Guest guest Posted October 2, 2003 Report Share Posted October 2, 2003 , There are two resurfacing devices currently in " clinical trials " here in the United States. A US company, Medical Technologies, markets the Conserve Plus (C+)and a British company, Corin Group, markets the C-2000 (C2K). Both trials are at or near completion and both companies are pursuing FDA approval in the near future. Many insurance policies will try to deny coverage for " investigational procedures " . If you can wait 6-12 months it is likely that the C+ device will receive FDA approval next year and that will simplify the insurance issue tremendously. I don't know what the time frame for the C2K device is looking like at this time. There are disadvantages to waiting too long however. I'm 53 and active in sailing, windsurfing, biking, scuba, swimming, and other sports. For three years I controlled the pain with NSAIDs and thought I was doing well. I have x-rays from three years ago, three months pre-op, and just pre-op. In the three months prior to my surgery, more damage and deterioration occurred then in the prior three years. The meds kept me going, but masked the fact that bad things were happening. I was still able to have resurfacing instead of THR, but not by much. For active patients I think that resurfacing has some worthwhile advantages over THR. At the very least, I would encourage you to keep your options open while you research the alternatives. I guess, my advice would be to try to last until insurance coverage is more certain (unless you can afford 30-50K on your own). But I would also keep a close eye on what's going on in your hip. The week I went off meds prior to surgery was a real eye opener. The pain was so much worse. I had no idea that my situation unmasked by drugs was so bad. Good luck with your decisions. Mike Trautman C2K, Kennedy, 02Sep03 ________________________________________________________________ The best thing to hit the internet in years - Juno SpeedBand! Surf the web up to FIVE TIMES FASTER! Only $14.95/ month - visit www.juno.com to sign up today! Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 2, 2003 Report Share Posted October 2, 2003 > > Two questions > > First -- is there only one company that makes a hip resurfacing device or more than one? Does anyone have web addresses that provide information about the device(s)? If there are more than one, is there any consensus about one being better than the other? Answer # 1: There has been little discussion on any of the devices being better than others. In my opinion, all the devices are relativly similar, from what I understand, and there hasn't been a long enough track record on any of them to tell us differently. However, a great majority of those of us with resurfs love them, regardless of who they're made by. As Ruth said before, there is a wealth of info on Activejoints.com, and as said, Peggathy's new book sounds incredibly informative. By the way, the Conserve Plus is made by . > > Second -- at what point did other people decide to go ahead and have the surgery? I have seen other folks who have waited for a very long time for surgery -- until they really are almost incapacitated. Is that the better choice? I would have to answer this with a resounding NO! First of all, in the process of waiting to become incapacitated, you give up more and more of your life. For someone your age, that's a sin. An unnecessary one. You give up sleep, you give up activity, you give up all kinds of things. You end up watching life go by instead of participating in it. I know, because I did it. You'll never be this young again. Secondly, if you decide to do it, the sooner you get this done, the better - for a variety of reasons. First of all, the bones grinding together, besides causing pain, are damaging each other. The longer you wait, the more damage done. In a THR, it doesn't matter - they're going to chop it all off anyway. With a resurf, they need enough good bone stock to work with. The better the bone, the better the chance of it taking well and lasting you possibly forever. Wait too long and they can't do it at all. Also, walking with a limp over time can create other problems that make recuperating harder. Other joints such as knees and spine can be affected, being forced into unnatural positions in the process of compensating for the hip pain. Your body gets into bad habits that are hard to break. Lastly, the longer you wait, the less activity you will participate in as time goes on, and your physical condition will deteriorate. Being in good physical condition makes recovery go so much faster. Your youth definitely helps in this department also. I researched for 7 months, decided in June, had surgery in early August and have been back in full swing for some time now. There have been many like me who recover so fast it's almost scary. My true downtime was 3 weeks. After that I was driving, out and about and was up (walking) more often than down(resting). At that point, I ditched the cane,(with my doctor's OK) unless I walked for a long time. Yes, there was still some pain, but it was sporadic, not longlasting and was absolutely nothing compared to the relentless pain I was in before surgery. Had I known how easy it was going to be for me, I would've done it LONG ago. Now I know, when the other hip goes, to just DO IT (in the immortal words of Nike) I'm 8 wks post op, and have virtually no pain, and in fact, very few thoughts even of the fact that I recently had surgery. Not all folks recover this quickly, tho. I attribute it to my doctor's technique and my physical strength before surgery, but I have absolutely no proof. It might be just dumb luck. Others need walking aids for longer, have various other complications, have different pain thresholds. Everyone of us is different. But it seems to me that just about all of us are thrilled with our new lives. So far, it has certainly been the answer to my prayers. Pardon the length of this novel- I get so excited about this that I get carried away. Good luck in your research and making your decision. Lois (the second) Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 3, 2003 Report Share Posted October 3, 2003 >--- Slowly progressing to the point where now, I am still active, but I limp reasonably regularly, have occasional pain at night, and have a tough time putting my left sock on and tying that shoe. If you have trouble with your shoe and sock, your hip is starting to " lock up " , and once that happens, it will probably never " unlock " , and cartilage will deteriorate rapidly. That's what happened in my case and a couple of others that I know about. If you can't bend your left knee to your chest as far as your right one, you have already lost some range of motion, and will start putting stress on other joints, using your body in an impaired way, etc. If you can afford it, or your insurance allows, I recommend getting on a waiting list to have it resurfaced as soon as possible, before your bone stock loses density from not putting your full weight on that leg (i.e., limping). Also I've been warned that anti-inflammatories not only mask pain and allow you to do things that your body should be warning you not to, but they also are destructive to cartilage. So if you keep on taking them, you will damage more cartilage (and perhaps eventually your stomach and esophagus). Definitely don't wait until your activities are greatly restricted and the pain is unbearable. Life is too short! Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 3, 2003 Report Share Posted October 3, 2003 Hi, Just my experience on " wating as long as you can " . I followed this advice. I waited 9 years! With excercise, condroition, chiropractic, etc (rarely used pain meds) I skiied, rode horses competively, did yoga....most everything I wanted. As I was managing so well I went to see Dr Klapper ( " Heal your Hips " author) to see if I was a canidate for joint " cleanout " . To my horror, I was more than bone-on-bone, I had developed a cyst 1/3 the size of the head of my femor. My thoughts are that this large hole acted as a hydrolic cushion each time I put weight on it so my pain was lessened. AND each step made the hole larger! I then fought with my insurance co. for a year! I am now scheduled with DeSmet in Belgium. I do not know if he will be able to give me a resurface. He at first turned me down, then decided that it was a good mathematical risk to take. I am very sorry I waited. So pain was not an indication of my bones condition. I now know I should have monitored it more closely. Carol in CA DeSmet BHR 10-22-03 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 3, 2003 Report Share Posted October 3, 2003 ---Iv'e read and recommend " Heal your Hips " to anyone with hip pain / problems . Just curious , what was Dr. Klapper opinion of resurfacing ?? Goldberg C+ 1/28/03 In surfacehippy , Carol Latta wrote: > Hi, > > Just my experience on " wating as long as you can " . I followed this advice. > I waited 9 years! With excercise, condroition, chiropractic, etc (rarely > used pain meds) I skiied, rode horses competively, did yoga....most > everything I wanted. > > As I was managing so well I went to see Dr Klapper ( " Heal your Hips " author) > to see if I was a canidate for joint " cleanout " . To my horror, I was more > than bone-on-bone, I had developed a cyst 1/3 the size of the head of my > femor. My thoughts are that this large hole acted as a hydrolic cushion each > time I put weight on it so my pain was lessened. AND each step made the > hole larger! > > I then fought with my insurance co. for a year! I am now scheduled with > DeSmet in Belgium. I do not know if he will be able to give me a resurface. > He at first turned me down, then decided that it was a good mathematical > risk to take. I am very sorry I waited. > > So pain was not an indication of my bones condition. I now know I should > have monitored it more closely. > > Carol in CA > DeSmet BHR 10-22-03 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 3, 2003 Report Share Posted October 3, 2003 ..>> The thing I liked about the Birmingham was the design of the acetabular cup (the cup that is inserted into the hip) because it has small 'nodes' all over it, and new bone tends to grow better onto those, making it more stable << Sharry, I can't speak for the Conserve plus, but the Cormet 2000 has what sounds like the same surface. It's very rough and porous and made of a substance that is supposed to encourage bone growth into it. It's uncemented and because the bone does grow into it, it creates great stability. Are there other major differences, perhaps? Lois the second Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 3, 2003 Report Share Posted October 3, 2003 hello- from what i understand, they are all very similar surfaces and none of them use cement. there were a few differences i came across in perusing the web: one is that the BHR offers a variation of the acetabular cup for people with dysplasia (shallow or deformed hip sockets), it has an added screw fixation feature for hips that may be too risky for the doctor to use the regular one. the other two companies don't yet have that option in there arsenal of components to select from during surgery if needed. the other reason i saw was marketed as the fabrication method used to create the rough surface. i think it is the BHR that uses the actual casting of the device to achieve the rough surface (pouro-cast?) while the cormet2000 used some kind of plasma coating process after the casting of the device. the rumor is that this second method may have some theoretical potential to delaminate. i may have the details of this wrong, so someone please correct me if necessary. there is a really good message board on the corin website that addresses this specific issue www.resurfacingofthehip.com ya know, it seemed to me that this was not a real significant reason to choose one over the other. i think the issue was generated by a tough marketing war between midland med technologies and corin medical. corin originally developed the bhr and then there was a spin-off company that became midland who now produces the BHR. this was brought up on this board a while back as some heresay. i tend to think they are all great choices when compared to the thr alternatives, at least until the next greatest thing comes along like zirconium coated metal components or genetically engineered resurfacing components grown from your own actual bone stock and cartiledge. i just can't wait that long. " resurfacing of the hippo " good luck, jeff Re: devices and timing .>> The thing I liked about the Birmingham was the design of the acetabular cup (the cup that is inserted into the hip) because it has small 'nodes' all over it, and new bone tends to grow better onto those, making it more stable << Sharry, I can't speak for the Conserve plus, but the Cormet 2000 has what sounds like the same surface. It's very rough and porous and made of a substance that is supposed to encourage bone growth into it. It's uncemented and because the bone does grow into it, it creates great stability. Are there other major differences, perhaps? Lois the second Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 3, 2003 Report Share Posted October 3, 2003 sorry- i included a funny picture in my last post. it was of hippos surfacing from the water in a river, but i guess it got censored at hippy control central. jeff Re: devices and timing .>> The thing I liked about the Birmingham was the design of the acetabular cup (the cup that is inserted into the hip) because it has small 'nodes' all over it, and new bone tends to grow better onto those, making it more stable << Sharry, I can't speak for the Conserve plus, but the Cormet 2000 has what sounds like the same surface. It's very rough and porous and made of a substance that is supposed to encourage bone growth into it. It's uncemented and because the bone does grow into it, it creates great stability. Are there other major differences, perhaps? Lois the second Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 3, 2003 Report Share Posted October 3, 2003 sorry- i included a funny picture in my last post. it was of hippos surfacing from the water in a river, but i guess it got censored at hippy control central. jeff Re: devices and timing .>> The thing I liked about the Birmingham was the design of the acetabular cup (the cup that is inserted into the hip) because it has small 'nodes' all over it, and new bone tends to grow better onto those, making it more stable << Sharry, I can't speak for the Conserve plus, but the Cormet 2000 has what sounds like the same surface. It's very rough and porous and made of a substance that is supposed to encourage bone growth into it. It's uncemented and because the bone does grow into it, it creates great stability. Are there other major differences, perhaps? Lois the second Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 3, 2003 Report Share Posted October 3, 2003 sorry- i included a funny picture in my last post. it was of hippos surfacing from the water in a river, but i guess it got censored at hippy control central. jeff Re: devices and timing .>> The thing I liked about the Birmingham was the design of the acetabular cup (the cup that is inserted into the hip) because it has small 'nodes' all over it, and new bone tends to grow better onto those, making it more stable << Sharry, I can't speak for the Conserve plus, but the Cormet 2000 has what sounds like the same surface. It's very rough and porous and made of a substance that is supposed to encourage bone growth into it. It's uncemented and because the bone does grow into it, it creates great stability. Are there other major differences, perhaps? Lois the second Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 3, 2003 Report Share Posted October 3, 2003 Hi, In amongst all that has been mentioned I would like to add a reminder to go back to what that Indian OS said in his email about how the loadings work for the prothesis........... in that the Resurface backs the loadings down onto the femur in its natural manner - thus keeping the femur stronger as we all climb through our aging process......... where the THR stem mechanism simply cannot do that well given it is down the middle of the femur - this seems to contribute to the need for revisions from what I gather............ I always felt that this is one of the important considerations left out of any debate......... and I know that the femur does strengthen following a BHR, as my 6 month xrays show that............ Edith LBHR Dr. L Walter Syd Aust 8/02 > > from what i understand, they are all very similar surfaces and > none of them use cement. > > there were a few differences i came across in perusing the web: > > one is that the BHR offers a variation of the acetabular cup > for people with dysplasia (shallow or deformed hip sockets), > it has an added screw fixation feature for hips that may be > too risky for the doctor to use the regular one. the other two > companies don't yet have that option in there arsenal of > components to select from during surgery if needed. > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 3, 2003 Report Share Posted October 3, 2003 Hi, In amongst all that has been mentioned I would like to add a reminder to go back to what that Indian OS said in his email about how the loadings work for the prothesis........... in that the Resurface backs the loadings down onto the femur in its natural manner - thus keeping the femur stronger as we all climb through our aging process......... where the THR stem mechanism simply cannot do that well given it is down the middle of the femur - this seems to contribute to the need for revisions from what I gather............ I always felt that this is one of the important considerations left out of any debate......... and I know that the femur does strengthen following a BHR, as my 6 month xrays show that............ Edith LBHR Dr. L Walter Syd Aust 8/02 > > from what i understand, they are all very similar surfaces and > none of them use cement. > > there were a few differences i came across in perusing the web: > > one is that the BHR offers a variation of the acetabular cup > for people with dysplasia (shallow or deformed hip sockets), > it has an added screw fixation feature for hips that may be > too risky for the doctor to use the regular one. the other two > companies don't yet have that option in there arsenal of > components to select from during surgery if needed. > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 3, 2003 Report Share Posted October 3, 2003 Hi, In amongst all that has been mentioned I would like to add a reminder to go back to what that Indian OS said in his email about how the loadings work for the prothesis........... in that the Resurface backs the loadings down onto the femur in its natural manner - thus keeping the femur stronger as we all climb through our aging process......... where the THR stem mechanism simply cannot do that well given it is down the middle of the femur - this seems to contribute to the need for revisions from what I gather............ I always felt that this is one of the important considerations left out of any debate......... and I know that the femur does strengthen following a BHR, as my 6 month xrays show that............ Edith LBHR Dr. L Walter Syd Aust 8/02 > > from what i understand, they are all very similar surfaces and > none of them use cement. > > there were a few differences i came across in perusing the web: > > one is that the BHR offers a variation of the acetabular cup > for people with dysplasia (shallow or deformed hip sockets), > it has an added screw fixation feature for hips that may be > too risky for the doctor to use the regular one. the other two > companies don't yet have that option in there arsenal of > components to select from during surgery if needed. > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 4, 2003 Report Share Posted October 4, 2003 Hi , I didn't discuss resurfacing with Dr. Klapper. I didn't even know about resurfacing at the time (January 02) and he didn't mention it to me. He recommended a " minimally invasive " THR. I declined, and met a fellow skiiing in February that had had 2 resurfed hips, and he gave me the name and web site of Schmalzried in LA.....that began my journey to resurfacing. Another friend heading for resurfacing gave me " Surfacehippy " URL that began my insurance fight. Carol in CA > Iv'e read and recommend " Heal your Hips " to anyone with hip pain / problems . ust curious , what was Dr. Klapper opinion of resurfacing ?? Goldberg C+ 1/28/03 In surfacehippy , Carol Latta wrote: Hi, Just my experience on " wating as long as you can " . I followed this advice. I waited 9 years! With excercise, condroition, chiropractic, etc (rarely used pain meds) I skiied, rode horses competively, did yoga....most everything I wanted. As I was managing so well I went to see Dr Klapper ( " Heal your > Hips " author) >> to see if I was a canidate for joint " cleanout " . To my horror, I > was more >> than bone-on-bone, I had developed a cyst 1/3 the size of the head > of my >> femor. My thoughts are that this large hole acted as a hydrolic > cushion each >> time I put weight on it so my pain was lessened. AND each step > made the >> hole larger! >> >> I then fought with my insurance co. for a year! I am now scheduled > with >> DeSmet in Belgium. I do not know if he will be able to give me a > resurface. >> He at first turned me down, then decided that it was a good > mathematical >> risk to take. I am very sorry I waited. >> >> So pain was not an indication of my bones condition. I now know I > should >> have monitored it more closely. >> >> Carol in CA >> DeSmet BHR 10-22-03 > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 4, 2003 Report Share Posted October 4, 2003 Virginia, Thank you for the information. It's wonderful that the full femoral head was available to you. Does the stem go as far into the femur like the THR stem? In the US, I think Technology makes a metal, large head system to use in a THR. Our OS said there is a new prosthesis in England that the stem does not go as far down into the femur. I am so afraid for Jeff's future if he has to have the THR now...I do have full confidence in our OS that he is thinking along the same lines we are. Thanks again, Jan > Jan, > There is a Birmingham component, made by Midland Medical > Technologies, that is a full femoral head. It's shaped like a ball, > wiht a hole in the back of it. Just as there are plastic or ceramic > heads that slot onto a standard THR stem (where there is a fracture > of the femoral nick) - well having the plastic can be avoided by > having the all-metal Birmingham head of femur (ball) component. It > slots onto the standard stem. I know because I saw it. The surgeon > made sure I got a good look on the video monitor at the shaped end of > the stem and the matching hole in the Birmingham head, and how they > slotted in. This is brilliant! This information isn't on the > websites - yet. > I am so grateful to have had this option. Ask the surgeons you > speak with, or, if they are unaware of it, contact Midland Medical > technologies through their website. Their reps can provide the > necesary information to the surgeon you choose for your son. > Basically, the surgeon needs to be BHR trained to insert the > acetabular " cup " component, because of the special instruments and > technique, but his eperience in standard hip surgery woule prepare > him to slot the BHR head onto a standard stem. > The main thing is to get the information, talk with the surgeons, > and make sure you and your son have an input into choices. > Good luck. > Virginia (5 1/2 weeks post-op) > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 5, 2003 Report Share Posted October 5, 2003 Jan, I have the usual THR stem. That's why I had to have the long metal " nail " (rod) removed from my femur before having this surgery. (The long " nail " was inserted and screwed to fix a really bad fracture last October of the distal femur, i.e. knee end, and was taken out through the knee.) Because of the fracture I didn't have a choice for that - but am very happy that I did have a choice when it came to having the Birmingham components. I have really thankful to my surgeon for offering it. He has been marvellous, and has always had my interests and independence at heart. Ask the surgeons you consult, and get all the answers as regards options. All anyone can do is make the best possible choice on the information available at the time. It looks as if you and your OS are thinking is terms of keeping open as many future options as possible for your son. If you aren't happy, get a 2nd and 3rd opinion. Good luck. Virginia > > Jan, > > There is a Birmingham component, made by Midland Medical > > Technologies, that is a full femoral head. It's shaped like a > ball, > > wiht a hole in the back of it. Just as there are plastic or > ceramic > > heads that slot onto a standard THR stem (where there is a > fracture > > of the femoral nick) - well having the plastic can be avoided by > > having the all-metal Birmingham head of femur (ball) component. > It > > slots onto the standard stem. I know because I saw it. The > surgeon > > made sure I got a good look on the video monitor at the shaped end > of > > the stem and the matching hole in the Birmingham head, and how > they > > slotted in. This is brilliant! This information isn't on the > > websites - yet. > > I am so grateful to have had this option. Ask the surgeons > you > > speak with, or, if they are unaware of it, contact Midland Medical > > technologies through their website. Their reps can provide the > > necesary information to the surgeon you choose for your son. > > Basically, the surgeon needs to be BHR trained to insert the > > acetabular " cup " component, because of the special instruments and > > technique, but his eperience in standard hip surgery woule prepare > > him to slot the BHR head onto a standard stem. > > The main thing is to get the information, talk with the > surgeons, > > and make sure you and your son have an input into choices. > > Good luck. > > Virginia (5 1/2 weeks post-op) > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 5, 2003 Report Share Posted October 5, 2003 Virgina, I am familiar with the metal screws. Jeff had three inserted to try to heal his original fracture. He was in a motorcycle accident shortly after he turned 18, although he had been riding a motorcycle for three years. The impact caused the complete fracture of the femoral head. We were told in the emergency room that this type of a fracture might not heal and could lead to AVN. We had hoped that possibility would be many years away. Jeff used a walker for 10 months before he was able to walk unassisted again. Five months later he had the screws removed because he was in so much pain. At that point the CT scan showed no AVN or cysts. The doctor did save the screws for him, at his request, and now one of our younger daughters has even taken them to school, along with x-rays, for a science presentation. These situations sure affect the entire family! His pain and limping increased over the next few months and the next x-rays showed total collapse of the femoral head. The first OS who took care of him since the accident told him to change his whole lifestyle (change majors in school, use a cane, get a desk job). This was devastating news. The surgeon we were then referred to, who treats younger patients for joint replacement, could only offer him a THR. But, he did refer us to our current surgeon who is doing resurfacing. At this point, we are just waiting to see if resurfacing is at all possible. Thanks again for your information. I really do appreciate all that I've learned here. Jan > > > Jan, > > > There is a Birmingham component, made by Midland Medical > > > Technologies, that is a full femoral head. It's shaped like a > > ball, > > > wiht a hole in the back of it. Just as there are plastic or > > ceramic > > > heads that slot onto a standard THR stem (where there is a > > fracture > > > of the femoral nick) - well having the plastic can be avoided by > > > having the all-metal Birmingham head of femur (ball) component. > > It > > > slots onto the standard stem. I know because I saw it. The > > surgeon > > > made sure I got a good look on the video monitor at the shaped > end > > of > > > the stem and the matching hole in the Birmingham head, and how > > they > > > slotted in. This is brilliant! This information isn't on the > > > websites - yet. > > > I am so grateful to have had this option. Ask the surgeons > > you > > > speak with, or, if they are unaware of it, contact Midland > Medical > > > technologies through their website. Their reps can provide the > > > necesary information to the surgeon you choose for your son. > > > Basically, the surgeon needs to be BHR trained to insert the > > > acetabular " cup " component, because of the special instruments > and > > > technique, but his eperience in standard hip surgery woule > prepare > > > him to slot the BHR head onto a standard stem. > > > The main thing is to get the information, talk with the > > surgeons, > > > and make sure you and your son have an input into choices. > > > Good luck. > > > Virginia (5 1/2 weeks post-op) > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 5, 2003 Report Share Posted October 5, 2003 Jan, Thanks for sharing Jeff's details. He has certainly had a very difficult (and painful) time. My thoughts go out to him for the best possible decision on current knowledge. Have you thought of sending digital photos of his x-rays to some of the surgeons mentioned on this list? I hope that, despite the advice from the OS, Jeff can continue with his education as his future job prospects are going to matter. There may be a compromise as regards courses taken.... Perhaps you can factor this into discussions with surgeons. All the best, Virginia > >Reply-To: surfacehippy >To: surfacehippy >Subject: Re: devices and timing >Date: Sun, 05 Oct 2003 15:57:58 -0000 > >Virgina, >I am familiar with the metal screws. Jeff had three inserted to try >to heal his original fracture. He was in a motorcycle accident >shortly after he turned 18, although he had been riding a motorcycle >for three years. The impact caused the complete fracture of the >femoral head. We were told in the emergency room that this type of a >fracture might not heal and could lead to AVN. We had hoped that >possibility would be many years away. Jeff used a walker for 10 >months before he was able to walk unassisted again. Five months >later he had the screws removed because he was in so much pain. At >that point the CT scan showed no AVN or cysts. The doctor did save >the screws for him, at his request, and now one of our younger >daughters has even taken them to school, along with x-rays, for a >science presentation. These situations sure affect the entire family! > His pain and limping increased over the next few months and the >next x-rays showed total collapse of the femoral head. The first OS >who took care of him since the accident told him to change his whole >lifestyle (change majors in school, use a cane, get a desk job). >This was devastating news. The surgeon we were then referred to, who >treats younger patients for joint replacement, could only offer him >a THR. But, he did refer us to our current surgeon who is doing >resurfacing. At this point, we are just waiting to see if >resurfacing is at all possible. >Thanks again for your information. I really do appreciate all that >I've learned here. >Jan > > > > > > > Jan, > > > > There is a Birmingham component, made by Midland Medical > > > > Technologies, that is a full femoral head. It's shaped like a > > > ball, > > > > wiht a hole in the back of it. Just as there are plastic or > > > ceramic > > > > heads that slot onto a standard THR stem (where there is a > > > fracture > > > > of the femoral nick) - well having the plastic can be avoided >by > > > > having the all-metal Birmingham head of femur (ball) >component. > > > It > > > > slots onto the standard stem. I know because I saw it. The > > > surgeon > > > > made sure I got a good look on the video monitor at the shaped > > end > > > of > > > > the stem and the matching hole in the Birmingham head, and how > > > they > > > > slotted in. This is brilliant! This information isn't on the > > > > websites - yet. > > > > I am so grateful to have had this option. Ask the >surgeons > > > you > > > > speak with, or, if they are unaware of it, contact Midland > > Medical > > > > technologies through their website. Their reps can provide >the > > > > necesary information to the surgeon you choose for your son. > > > > Basically, the surgeon needs to be BHR trained to insert the > > > > acetabular " cup " component, because of the special instruments > > and > > > > technique, but his eperience in standard hip surgery woule > > prepare > > > > him to slot the BHR head onto a standard stem. > > > > The main thing is to get the information, talk with the > > > surgeons, > > > > and make sure you and your son have an input into choices. > > > > Good luck. > > > > Virginia (5 1/2 weeks post-op) > > > > > _________________________________________________________________ Chat via SMS. Simply send 'CHAT' to 1889918. More info at http://ninemsn.com.au/mobilemania/MoChat.asp?blipid=6800 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 5, 2003 Report Share Posted October 5, 2003 Jan, Thanks for sharing Jeff's details. He has certainly had a very difficult (and painful) time. My thoughts go out to him for the best possible decision on current knowledge. Have you thought of sending digital photos of his x-rays to some of the surgeons mentioned on this list? I hope that, despite the advice from the OS, Jeff can continue with his education as his future job prospects are going to matter. There may be a compromise as regards courses taken.... Perhaps you can factor this into discussions with surgeons. All the best, Virginia > >Reply-To: surfacehippy >To: surfacehippy >Subject: Re: devices and timing >Date: Sun, 05 Oct 2003 15:57:58 -0000 > >Virgina, >I am familiar with the metal screws. Jeff had three inserted to try >to heal his original fracture. He was in a motorcycle accident >shortly after he turned 18, although he had been riding a motorcycle >for three years. The impact caused the complete fracture of the >femoral head. We were told in the emergency room that this type of a >fracture might not heal and could lead to AVN. We had hoped that >possibility would be many years away. Jeff used a walker for 10 >months before he was able to walk unassisted again. Five months >later he had the screws removed because he was in so much pain. At >that point the CT scan showed no AVN or cysts. The doctor did save >the screws for him, at his request, and now one of our younger >daughters has even taken them to school, along with x-rays, for a >science presentation. These situations sure affect the entire family! > His pain and limping increased over the next few months and the >next x-rays showed total collapse of the femoral head. The first OS >who took care of him since the accident told him to change his whole >lifestyle (change majors in school, use a cane, get a desk job). >This was devastating news. The surgeon we were then referred to, who >treats younger patients for joint replacement, could only offer him >a THR. But, he did refer us to our current surgeon who is doing >resurfacing. At this point, we are just waiting to see if >resurfacing is at all possible. >Thanks again for your information. I really do appreciate all that >I've learned here. >Jan > > > > > > > Jan, > > > > There is a Birmingham component, made by Midland Medical > > > > Technologies, that is a full femoral head. It's shaped like a > > > ball, > > > > wiht a hole in the back of it. Just as there are plastic or > > > ceramic > > > > heads that slot onto a standard THR stem (where there is a > > > fracture > > > > of the femoral nick) - well having the plastic can be avoided >by > > > > having the all-metal Birmingham head of femur (ball) >component. > > > It > > > > slots onto the standard stem. I know because I saw it. The > > > surgeon > > > > made sure I got a good look on the video monitor at the shaped > > end > > > of > > > > the stem and the matching hole in the Birmingham head, and how > > > they > > > > slotted in. This is brilliant! This information isn't on the > > > > websites - yet. > > > > I am so grateful to have had this option. Ask the >surgeons > > > you > > > > speak with, or, if they are unaware of it, contact Midland > > Medical > > > > technologies through their website. Their reps can provide >the > > > > necesary information to the surgeon you choose for your son. > > > > Basically, the surgeon needs to be BHR trained to insert the > > > > acetabular " cup " component, because of the special instruments > > and > > > > technique, but his eperience in standard hip surgery woule > > prepare > > > > him to slot the BHR head onto a standard stem. > > > > The main thing is to get the information, talk with the > > > surgeons, > > > > and make sure you and your son have an input into choices. > > > > Good luck. > > > > Virginia (5 1/2 weeks post-op) > > > > > _________________________________________________________________ Chat via SMS. Simply send 'CHAT' to 1889918. More info at http://ninemsn.com.au/mobilemania/MoChat.asp?blipid=6800 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 5, 2003 Report Share Posted October 5, 2003 Jan, Thanks for sharing Jeff's details. He has certainly had a very difficult (and painful) time. My thoughts go out to him for the best possible decision on current knowledge. Have you thought of sending digital photos of his x-rays to some of the surgeons mentioned on this list? I hope that, despite the advice from the OS, Jeff can continue with his education as his future job prospects are going to matter. There may be a compromise as regards courses taken.... Perhaps you can factor this into discussions with surgeons. All the best, Virginia > >Reply-To: surfacehippy >To: surfacehippy >Subject: Re: devices and timing >Date: Sun, 05 Oct 2003 15:57:58 -0000 > >Virgina, >I am familiar with the metal screws. Jeff had three inserted to try >to heal his original fracture. He was in a motorcycle accident >shortly after he turned 18, although he had been riding a motorcycle >for three years. The impact caused the complete fracture of the >femoral head. We were told in the emergency room that this type of a >fracture might not heal and could lead to AVN. We had hoped that >possibility would be many years away. Jeff used a walker for 10 >months before he was able to walk unassisted again. Five months >later he had the screws removed because he was in so much pain. At >that point the CT scan showed no AVN or cysts. The doctor did save >the screws for him, at his request, and now one of our younger >daughters has even taken them to school, along with x-rays, for a >science presentation. These situations sure affect the entire family! > His pain and limping increased over the next few months and the >next x-rays showed total collapse of the femoral head. The first OS >who took care of him since the accident told him to change his whole >lifestyle (change majors in school, use a cane, get a desk job). >This was devastating news. The surgeon we were then referred to, who >treats younger patients for joint replacement, could only offer him >a THR. But, he did refer us to our current surgeon who is doing >resurfacing. At this point, we are just waiting to see if >resurfacing is at all possible. >Thanks again for your information. I really do appreciate all that >I've learned here. >Jan > > > > > > > Jan, > > > > There is a Birmingham component, made by Midland Medical > > > > Technologies, that is a full femoral head. It's shaped like a > > > ball, > > > > wiht a hole in the back of it. Just as there are plastic or > > > ceramic > > > > heads that slot onto a standard THR stem (where there is a > > > fracture > > > > of the femoral nick) - well having the plastic can be avoided >by > > > > having the all-metal Birmingham head of femur (ball) >component. > > > It > > > > slots onto the standard stem. I know because I saw it. The > > > surgeon > > > > made sure I got a good look on the video monitor at the shaped > > end > > > of > > > > the stem and the matching hole in the Birmingham head, and how > > > they > > > > slotted in. This is brilliant! This information isn't on the > > > > websites - yet. > > > > I am so grateful to have had this option. Ask the >surgeons > > > you > > > > speak with, or, if they are unaware of it, contact Midland > > Medical > > > > technologies through their website. Their reps can provide >the > > > > necesary information to the surgeon you choose for your son. > > > > Basically, the surgeon needs to be BHR trained to insert the > > > > acetabular " cup " component, because of the special instruments > > and > > > > technique, but his eperience in standard hip surgery woule > > prepare > > > > him to slot the BHR head onto a standard stem. > > > > The main thing is to get the information, talk with the > > > surgeons, > > > > and make sure you and your son have an input into choices. > > > > Good luck. > > > > Virginia (5 1/2 weeks post-op) > > > > > _________________________________________________________________ Chat via SMS. Simply send 'CHAT' to 1889918. More info at http://ninemsn.com.au/mobilemania/MoChat.asp?blipid=6800 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 5, 2003 Report Share Posted October 5, 2003 Hi Jan, Go have a look at Totallyhip List as a little while back a young woman from down south here in Australia spoke of her being a trial for a much smaller shafted THR.......... I think the German's may also be doing things with these too - they have a screw type mechanism that is different to the normal everyday THR shaft....... All may be worth a check out and may be more advisable for a younger person......... Meanwhile one can hope there is enough good bone left for a Resurface for if he must start needing replacements that would seem to be to be the best first up on someone so young........ Edith LBHR Dr. L Walter Syd Aust 8/02 > I am familiar with the metal screws. Jeff had three inserted to try > to heal his original fracture. He was in a motorcycle accident > shortly after he turned 18, although he had been riding a motorcycle > for three years. The impact caused the complete fracture of the > femoral head. We were told in the emergency room that this type of a > fracture might not heal and could lead to AVN. We had hoped that > possibility would be many years away. Jeff used a walker for 10 > months before he was able to walk unassisted again. Five months > later he had the screws removed because he was in so much pain. At > that point the CT scan showed no AVN or cysts. The doctor did save Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 6, 2003 Report Share Posted October 6, 2003 Hello Edith, I will visit the Totallyhip site to see what I can find out. Thanks for letting me know about it. Our OS said there were two other devices that did not have the stem go far down into the femur. I don't think they are available in the U.S. though. If it comes to that the OS said something about applying to the FDA for a " compassionate " use of the prosthesis. Unfortunately, he said if we have to go in this direction it would take time for all the paperwork, etc. Thanks again for your help, Jan > Hi Jan, > > Go have a look at Totallyhip List as a little while back a young woman from > down south here in Australia spoke of her being a trial for a much smaller > shafted THR.......... I think the German's may also be doing things with > these too - they have a screw type mechanism that is different to the normal > everyday THR shaft....... All may be worth a check out and may be more > advisable for a younger person......... > > Meanwhile one can hope there is enough good bone left for a Resurface for if > he must start needing replacements that would seem to be to be the best > first up on someone so young........ > > Edith LBHR Dr. L Walter Syd Aust 8/02 > > > > > I am familiar with the metal screws. Jeff had three inserted to try > > to heal his original fracture. He was in a motorcycle accident > > shortly after he turned 18, although he had been riding a motorcycle > > for three years. The impact caused the complete fracture of the > > femoral head. We were told in the emergency room that this type of a > > fracture might not heal and could lead to AVN. We had hoped that > > possibility would be many years away. Jeff used a walker for 10 > > months before he was able to walk unassisted again. Five months > > later he had the screws removed because he was in so much pain. At > > that point the CT scan showed no AVN or cysts. The doctor did save Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 7, 2003 Report Share Posted October 7, 2003 Also, with a THR, the femur itself looses bone mass, due to it no longer flexing microscopically with every step.... " stress shiedling " ?. To: surfacehippy > cc: Subject: Re: Re: devices and timing " ecrow " ecrow@...> 04/10/2003 03:13 Hi, In amongst all that has been mentioned I would like to add a reminder to go back to what that Indian OS said in his email about how the loadings work for the prothesis........... in that the Resurface backs the loadings down onto the femur in its natural manner - thus keeping the femur stronger as we all climb through our aging process......... where the THR stem mechanism simply cannot do that well given it is down the middle of the femur - this seems to contribute to the need for revisions from what I gather............ I always felt that this is one of the important considerations left out of any debate......... and I know that the femur does strengthen following a BHR, as my 6 month xrays show that............ Edith LBHR Dr. L Walter Syd Aust 8/02 > > from what i understand, they are all very similar surfaces and > none of them use cement. > > there were a few differences i came across in perusing the web: > > one is that the BHR offers a variation of the acetabular cup > for people with dysplasia (shallow or deformed hip sockets), > it has an added screw fixation feature for hips that may be > too risky for the doctor to use the regular one. the other two > companies don't yet have that option in there arsenal of > components to select from during surgery if needed. > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 7, 2003 Report Share Posted October 7, 2003 Also, with a THR, the femur itself looses bone mass, due to it no longer flexing microscopically with every step.... " stress shiedling " ?. To: surfacehippy > cc: Subject: Re: Re: devices and timing " ecrow " ecrow@...> 04/10/2003 03:13 Hi, In amongst all that has been mentioned I would like to add a reminder to go back to what that Indian OS said in his email about how the loadings work for the prothesis........... in that the Resurface backs the loadings down onto the femur in its natural manner - thus keeping the femur stronger as we all climb through our aging process......... where the THR stem mechanism simply cannot do that well given it is down the middle of the femur - this seems to contribute to the need for revisions from what I gather............ I always felt that this is one of the important considerations left out of any debate......... and I know that the femur does strengthen following a BHR, as my 6 month xrays show that............ Edith LBHR Dr. L Walter Syd Aust 8/02 > > from what i understand, they are all very similar surfaces and > none of them use cement. > > there were a few differences i came across in perusing the web: > > one is that the BHR offers a variation of the acetabular cup > for people with dysplasia (shallow or deformed hip sockets), > it has an added screw fixation feature for hips that may be > too risky for the doctor to use the regular one. the other two > companies don't yet have that option in there arsenal of > components to select from during surgery if needed. > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 7, 2003 Report Share Posted October 7, 2003 Also, with a THR, the femur itself looses bone mass, due to it no longer flexing microscopically with every step.... " stress shiedling " ?. To: surfacehippy > cc: Subject: Re: Re: devices and timing " ecrow " ecrow@...> 04/10/2003 03:13 Hi, In amongst all that has been mentioned I would like to add a reminder to go back to what that Indian OS said in his email about how the loadings work for the prothesis........... in that the Resurface backs the loadings down onto the femur in its natural manner - thus keeping the femur stronger as we all climb through our aging process......... where the THR stem mechanism simply cannot do that well given it is down the middle of the femur - this seems to contribute to the need for revisions from what I gather............ I always felt that this is one of the important considerations left out of any debate......... and I know that the femur does strengthen following a BHR, as my 6 month xrays show that............ Edith LBHR Dr. L Walter Syd Aust 8/02 > > from what i understand, they are all very similar surfaces and > none of them use cement. > > there were a few differences i came across in perusing the web: > > one is that the BHR offers a variation of the acetabular cup > for people with dysplasia (shallow or deformed hip sockets), > it has an added screw fixation feature for hips that may be > too risky for the doctor to use the regular one. the other two > companies don't yet have that option in there arsenal of > components to select from during surgery if needed. > Quote Link to comment Share on other sites More sharing options...
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