Re: Incision Size & DVT Issues

[Guest guest]

Jack,

Just a comment on the THR procedure. Led by a new technique at the

Rush-Presbyterian Medical Center in Chicago, surgeons make two 1 " incisions

and are able to work around most tendons and muscle. Patients are sent home

on crutches the day after the operation. These operations are also done in

Portland, Oregon and Montreal. I believe they just added New Jersey as well.

One more thing -- what is " Deep vein thrombosis or DVT " ?

Thanks

Al.

[Guest guest]

Interesting questons. I had a 12 " incision with my bilateral resurfs with Dr

DeSmet. NO muscle cutting and I'm having a fast recovery. Trudy had a small

incision with Dr Gross and I think she is recovering well but slower than me.

The JRI guys get their muscles cut (i.e. KBrewster) and I believe his recovery

was slower. Of course, precondition is a big factor. The dr said my hips were

pretty bad but I was in excellent shape with my muscle strength before hand.

It will be interesting to hear more feed back from this site.

Saeed

Madison, WI

[Guest guest]

Jack,

It does seem to make a difference. I have the foot long scar from

Dr De Smet. I walked a mile and a half in the rain to see my

surfmate from England off for home on day three after surgery.

Two days later toured Bruges, and on day 13 walked four hours

through the grounds a Versailles. Flew home on day 14, and

walked up two flights of stairs to take my first shower (no

crutches and no hand rail). While it is preferable to be in great

shape, I'm 63, 300# desk jockey, so no advantage there. Now

nearing six month, I walk whenever I get the opportunity, up to 10

miles at a time. I'm still waiting to take my first asprin or such

since surgery.

I've heard that DVT is so prevalent in thr because driving the

spike into the bone forces marrow out and into the blood

causing the clots. That does not happen in resurfacing, and it

would seem that with all the people flying to Europe and

returning without developing DVT that it must be rare.

Hope this helps,

Verne

> Hello. I'm hearing two different things as I read the postings on

> this site. Some surfers seem to have a smaller incision site

but

> with that comes muscle " cutting " . Others say that with a larger

> incision comes muscle " seperating " but no real cutting. Are

there

> radically different techniques for a re-surfacing depending on

who

> you have do it? Which technique offers the least invasiveness

and

> fastest recovery? What is the range of the incision size? I've

seen

> some say as long as 13 " ! What are the smaller/shorter

incisions

> coming in at?

> Also: A regular THR has the highest deep vein thrombosis

occurence

> of any surgical procedure. Some say as high as 92%! How is

the DVT

> rate with re-surfacing? Have any surfers experienced a DVT

issue

> post-op?

> Thanks much.

> ...Jack

[Guest guest]

> Interesting questons. I had a 12 " incision with my bilateral

resurfs with Dr DeSmet. NO muscle cutting and I'm having a fast

recovery. Trudy had a small incision with Dr Gross and I think she is

recovering well but slower than me. The JRI guys get their muscles

cut (i.e. KBrewster) and I believe his recovery was slower. Of

course, precondition is a big factor. The dr said my hips were pretty

bad but I was in excellent shape with my muscle strength before hand.

> It will be interesting to hear more feed back from this site.

> Saeed

> Madison, W

To clarify..

As Saeed says recovey has much to do with pre-condition. I was a

limping mess for about 5-7 years. I think most of you who bounce

back quickly from this get to surgery much quicker than I. The fact

that I went to the bitter end with osteoarthritis doesn't bother me

because I never would have heard of resurfacing. This is what I was

waiting for.

Trudy

[Guest guest]

Hi Verne,

I wanted to thank you again for your encouragement and validating the greatness

of DR DeSmet. As I have told people, I had high expectations and they were

exceeded. That is saying something!

Regards,

Saeed

[Guest guest]

> > Interesting questons. I had a 12 " incision with my bilateral

> resurfs with Dr DeSmet. NO muscle cutting and I'm having a fast

> recovery. Trudy had a small incision with Dr Gross and I think she

is

> recovering well but slower than me. The JRI guys get their muscles

> cut (i.e. KBrewster) and I believe his recovery was slower. Of

> course, precondition is a big factor. The dr said my hips were

pretty

> bad but I was in excellent shape with my muscle strength before

hand.

> > It will be interesting to hear more feed back from this site.

> > Saeed

> > Madison, W

>

> To clarify..

> As Saeed says recovey has much to do with pre-condition. I was a

> limping mess for about 5-7 years. I think most of you who bounce

> back quickly from this get to surgery much quicker than I. The

fact

> that I went to the bitter end with osteoarthritis doesn't bother me

> because I never would have heard of resurfacing. This is what I

was

> waiting for.

> Trudy

Trudy,

Hi and thanks for the response. Could you please elaborate on your

incision length. About how long was it? Saeed stated Dr. Gross has

a smaller incision with some muscle cutting involved. I would just

be interested in any info. on the details you could give. Thanks

much!

....Jack

[Guest guest]

> Jack,

> Just a comment on the THR procedure. Led by a new technique at the

> Rush-Presbyterian Medical Center in Chicago, surgeons make two 1 "

incisions

> and are able to work around most tendons and muscle. Patients are

sent home

> on crutches the day after the operation. These operations are also

done in

> Portland, Oregon and Montreal. I believe they just added New Jersey

as well.

> One more thing -- what is " Deep vein thrombosis or DVT " ?

> Thanks

> Al.

Hi Al,

Thanks for the posting. A DVT is a blood clot that can form in the

leg as a result of a standard THR procedure. They could possibly

break away from the leg if not treated immediately and properly.

If it lodges in the lungs or heart it can be a very serious, even

life threatening situation. Hope this helps.

....Jack

[Guest guest]

>

>> > Interesting questons. I had a 12 " incision with my bilateral

>> resurfs with Dr DeSmet. NO muscle cutting and I'm having a fast

>> recovery. Trudy had a small incision with Dr Gross and I think she

>is

>> recovering well but slower than me. The JRI guys get their muscles

>> cut (i.e. KBrewster) and I believe his recovery was slower. Of

>> course, precondition is a big factor. The dr said my hips were

>pretty

>> bad but I was in excellent shape with my muscle strength before

>hand.

>> > It will be interesting to hear more feed back from this site.

>> > Saeed

>> > Madison, W

>>

>> To clarify..

>> As Saeed says recovey has much to do with pre-condition. I was a

>> limping mess for about 5-7 years. I think most of you who bounce

>> back quickly from this get to surgery much quicker than I. The

>fact

>> that I went to the bitter end with osteoarthritis doesn't bother me

>> because I never would have heard of resurfacing. This is what I

>was

>> waiting for.

>> Trudy

>

>Trudy,

>Hi and thanks for the response. Could you please elaborate on your

>incision length. About how long was it? Saeed stated Dr. Gross has

>a smaller incision with some muscle cutting involved. I would just

>be interested in any info. on the details you could give. Thanks

>much!

I don't think the incision size matters. At one year post-op, mine has

faded to the point that people I show it to sometimes have trouble finding

it. The issues are whether any major muscles get cut (more crutch time)

and how well it closes post-op. I'd go with a longer scar and no major

muscles cut -- which is what McMinn did. I was 100% weight bearing 24 hours

post-op. Not a lick of trouble with any of it.

$.02

Jeff

>...Jack

>

>

>

>

[Guest guest]

Hi. I have a ten and a half inch incision but it curves to avoid cutting

muscles. I had a very quick recovery--no limp and have been treadmilling and

doing water exercises for five weeks (11 weeks post op now.) ann

J Gaynor/jqhome wrote:

>

>> > Interesting questons. I had a 12 " incision with my bilateral

>> resurfs with Dr DeSmet. NO muscle cutting and I'm having a fast

>> recovery. Trudy had a small incision with Dr Gross and I think she

>is

>> recovering well but slower than me. The JRI guys get their muscles

>> cut (i.e. KBrewster) and I believe his recovery was slower. Of

>> course, precondition is a big factor. The dr said my hips were

>pretty

>> bad but I was in excellent shape with my muscle strength before

>hand.

>> > It will be interesting to hear more feed back from this site.

>> > Saeed

>> > Madison, W

>>

>> To clarify..

>> As Saeed says recovey has much to do with pre-condition. I was a

>> limping mess for about 5-7 years. I think most of you who bounce

>> back quickly from this get to surgery much quicker than I. The

>fact

>> that I went to the bitter end with osteoarthritis doesn't bother me

>> because I never would have heard of resurfacing. This is what I

>was

>> waiting for.

>> Trudy

>

>Trudy,

>Hi and thanks for the response. Could you please elaborate on your

>incision length. About how long was it? Saeed stated Dr. Gross has

>a smaller incision with some muscle cutting involved. I would just

>be interested in any info. on the details you could give. Thanks

>much!

I don't think the incision size matters. At one year post-op, mine has

faded to the point that people I show it to sometimes have trouble finding

it. The issues are whether any major muscles get cut (more crutch time)

and how well it closes post-op. I'd go with a longer scar and no major

muscles cut -- which is what McMinn did. I was 100% weight bearing 24 hours

post-op. Not a lick of trouble with any of it.

$.02

Jeff

>...Jack

>

>

>

>

[Guest guest]

At 03:19 AM 8/7/2002 +0000, you wrote:

>I've heard that DVT is so prevalent in thr because driving the

>spike into the bone forces marrow out and into the blood

>causing the clots. That does not happen in resurfacing, and it

>would seem that with all the people flying to Europe and

>returning without developing DVT that it must be rare.

It's not even the spike in the bone. They invade the cancellous bone

(spongier bone inside the stronger cortical bone), and the pressure is

released which is when marrow comes out. That is the one part that turned

my stomach when watching a video of THR-and I happened to be eating dinner

while watching it! The marrow canal is not invaded during resurfacing, so

that pressure is not released and the contents are not able to get into the

bloodstream. That process is probably what causes 95% or more of

DVT's. The others are just the unlucky ones that happen to develop a clot

just because they had lower limb surgery. Definitely something to be aware

of because it is so dangerous, but much less likely to happen with resurfacing.