Re: Less than ideal hip resfacing candidates

[Guest guest]

At 02:22 PM 11/12/2003 -0500, you wrote:

> I very much want a resurfacing and would have it in a heartbeat if I was

> reasonably confident that the procedure would hold and be long lasting.

>

>Recently, I have flown to see Dr. Schmalzried in LA at the Joint

>Replacement Institute. He said he would perform hip resurfacing if I

>wanted it. However, he said I have " early femoral failure " and cyst

>present. He said further, that normally the outcome is 95% successful, but

>for me it would be 88%. Wonder, whether, given the increased odds against

>me, I ought take the risk.

,

I was not an ideal candidate, but I was an even worse candidate for THR's

(the interior of my femurs are shaped funny and a regular stem would likely

have fractured them). I wonder if longer time on crutches might make some

of the borderline cases less so--the crutches giving the body time to

strengthen and heal without the stress of full weight-bearing and

activity. I was on crutches for seven months, then a cane for another few

months after that. So many say " I could never do that! " If you could

never do that, then get a large head THR. If you could, I wonder if that

would increase your chances of success? I had no trouble with the time on

crutches, as I was FAR more mobile with them than I had been pre-op, so

life on crutches was a HUGE improvement over what I had pre-op.

Thinking out loud again,

Cindy

C+ 5/25/01 and 6/28/01

[Guest guest]

At 02:22 PM 11/12/2003 -0500, you wrote:

> I very much want a resurfacing and would have it in a heartbeat if I was

> reasonably confident that the procedure would hold and be long lasting.

>

>Recently, I have flown to see Dr. Schmalzried in LA at the Joint

>Replacement Institute. He said he would perform hip resurfacing if I

>wanted it. However, he said I have " early femoral failure " and cyst

>present. He said further, that normally the outcome is 95% successful, but

>for me it would be 88%. Wonder, whether, given the increased odds against

>me, I ought take the risk.

,

I was not an ideal candidate, but I was an even worse candidate for THR's

(the interior of my femurs are shaped funny and a regular stem would likely

have fractured them). I wonder if longer time on crutches might make some

of the borderline cases less so--the crutches giving the body time to

strengthen and heal without the stress of full weight-bearing and

activity. I was on crutches for seven months, then a cane for another few

months after that. So many say " I could never do that! " If you could

never do that, then get a large head THR. If you could, I wonder if that

would increase your chances of success? I had no trouble with the time on

crutches, as I was FAR more mobile with them than I had been pre-op, so

life on crutches was a HUGE improvement over what I had pre-op.

Thinking out loud again,

Cindy

C+ 5/25/01 and 6/28/01

[Guest guest]

Hi

I was certanly less than an ideal candidate, and the OS I saw here tolf me

he would not do a resurf on me, because he thought there was a chance he would

fracture my pelvis when inserting the acetabular cup (I had virtually no surface

left on the abdominal surface of the acetabular cup). He was a surgeon who had

done very few resurfs. Luckily I contacted Dr De Smet in Belgium and he gave me

the okay with no hesitation. It certainly does depend on the experience the

surgeon has in resurfs, if you are a more difficult case. The first OS I saw

admitted that dr De Smet could do my surgery successfully, whereas he couldn't.

I had it done 2 months ago in Belgium and so far I couldn't be happier. I am

still recovering in terms of strength, flexibility and stamina, but I think that

is more from pre-op inactivity and my body readjusting than to surgery. There

is no more hip joint pain. As others point out, there is always the risk , as

in any surgery, of things going wrong, and maybe I'm looking at a THR someday.

At some point, when we have done as much research as can possibly be done, we

still have to take the risk of jumping off the dock into unkown waters. One

warning though, and that is not to wait too long. Some have done that and would

have been candidates for a resurf but were too far gone - I was almost one of

them.

All the best with your decision.

Sharry

Less than ideal hip resfacing candidates

Hello Everyone,

Reading many wonderful postings about people being evaluated as good

candidates for hip resurfacing. Wish all of you great success! Wonder, if there

are any people who were evaluated as less than ideal candidates, but who had the

surgery anyway and have had positive outcomes. Of course, would want to know

about situations where outcomes were not positive (Hope, though, that everyone

succeeded)

I have been diagnosed with advanced Avascular Necrosis (Oct 16, 2003) of my

right hip. Surgeons here in NYC suggested a THR. I am 46 years old, and until

recently, was very physically active. I completed the NYC Marathon and

sky-dived. I very much want a resurfacing and would have it in a heartbeat if I

was reasonably confident that the procedure would hold and be long lasting.

Recently, I have flown to see Dr. Schmalzried in LA at the Joint

Replacement Institute. He said he would perform hip resurfacing if I wanted it.

However, he said I have " early femoral failure " and cyst present. He said

further, that normally the outcome is 95% successful, but for me it would be

88%. Wonder, whether, given the increased odds against me, I ought take the

risk.

It appears, I face a very difficult decision. Am I alone in this are there

others out there in similar situations and hopefully may have some useful advice

to pass my way? Any information is greatly appreciated.

(hopeful and determined to find the best treatment given my situation)

Warmly,

(New York City)

[Guest guest]

Hi

I was certanly less than an ideal candidate, and the OS I saw here tolf me

he would not do a resurf on me, because he thought there was a chance he would

fracture my pelvis when inserting the acetabular cup (I had virtually no surface

left on the abdominal surface of the acetabular cup). He was a surgeon who had

done very few resurfs. Luckily I contacted Dr De Smet in Belgium and he gave me

the okay with no hesitation. It certainly does depend on the experience the

surgeon has in resurfs, if you are a more difficult case. The first OS I saw

admitted that dr De Smet could do my surgery successfully, whereas he couldn't.

I had it done 2 months ago in Belgium and so far I couldn't be happier. I am

still recovering in terms of strength, flexibility and stamina, but I think that

is more from pre-op inactivity and my body readjusting than to surgery. There

is no more hip joint pain. As others point out, there is always the risk , as

in any surgery, of things going wrong, and maybe I'm looking at a THR someday.

At some point, when we have done as much research as can possibly be done, we

still have to take the risk of jumping off the dock into unkown waters. One

warning though, and that is not to wait too long. Some have done that and would

have been candidates for a resurf but were too far gone - I was almost one of

them.

All the best with your decision.

Sharry

Less than ideal hip resfacing candidates

Hello Everyone,

Reading many wonderful postings about people being evaluated as good

candidates for hip resurfacing. Wish all of you great success! Wonder, if there

are any people who were evaluated as less than ideal candidates, but who had the

surgery anyway and have had positive outcomes. Of course, would want to know

about situations where outcomes were not positive (Hope, though, that everyone

succeeded)

I have been diagnosed with advanced Avascular Necrosis (Oct 16, 2003) of my

right hip. Surgeons here in NYC suggested a THR. I am 46 years old, and until

recently, was very physically active. I completed the NYC Marathon and

sky-dived. I very much want a resurfacing and would have it in a heartbeat if I

was reasonably confident that the procedure would hold and be long lasting.

Recently, I have flown to see Dr. Schmalzried in LA at the Joint

Replacement Institute. He said he would perform hip resurfacing if I wanted it.

However, he said I have " early femoral failure " and cyst present. He said

further, that normally the outcome is 95% successful, but for me it would be

88%. Wonder, whether, given the increased odds against me, I ought take the

risk.

It appears, I face a very difficult decision. Am I alone in this are there

others out there in similar situations and hopefully may have some useful advice

to pass my way? Any information is greatly appreciated.

(hopeful and determined to find the best treatment given my situation)

Warmly,

(New York City)

[Guest guest]

Thank you for the numerous thoughtful, insightful, encouraging and frank

replies to my posting a few days ago. It has certainly has given me much

to think about. This is really a great group and I am very glad to have

discovered it not so long ago. Will keep you updated with future

developments.

Warmly,

(NYC)

treverfox@... wrote:

>Hello Everyone,

>

>Reading many wonderful postings about people being evaluated as good candidates

for hip resurfacing. Wish all of you great success! Wonder, if there are any

people who were evaluated as less than ideal candidates, but who had the surgery

anyway and have had positive outcomes. Of course, would want to know about

situations where outcomes were not positive (Hope, though, that everyone

succeeded)

>

>I have been diagnosed with advanced Avascular Necrosis (Oct 16, 2003) of my

right hip. Surgeons here in NYC suggested a THR. I am 46 years old, and until

recently, was very physically active. I completed the NYC Marathon and

sky-dived. I very much want a resurfacing and would have it in a heartbeat if I

was reasonably confident that the procedure would hold and be long lasting.

>

>Recently, I have flown to see Dr. Schmalzried in LA at the Joint

Replacement Institute. He said he would perform hip resurfacing if I wanted it.

However, he said I have " early femoral failure " and cyst present. He said

further, that normally the outcome is 95% successful, but for me it would be

88%. Wonder, whether, given the increased odds against me, I ought take the

risk.

>

>It appears, I face a very difficult decision. Am I alone in this are there

others out there in similar situations and hopefully may have some useful advice

to pass my way? Any information is greatly appreciated.

>

>(hopeful and determined to find the best treatment given my situation)

>

>Warmly,

> (New York City)

>

>

>

[Guest guest]

" chance he would fracture my pelvis when inserting the acetabular cup "

why would this be any different for a normal small-diameter THR?

My understanding was that the OUTSIDE diameter of the acetabularcomponent

is the same - just the small-diameter THR has a poly lining to the

acetabular component???

To:

surfacehippy >

cc:

Subject: Re: Less

than ideal hip resfacing candidates

" Sharry Schneider "

sharry_schneider@...

>

14/11/2003 04:29

Hi

I was certanly less than an ideal candidate, and the OS I saw here tolf

me he would not do a resurf on me, because he thought there was a chance he

would fracture my pelvis when inserting the acetabular cup (I had virtually

no surface left on the abdominal surface of the acetabular cup). He was a

surgeon who had done very few resurfs. Luckily I contacted Dr De Smet in

Belgium and he gave me the okay with no hesitation. It certainly does

depend on the experience the surgeon has in resurfs, if you are a more

difficult case. The first OS I saw admitted that dr De Smet could do my

surgery successfully, whereas he couldn't. I had it done 2 months ago in

Belgium and so far I couldn't be happier. I am still recovering in terms

of strength, flexibility and stamina, but I think that is more from pre-op

inactivity and my body readjusting than to surgery. There is no more hip

joint pain. As others point out, there is always the risk , as in any

surgery, of things going wron!

g, and maybe I'm looking at a THR someday. At some point, when we have

done as much research as can possibly be done, we still have to take the

risk of jumping off the dock into unkown waters. One warning though, and

that is not to wait too long. Some have done that and would have been

candidates for a resurf but were too far gone - I was almost one of them.

All the best with your decision.

Sharry

Less than ideal hip resfacing candidates

Hello Everyone,

Reading many wonderful postings about people being evaluated as good

candidates for hip resurfacing. Wish all of you great success! Wonder, if

there are any people who were evaluated as less than ideal candidates, but

who had the surgery anyway and have had positive outcomes. Of course, would

want to know about situations where outcomes were not positive (Hope,

though, that everyone succeeded)

I have been diagnosed with advanced Avascular Necrosis (Oct 16, 2003) of

my right hip. Surgeons here in NYC suggested a THR. I am 46 years old, and

until recently, was very physically active. I completed the NYC Marathon

and sky-dived. I very much want a resurfacing and would have it in a

heartbeat if I was reasonably confident that the procedure would hold and

be long lasting.

Recently, I have flown to see Dr. Schmalzried in LA at the Joint

Replacement Institute. He said he would perform hip resurfacing if I wanted

it. However, he said I have " early femoral failure " and cyst present. He

said further, that normally the outcome is 95% successful, but for me it

would be 88%. Wonder, whether, given the increased odds against me, I ought

take the risk.

It appears, I face a very difficult decision. Am I alone in this are

there others out there in similar situations and hopefully may have some

useful advice to pass my way? Any information is greatly appreciated.

(hopeful and determined to find the best treatment given my situation)

Warmly,

(New York City)

[Guest guest]

G'day ,

I wasn't guaranteed a bhr when I went in for the actual surgery, I

was 50/50 resurfacing or thr.

I wasn't a particularly good candidate due to chd and resultant wear

and tear over the years of a redesigned hip.

So at the age of 35 I had to get something done and either way I was

comfortable in the decision of bhr first option, thr second option.

Therefore my advice is to plan for both and feel comfortable in your

decision.

OOOOrrrooo

Skip

LBHR Nov 2001, Melbourne

> Hello Everyone,

>

> Reading many wonderful postings about people being evaluated as

good candidates for hip resurfacing. Wish all of you great success!

Wonder, if there are any people who were evaluated as less than ideal

candidates, but who had the surgery anyway and have had positive

outcomes. Of course, would want to know about situations where

outcomes were not positive (Hope, though, that everyone succeeded)

>

> I have been diagnosed with advanced Avascular Necrosis (Oct 16,

2003) of my right hip. Surgeons here in NYC suggested a THR. I am 46

years old, and until recently, was very physically active. I

completed the NYC Marathon and sky-dived. I very much want a

resurfacing and would have it in a heartbeat if I was reasonably

confident that the procedure would hold and be long lasting.

>

> Recently, I have flown to see Dr. Schmalzried in LA at the

Joint Replacement Institute. He said he would perform hip resurfacing

if I wanted it. However, he said I have " early femoral failure " and

cyst present. He said further, that normally the outcome is 95%

successful, but for me it would be 88%. Wonder, whether, given the

increased odds against me, I ought take the risk.

>

> It appears, I face a very difficult decision. Am I alone in this

are there others out there in similar situations and hopefully may

have some useful advice to pass my way? Any information is greatly

appreciated.

>

> (hopeful and determined to find the best treatment given my

situation)

>

> Warmly,

> (New York City)

[Guest guest]

G'day ,

I wasn't guaranteed a bhr when I went in for the actual surgery, I

was 50/50 resurfacing or thr.

I wasn't a particularly good candidate due to chd and resultant wear

and tear over the years of a redesigned hip.

So at the age of 35 I had to get something done and either way I was

comfortable in the decision of bhr first option, thr second option.

Therefore my advice is to plan for both and feel comfortable in your

decision.

OOOOrrrooo

Skip

LBHR Nov 2001, Melbourne

> Hello Everyone,

>

> Reading many wonderful postings about people being evaluated as

good candidates for hip resurfacing. Wish all of you great success!

Wonder, if there are any people who were evaluated as less than ideal

candidates, but who had the surgery anyway and have had positive

outcomes. Of course, would want to know about situations where

outcomes were not positive (Hope, though, that everyone succeeded)

>

> I have been diagnosed with advanced Avascular Necrosis (Oct 16,

2003) of my right hip. Surgeons here in NYC suggested a THR. I am 46

years old, and until recently, was very physically active. I

completed the NYC Marathon and sky-dived. I very much want a

resurfacing and would have it in a heartbeat if I was reasonably

confident that the procedure would hold and be long lasting.

>

> Recently, I have flown to see Dr. Schmalzried in LA at the

Joint Replacement Institute. He said he would perform hip resurfacing

if I wanted it. However, he said I have " early femoral failure " and

cyst present. He said further, that normally the outcome is 95%

successful, but for me it would be 88%. Wonder, whether, given the

increased odds against me, I ought take the risk.

>

> It appears, I face a very difficult decision. Am I alone in this

are there others out there in similar situations and hopefully may

have some useful advice to pass my way? Any information is greatly

appreciated.

>

> (hopeful and determined to find the best treatment given my

situation)

>

> Warmly,

> (New York City)

[Guest guest]

G'day ,

I wasn't guaranteed a bhr when I went in for the actual surgery, I

was 50/50 resurfacing or thr.

I wasn't a particularly good candidate due to chd and resultant wear

and tear over the years of a redesigned hip.

So at the age of 35 I had to get something done and either way I was

comfortable in the decision of bhr first option, thr second option.

Therefore my advice is to plan for both and feel comfortable in your

decision.

OOOOrrrooo

Skip

LBHR Nov 2001, Melbourne

> Hello Everyone,

>

> Reading many wonderful postings about people being evaluated as

good candidates for hip resurfacing. Wish all of you great success!

Wonder, if there are any people who were evaluated as less than ideal

candidates, but who had the surgery anyway and have had positive

outcomes. Of course, would want to know about situations where

outcomes were not positive (Hope, though, that everyone succeeded)

>

> I have been diagnosed with advanced Avascular Necrosis (Oct 16,

2003) of my right hip. Surgeons here in NYC suggested a THR. I am 46

years old, and until recently, was very physically active. I

completed the NYC Marathon and sky-dived. I very much want a

resurfacing and would have it in a heartbeat if I was reasonably

confident that the procedure would hold and be long lasting.

>

> Recently, I have flown to see Dr. Schmalzried in LA at the

Joint Replacement Institute. He said he would perform hip resurfacing

if I wanted it. However, he said I have " early femoral failure " and

cyst present. He said further, that normally the outcome is 95%

successful, but for me it would be 88%. Wonder, whether, given the

increased odds against me, I ought take the risk.

>

> It appears, I face a very difficult decision. Am I alone in this

are there others out there in similar situations and hopefully may

have some useful advice to pass my way? Any information is greatly

appreciated.

>

> (hopeful and determined to find the best treatment given my

situation)

>

> Warmly,

> (New York City)

[Guest guest]

I second this suggestion. You might also want to look at the x rays

on RichieRich's website (in the Links on this site - thunderballhip)

If I am not mistaken, he was turned down by Dr. Treacy, but Dr.

DeSmet was surely successful. On the other hand, if Dr. DeSmet turns

you down, I would go on to plan B! Dr. desmet does not do any cases

he does not expect to be successful - from what I can tell, his track

record does not include excuses for taking hard cases -

In my case, he told me there was a " mathematical risk " of a neck of

femur fracture (avn, cysts,) - but i doubt he would have touched me

if he weren't confident of success.

Bev

rBHR 2/19/03 Desmet

> I suggest you send your xrays to Dr. DeSmet (see contact info in

> surfacehippy files - Ghent, Belgium). He is known for doing

> difficult cases and will not charge you to look at your xrays. He

> will give you a clear picture of your candidacy for resurfacing.

All

> the best.

>

> R. Bures rbhr, DeSmet, 5/13/03