surface replacement > recipients that speak to the procedure as having been a negative > experience for them " . Mark, One reason I started this forum was to see if there are any people developing problems with their surface replacements (this was after I decided to have it done myself, but I also had not heard of any negative experiences and there were just a few in hundreds in documentation provided by Dr. Amstutz -- even those had special circumstances). Since putting my info out on the net, I still have not heard of any major problems. In email I have gotten a story of lingering pain from someone who had a hemi-resurfacing, that seems to be a more difficult thing to get to work perfectly. Knock on simulated woodgrain finish the success continues! Good luck to you, - Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 3, 2000 Report Share Posted November 3, 2000 >> There are most definitly cases of surface replacement in which the outcome was not what was expected or hoped for (i.e. negative) and those individuals have gone on to the have the traditional total hip replacement. << I had my resurfacing in May of 2000 by Dr. Amstutz at JRI. I was told at the time that out of 345+ resurfacing procedures that were performed with the latest Conserve Plus, there were only 3 failures ... One was because the patient became too active (and was warned not to over do it) before the prothesis had a chance to heal ... Another was really not a candidate for the operation from the beginning ... and the other was (if I can remember) the victim of an infection ... Was anyone else told of these results ... Did Dr. Schmalzried at JRI show any statistics to back this up ... who were these failures so far ... P.J. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 3, 2000 Report Share Posted November 3, 2000 To all those who are interested and those that have E-mailed me as opposed to posting on the list: I spoke to Dr. Schmalzried at the Joint Replacement Institute yesterday. The phone consultation was in regard to my application for participation in the metal on metal surface replacement clinical trial. During our conversation I asked Dr. Schmalzried about " negative " results with the surface replacement device and procedure. He was very clear in his response and asked me to pass along his comments to the E-group and any others I have contact with. Here is my paraphrase of what Dr. Schmalzried has to say about negative results in surface replacement: Paraphrase - There are most definitly cases of surface replacement in which the outcome was not what was expected or hoped for (i.e. negative) and those individuals have gone on to the have the traditional total hip replacement. The information that is out there on the web and included in the " marketing literature " that is sent to prospective surface replacement clinical trial participants is biased and not telling the entire story. Surface replacement is not a miracle cure, we have a long way to go and this is nothing more than another step in the struggle to develop a better and longer lasting prosthesis. This is a " clinical trial " and as such is designed for the purpose of gathering data. We don't know what m/m surface replacement is going to look long term and that is exactly why we are conducting the trial. By participating in the trial you are taking a risk. The risk is unknown and you could have poor results and then have to move on to a THR. That is the risk you take when you participate in a clinical trial. As to the procedural differences between JRI and the UK surface replacement that have been discussed on E groups and else where, Dr. Schmalzried had the following to say: he requires a 6 week period on crutches or less than 100% weight-bearing because of his philosophical approach to bone healing and not because you could not weight-bear on the surface replacement at 24 hours. He stated that his view (and that of his colleagues) is that the bone has been " injured " during the resurfacing. This " injury " is then allowed to heal in the same way that you would allow any broken bone to heal, either in a cast for six weeks or some other form of less than total weight bearing. He further stated that he felt it is critical to allow the bone/metal interface to heal properly before weight-bearing in order to give the prosthesis optimal conditions for long term success. In regard to the UK prosthesis, Dr. Schmalzried said that the UK is on their 4th generation of their resurfacing device and that they are no further ahead than we are when it comes to this procedure. He said that the current M/M acetabulum cup JRI is using has NO incidence of failure due to the beads coming off (something that was suggested by the rep in the UK because the JRI cup does not have beads that are poured as part of the original casting). End of paraphrase. Mark Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 3, 2000 Report Share Posted November 3, 2000 > Paraphrase - There are most definitly cases of surface replacement > in which the outcome was not what was expected or hoped for (i.e. > negative) and those individuals have gone on to the have the > traditional total hip replacement. The information that is out there > on the web and included in the " marketing literature " that is > sent to > prospective surface replacement clinical trial participants is biased > and not telling the entire story. Mark, Interesting, but I think it is unhelpful to say that " the information which is out there is biased " , without specifying what information (all of it??) and what is wrong with it. Are the published statistics lies, or presented misleadingly, or selected in some way? Without more specifics, it's just spreading fear, uncertainty and doubt. On the differences in recovery protocols, does he have any clinical evidence or is it opinion (not that there is anything wrong with opinion - just nice to know the basis). McMinn's patients (I am one of them) certainly go to full weightbearing early, so I guess his opinion is different. With over 1,000 resurfacings performed over about 9 years (5+ years with a consistent procedure) you would think he would start to notice problems. Dave Vale Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 3, 2000 Report Share Posted November 3, 2000 > > >> Paraphrase - There are most definitly cases of surface replacement >> in which the outcome was not what was expected or hoped for (i.e. >> negative) and those individuals have gone on to the have the >> traditional total hip replacement. The information that is out >there >> on the web and included in the " marketing literature " that is >> sent to >> prospective surface replacement clinical trial participants is >biased >> and not telling the entire story. > >Mark, > >Interesting, but I think it is unhelpful to say that " the information >which is out there is biased " , without specifying what information >(all of it??) and what is wrong with it. Are the published statistics >lies, or presented misleadingly, or selected in some way? > One other thought is that we don't know which procedure the good doctor is referring to. All resurfacings (even the earliest failed attempts?) Only those of the clinical trials? What percentage of these required revision. If the number is small (< 1%) then what were the circumstances. Failures at such small percentages cannot be used to deduce trends--usually. It would be good to know if the failures, e.g. only applied to people with advanced AVN ( I remember seeing in one piece of literature that one resurfacing had the femoral head collapse in this case. No, I don't have the source with me.) That would be different. I appreciate the information and this was the right question to ask. The doctor's response was certainly well-intentioned, but as Disraeli said, there are " lies, damned lies and statistics " (no my fellow Americans, it was *not* Mark Twain who said it first!). Reading a full report on the failures is about the only way to ferret this out. Even that might give you fits. References anyone? Finally, I think that the marketing literature would tend top be a bit less biased in the US, since we are quite litigation happy. A few misleading words in a brochure ushering in a nice big thumping disaster would easily put the company out of business. I would expect some fine print where they disavow any liability, claim it doesn't work anyway and distance themselves from their own product as far as they can without giving up the revenues. >Without more specifics, it's just spreading fear, uncertainty and >doubt. > Known as the " FUD-factor " . >On the differences in recovery protocols, does he have any clinical >evidence or is it opinion (not that there is anything wrong with >opinion - just nice to know the basis). McMinn's patients (I am one >of them) certainly go to full weightbearing early, so I guess his >opinion is different. With over 1,000 resurfacings performed over >about 9 years (5+ years with a consistent procedure) you would think >he would start to notice problems. > >Dave Vale > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 3, 2000 Report Share Posted November 3, 2000 Dear Hippies, Having said what I said and thoroughly stirred the hornets nest ... let me qualify my position by saying that I have decided to move forward with surface replacement via Dr. Schmalzried ... so, please don't confuse me with one who does not still think this is the right way to go. Yes, even with the gloom and doom I have infected this site with, I am going ahead with the procedure. And like many of you that have already been down this road, the next hurdle is with my insurance company. So, if you have a strategy that worked for you, please feel free to E-mail it to me! If for some reason my insurance does not come through I will seriously consider flying to England and having the procedure done there for $12,000 out of pocket (can you say second mortgage). In which case we can have a lively conversation upon my return, without crutches … HA HA HA! Have a Good Weekend! Mark Quote Link to comment Share on other sites More sharing options...
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