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[Guest guest]

At 07:22 PM 1/1/2003 +0000, you wrote:

>I still have a very fuzzy idea of what might be disqualifying

>conditions for resurfacing. I've seen mention of cysts, collapsing

>(ball and stem parts of femur) structures, soft bone, etc. as reasons,

>but how are these quantified and determined to be disqualifying?

MRI's and/or CAT scans are often used along with templates to determine if

there is enough bone to resurface. I imagine after some early failures,

the docs have a good idea just how much bone stock is required to support

the implant, and if you don't have it, you get THR. Osteoporotic bone can

also be seen on x-ray, but sometimes the real bone quality is not able to

be determined until they start drilling into it. Again, the experience of

the surgeon is probably the determining factor.

>I've seen a few comments that suggest overweight, though less than

>ideal, does not significantly interfere with resurfacing. Is that so?

Overweight always makes life a little more difficult, but does not make it

impossible. Things that the doc needs to get to are further away than they

would like, but again, not necessarily impossible. Sometimes I feel that

the prejudice of some docs against overweight patients influences their

willingness to even attempt a procedure...

>Is resurfacing better at responding to dysplasia difficulties than

>THR?

It certainly can be. Dysplasia not only affects the geometry of the ball

and socket and just how they are placed into the pelvis, but the internal

geometry of the bones as well. The interior of the femur is not perfectly

round, but instead is sort of ovoid. In my femurs for instance, the long

side of the ovoid faces the opposite direction of normal femurs, so a THR

stem made to fit the normal femur would have most likely fractured

mine. Because of the funny geometry of dysplastic hips, the dislocation

rate is about three times higher than for a regular total hip (9% vs. 3% is

coming to mind, but don't quote me), and revisions are necessary much more

frequently, as the wear patterns are different.

>Having let the hip problem continue too long, as I have, how often

>does a hippy find other problems that interfere with normal

>functioning, after even the most successful resurfacing?

Disappointment? NO WAY!! I still have muscle and nerve issues on the

left side, and am still learning to walk properly (erasing 39 years of

improper walking isn't happening overnight). I functioned pre-op, even

with the bad hips. Now I function much more normally, am pain-free, and

continuing to improve both physically and mentally. Life is wonderful!!

Conserve Plus

5/25/01 and 6/28/01