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Re: Not all US Orthopedic Surgeons are idiots! - initial research results

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Hi Diane

When I was looking into my options, my physiotherapist gave me a

list of a bunch of orthopedic associations and journals. I looked them

all up on the Internet, and found the same results as you did. If I

searched their archives for " resurfacing " , I only found a few articles

on hemi-resurfacing for young patients with AVN. From what I could

see, the professional journals have only published a handful of

articles on resurfacing, and mostly very recently. This seems rather

strange to me, when it's been done for 12 years. Perhaps some

presentations were also made at conferences, but the text versions

weren't available on-line? I'm wondering if the journals' " peer

reviewers " don't approve resurfacing articles because they feel the

research isn't scientific enough, or if the resurfacing OS's are too

busy trying to look after their long list of eager patients to find

the time to publish research very often?

I only found out by accident that there was actually a whole

medical conference on hip resurfacing held in Spain last June,

sponsored by Midland Medical Technologies, because MMT submitted a

press release about it to a commercial magazine called Orthopaedic

Product News. So far as I could see, there is no other mention of this

conference on the Internet. (See

http://www.opnews.com/articles/jul2003/articles.php#1 if you are

interested.)

I have to admit, hardly seeing ANY articles on resurfacing in the

professional journals, when it seems like an exciting option most

doctors would want to be able to offer their patients, was very scary

for me. If I hadn't had the opportunity to talk to several local

people who had the operation, plus read the postings on this board, it

would have been a lot harder to make the decision to spend a lot of

money and fly so far from home for an operation that most doctors here

had never even heard of.

Even though I eventually learned that there are at least 5

surgeons in the Vancouver area who do resurfacing, they are also in

high-demand for op's such as THR's and knee replacements, plus some of

them teach at the University of B.C. medical school, and it's

extremely difficult to get an consultation with any of them. In fact,

the first OS I saw said he knew some of the resurfacing OS's very

well, yet he'd never heard them mention this procedure! He also told

me that it probably wouldn't work for me because my leg lengths were a

bit different, and I'd need a THR to fix that. Later I learned that

many people who have a THR actually end up with a leg length imbalance

and are expected to just wear an insert in their shoe and put up with

it! While on the other hand, the BHR procedure moved my hip into the

right position for the first time in years, and my legs evened out as

a result. So I'm glad I got some other opinions.

What finally convinced me was a few people telling me that

resurfacing " gave them their life back " . And that's what I wanted,

too; to have my life back. When my hip locked up at age 49 and I was

almost immobilized by pain and back spasms, I didn't feel old enough

to have the restrictions of a THR, and I certainly didn't want to face

having a second one 15-20 years later. I haven't quite reached my

goal, but I do have a life again, and it seems possible that with

perseverance at those boring exercises I'll be even more mobile in my

mid-50's than I was in my 40's. So for the people who are still trying

to make a decision, don't be scared if your OS tries to warn you off;

get another opinion from someone who actually does resurfacing. A

resurf is major surgery, but the recovery time is usually twice as

fast as for a THR, so I think that if you qualify it's well worth

trying the less invasive option first.

n

rBHR Oct.17/03 McMinn

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KUDOS to you . Very well said - and I appreciate the

thoughtfullness that went into your posting.

Joe

Bilateral, 5/8/03 C+ Dr. Amstutz

> I understand that general frustration with the slow pace of

acceptance for

> resurfacing in the US. But I think it's unfair to blame the average

OS in

> the US for this. Two things will change the hip replacement

landscape.

>

> 1. FDA approval

> 2. Marketing efforts by orthopeadic companies once FDA approval

occurs.

>

> No reputable journal, organization, or individual OS is going to

promote or

> encourage a procedure until it becomes " standard of care " . Even OSs

who do

> resurfacing are careful to avoid pushing patients in that

direction. It is

> presented as one option and carefully characterized

as " investigational " .

>

> Resurfacing is a tremendous boon to hip patients who are young and

active.

> Once resurfacing is FDA approved, it will join the other arrows in

most OS's

> quivers and become commonplace. Until then it will remain a

relatively

> obscure and questionable procedure in the US.

>

> To charactorize US surgeons as reactionary is unfair. And it's also

not

> productive to try and rate one country's surgeons above another's.

This

> forum is for discussion and support, not competition or promotion.

>

> Mike Trautman

> C2K, Kennedy, Sep 03

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