Re: Re: Current sucess rate for resufacing

[Guest guest]

Saeed,

You said, " Not once has beth, for example, mentioned that Surface Hippy

is a good resource. " I do read Totally Hip and must correct this statement.

Last year when I had decided to schedule my THR, I posted my situation on

Totally Hip. Some of the most beneficial information that I received was

from beth. She encouraged me to explore the possibility of resurfacing

and steered me toward Surface Hippy. Because of her encouragement, I

cancelled one week before my surgery and have sent my x-rays to Dr. Mont.

I am now in the situation that many of us are. I AM a candidate for

resurfacing, but have an insurance company which is unwilling to pay for the

surgery. Unlike you, I am not fortunate enough to be in a position to pay

for this surgery out of pocket. In fact I almost wish I was NOT a candidate,

then I could happily schedule a THR and be pain-free in the near future. As

it is, I now feel that I should fight for insurance coverage.

You also state, referring to Dr. DeSmet, that " With only one failure (his #3

with an elderly patient) in over 500 surgeries, you would be hard pressed to

find a better surgeon in the whole wide world. " Unfortunately, the European

doctors who have pioneered this procedure seem to be either unwilling or

unable to document their success and follow-up of their patients. Should

they do so, perhaps this data could be used to urge the FDA to move things

along much quicker and potential surfers like me would be able to have this

surgery. As things stand, I may find myself with little choice but to go

with the THR as I seriously doubt that I would still be a candidate for the

procedure by the time the FDA gets around to approving it. That's if I could

wait that long.

I can honestly say that I have never read anything on Totally Hip that I felt

discouraged me from exploring the possible benefits of resurfacing, although

I have read a number of posts that seemed to belittle the benefits of THR.

Blanket negative comments about the limitations of THR that are later

contradicted by those with THR's only cause others to question the

credibility of the person making those negative comments.

Please remember that resurfacing is not for everyone. There are insurance

problems, monetary difficulties, lack of access to a resurf doctor, as well

as physical problems that make a person ineligible. The goal of all of us is

to end the pain and if resurfacing is impossible, then THR is a godsend.

Once I am out of pain and my current limitations are gone, I am sure that I

will sing the praises of whatever procedure and device has removed that pain.

[Guest guest]

Saeed,

You said, " Not once has beth, for example, mentioned that Surface Hippy

is a good resource. " I do read Totally Hip and must correct this statement.

Last year when I had decided to schedule my THR, I posted my situation on

Totally Hip. Some of the most beneficial information that I received was

from beth. She encouraged me to explore the possibility of resurfacing

and steered me toward Surface Hippy. Because of her encouragement, I

cancelled one week before my surgery and have sent my x-rays to Dr. Mont.

I am now in the situation that many of us are. I AM a candidate for

resurfacing, but have an insurance company which is unwilling to pay for the

surgery. Unlike you, I am not fortunate enough to be in a position to pay

for this surgery out of pocket. In fact I almost wish I was NOT a candidate,

then I could happily schedule a THR and be pain-free in the near future. As

it is, I now feel that I should fight for insurance coverage.

You also state, referring to Dr. DeSmet, that " With only one failure (his #3

with an elderly patient) in over 500 surgeries, you would be hard pressed to

find a better surgeon in the whole wide world. " Unfortunately, the European

doctors who have pioneered this procedure seem to be either unwilling or

unable to document their success and follow-up of their patients. Should

they do so, perhaps this data could be used to urge the FDA to move things

along much quicker and potential surfers like me would be able to have this

surgery. As things stand, I may find myself with little choice but to go

with the THR as I seriously doubt that I would still be a candidate for the

procedure by the time the FDA gets around to approving it. That's if I could

wait that long.

I can honestly say that I have never read anything on Totally Hip that I felt

discouraged me from exploring the possible benefits of resurfacing, although

I have read a number of posts that seemed to belittle the benefits of THR.

Blanket negative comments about the limitations of THR that are later

contradicted by those with THR's only cause others to question the

credibility of the person making those negative comments.

Please remember that resurfacing is not for everyone. There are insurance

problems, monetary difficulties, lack of access to a resurf doctor, as well

as physical problems that make a person ineligible. The goal of all of us is

to end the pain and if resurfacing is impossible, then THR is a godsend.

Once I am out of pain and my current limitations are gone, I am sure that I

will sing the praises of whatever procedure and device has removed that pain.

[Guest guest]

See 's post of today. This study has been around and unfortunately we still

have people who refuse to acknowledge it.

I spoke with DeSmet and he said that he has never received an invitation to

speak at US Conferences. Why is this?

Saeed

[Guest guest]

See 's post of today. This study has been around and unfortunately we still

have people who refuse to acknowledge it.

I spoke with DeSmet and he said that he has never received an invitation to

speak at US Conferences. Why is this?

Saeed

[Guest guest]

Hope you have read the statistical info I have mailed - including the American

Academy of Orthopaedic Surgeons conference speech by the UK's McMinn.

Please don't blame our Surgeons - the published follow ups are ongoing (of which

I'm a part). The data is there for the FDA to use but as the old saying goes

" you can lead a horse to water but you can't make it drink " . I realise your

frustrations but please lay the blame at the door of those that are to blame.

Incidentally our closest equivalent to the FDA - the NHS have published their

approval to resurfacing as an option for the more active and younger patient (I

personally oppose the age issue).

Re: Re: Current sucess rate for resufacing

Saeed,

You also state, referring to Dr. DeSmet, that " With only one failure (his #3

with an elderly patient) in over 500 surgeries, you would be hard pressed to

find a better surgeon in the whole wide world. " Unfortunately, the European

doctors who have pioneered this procedure seem to be either unwilling or

unable to document their success and follow-up of their patients. Should

they do so, perhaps this data could be used to urge the FDA to move things

along much quicker and potential surfers like me would be able to have this

surgery. As things stand, I may find myself with little choice but to go

with the THR as I seriously doubt that I would still be a candidate for the

procedure by the time the FDA gets around to approving it. That's if I could

wait that long.

[Guest guest]

I agree with you that my choice of phrase was a little tactless. When you

write something down it sometimes appears OK but a couple of hours later you

realise it could have been presented better. I don't think however that the

differences in the device types are that great - If they were then it would seem

pointless that the American Academy of Orthopaedic Surgeons would invite

McMinn to make a presentation and issue a paper making reference to it - the

data given must have been important to such a learned Academy - so why not the

FDA?

I'm just making a point and treading carefully because it's not my intention to

upset anyone. I realise that your fellow countrymen are patiently waiting for

the FDA approval but if these statistics are relevent then it must aid the

situation and not hinder it.

Re: Current sucess rate for resufacing

At 11:56 AM 10/16/2002 +0100, you wrote:

>The data is there for the FDA to use but as the old saying goes " you can

>lead a horse to water but you can't make it drink " .

The data is there for the BHR, but that is not the device that is currently

under FDA investigation, so the data serves them no real

purpose. Remember that resurfacing as a procedure is FDA approved. If

your surgeon has it available, you can get a lovely metal/poly resurf that

has been available for years (no thanks!). It is the new generation of m/m

devices that are under investigation, and and Corin are both in

separate trials because the devices are considered substantially different

(probably mostly in the coating on the acetabular component).

[Guest guest]

I have read your mail again and I don't think you have understood me. It could

be down to me and the fact that I've made references to several data sources but

in the UK there is " NICE " approval for BHR, Corin, & Sulzer. Therefore

the precedence has been set. NICE are not restricting themselves to BHR as the

approval document refers to all 4 manufacturers.

Re: Current sucess rate for resufacing

At 11:56 AM 10/16/2002 +0100, you wrote:

>The data is there for the FDA to use but as the old saying goes " you can

>lead a horse to water but you can't make it drink " .

The data is there for the BHR, but that is not the device that is currently

under FDA investigation, so the data serves them no real

purpose. Remember that resurfacing as a procedure is FDA approved. If

your surgeon has it available, you can get a lovely metal/poly resurf that

has been available for years (no thanks!). It is the new generation of m/m

devices that are under investigation, and and Corin are both in

separate trials because the devices are considered substantially different

(probably mostly in the coating on the acetabular component).

[Guest guest]

I have read your mail again and I don't think you have understood me. It could

be down to me and the fact that I've made references to several data sources but

in the UK there is " NICE " approval for BHR, Corin, & Sulzer. Therefore

the precedence has been set. NICE are not restricting themselves to BHR as the

approval document refers to all 4 manufacturers.

Re: Current sucess rate for resufacing

At 11:56 AM 10/16/2002 +0100, you wrote:

>The data is there for the FDA to use but as the old saying goes " you can

>lead a horse to water but you can't make it drink " .

The data is there for the BHR, but that is not the device that is currently

under FDA investigation, so the data serves them no real

purpose. Remember that resurfacing as a procedure is FDA approved. If

your surgeon has it available, you can get a lovely metal/poly resurf that

has been available for years (no thanks!). It is the new generation of m/m

devices that are under investigation, and and Corin are both in

separate trials because the devices are considered substantially different

(probably mostly in the coating on the acetabular component).

[Guest guest]

I have read your mail again and I don't think you have understood me. It could

be down to me and the fact that I've made references to several data sources but

in the UK there is " NICE " approval for BHR, Corin, & Sulzer. Therefore

the precedence has been set. NICE are not restricting themselves to BHR as the

approval document refers to all 4 manufacturers.

Re: Current sucess rate for resufacing

At 11:56 AM 10/16/2002 +0100, you wrote:

>The data is there for the FDA to use but as the old saying goes " you can

>lead a horse to water but you can't make it drink " .

The data is there for the BHR, but that is not the device that is currently

under FDA investigation, so the data serves them no real

purpose. Remember that resurfacing as a procedure is FDA approved. If

your surgeon has it available, you can get a lovely metal/poly resurf that

has been available for years (no thanks!). It is the new generation of m/m

devices that are under investigation, and and Corin are both in

separate trials because the devices are considered substantially different

(probably mostly in the coating on the acetabular component).

[Guest guest]

Hi ,

Ah ......... I have a BHR I thought i.e. it is called a Birmingham Hip

Replacement .........and it is metal on metal....... I handled it at the

Doctors office............and the xray shows it to be metal....... so what

am I missing here?

Edith

> At 11:56 AM 10/16/2002 +0100, you wrote:

> >The data is there for the FDA to use but as the old saying goes " you can

> >lead a horse to water but you can't make it drink " .

>

> The data is there for the BHR, but that is not the device that is

currently

> under FDA investigation, so the data serves them no real

> purpose. Remember that resurfacing as a procedure is FDA approved. If

> your surgeon has it available, you can get a lovely metal/poly resurf that

> has been available for years (no thanks!). It is the new generation of

m/m

> devices that are under investigation, and and Corin are both in

> separate trials because the devices are considered substantially different

> (probably mostly in the coating on the acetabular component).

>

>

>

>

>

>

>

>

[Guest guest]

Hi ,

Ah ......... I have a BHR I thought i.e. it is called a Birmingham Hip

Replacement .........and it is metal on metal....... I handled it at the

Doctors office............and the xray shows it to be metal....... so what

am I missing here?

Edith

> At 11:56 AM 10/16/2002 +0100, you wrote:

> >The data is there for the FDA to use but as the old saying goes " you can

> >lead a horse to water but you can't make it drink " .

>

> The data is there for the BHR, but that is not the device that is

currently

> under FDA investigation, so the data serves them no real

> purpose. Remember that resurfacing as a procedure is FDA approved. If

> your surgeon has it available, you can get a lovely metal/poly resurf that

> has been available for years (no thanks!). It is the new generation of

m/m

> devices that are under investigation, and and Corin are both in

> separate trials because the devices are considered substantially different

> (probably mostly in the coating on the acetabular component).

>

>

>

>

>

>

>

>

[Guest guest]

Hi ,

Ah ......... I have a BHR I thought i.e. it is called a Birmingham Hip

Replacement .........and it is metal on metal....... I handled it at the

Doctors office............and the xray shows it to be metal....... so what

am I missing here?

Edith

> At 11:56 AM 10/16/2002 +0100, you wrote:

> >The data is there for the FDA to use but as the old saying goes " you can

> >lead a horse to water but you can't make it drink " .

>

> The data is there for the BHR, but that is not the device that is

currently

> under FDA investigation, so the data serves them no real

> purpose. Remember that resurfacing as a procedure is FDA approved. If

> your surgeon has it available, you can get a lovely metal/poly resurf that

> has been available for years (no thanks!). It is the new generation of

m/m

> devices that are under investigation, and and Corin are both in

> separate trials because the devices are considered substantially different

> (probably mostly in the coating on the acetabular component).

>

>

>

>

>

>

>

>

[Guest guest]

Thank you for the information. Some of this I have seen before, but the full

report of the NICE report is new. Have looked through some of it, but will

have to go through it a bit at a time.

I guess the FDA is being overly cautious after the Sulzer problems - too many

people left in too much pain after being fitted with an approved device. In

my opinion the approval process for any device should include data from

anywhere and everywhere it can be obtained, but the FDA has not asked for my

advice.

[Guest guest]

Thank you for the information. Some of this I have seen before, but the full

report of the NICE report is new. Have looked through some of it, but will

have to go through it a bit at a time.

I guess the FDA is being overly cautious after the Sulzer problems - too many

people left in too much pain after being fitted with an approved device. In

my opinion the approval process for any device should include data from

anywhere and everywhere it can be obtained, but the FDA has not asked for my

advice.