SROM-THR lasts a life time

January 19, 2004

You make the statement that surface replacement does not have long term

research to prove that it is better than THR. Then you say that " hearing that a

THR

could last 35-40 years is encouraging " doesn't make sense.

There is over ten years of results from hip resurfacing that shows great

success. Something that " could " give you 35-40 years in the form of SROM-THR has

a

long way to go before it proves itself to be real.

You also state that " previous surface devices were not good. " Most of these

early failures were in the US because they didn't get the materials in the

right combination as the Birmingham scientists did with far less early failures.

In any case the early failures paved the way for the fabulous results that I

and many other surface hippies have been enjoying for a long enough time. The

failure rate for resurfacing is far less than THR as you can research in our

archives.

Believe me, if anything has a chance to last 35-40 years it will be a hip

resurface device, not a THR. Of course I'm talking about the procedures in

general. I know that there have been isolated cases of THR's that have lasted an

extraordinarily long time, but on the whole they cannot compare to the

percentages of success of resurfacing-not to mention the obvious superiority in

holding

up in the stresses of impact sports. (See Ironman Triathlete Dru Dixon's last

post.)

Saeed

bilateral BHR, DeSmet 7-2-02

January 19, 2004

By recommendation of my Phy Therapist and Chiropractor I went

to see Dr. Sampson in S.F. In runs a clinic and performs many

THR a year.

He said he has his refined his method and felt a THR with a

SROM could last me my lifetime. He says the method and

experience of the sugeon was very important in success and the

device had many years of research to support it.

Wondering what others think of this. Having 1 surgury to last a

lifetime even without some expectations surface replacement

hopes for seems very desirable.

I would appreciate hearing thoughts and this.

thank you kindly

happeehip

January 19, 2004

How old are you and what does this mean? ?

" ... lifetime even without some expectations surface replacement

> hopes for seems very desirable. .. "

You'll get lots of support here, and searching the files (archives) will

help a lot.

Also read this:

http://www.hip-clinic.com/assets/downloads/BHRlagomaggiore.pdf

Dave

Boyd C+

12/18/03

--------------------------------------------

>

> Reply-To: surfacehippy

> Date: Tue, 20 Jan 2004 06:28:55 -0000

> To: surfacehippy

> Subject: SROM-THR lasts a life time

>

> By recommendation of my Phy Therapist and Chiropractor I went

> to see Dr. Sampson in S.F. In runs a clinic and performs many

> THR a year.

> He said he has his refined his method and felt a THR with a

> SROM could last me my lifetime. He says the method and

> experience of the sugeon was very important in success and the

> device had many years of research to support it.

> Wondering what others think of this. Having 1 surgury to last a

> lifetime even without some expectations surface replacement

> hopes for seems very desirable.

> I would appreciate hearing thoughts and this.

> thank you kindly

> happeehip

>

January 20, 2004

> By recommendation of my Phy Therapist and Chiropractor I went

> to see Dr. ??????? in S.F. In runs a clinic and performs many

> THR a year.

> He said he has his refined his method and felt a THR with a

> SROM could last me my lifetime.

In my opinion, any OS who tells you that any implant will last you a

lifetime (and you are younger than 70-years) is FULL OF IT. I would

run away from this doc as fast as I could.

My resurf doc installs SROM THRs and it is my understanding that he

also has authored the manufacturers installation instructions. He

has told me that he can guarantee NOTHING as every hip replacement

operation is investigational due to many factors, including the

unique nature of each patient and the skill of each surgeon on any

given day.

> I would appreciate hearing thoughts and this.

> thank you kindly

> happeehip

My advise:

Call Carol at JRI [] and make an appointment with Dr.

Schmalzried to discuss all of your hip replacement options and their

associated tradeoffs. Warning: he will give you unvarnished

information, pie in the sky utopia BS

, bilat C+ July 01, Dr. S.

January 20, 2004

---what exactly is an SROM-THR, who exactly is this doctor, and what

is the method of his refinement? i would settle for knowing just

what an SROM-THR actually is, or is this just the stemmed variety???

MLW...CANCELLED TODAY BY MONT...due to the FDA tribulations

In surfacehippy , " rtdinc2003 " wrote:

>

> > By recommendation of my Phy Therapist and Chiropractor I went

> > to see Dr. ??????? in S.F. In runs a clinic and performs many

> > THR a year.

> > He said he has his refined his method and felt a THR with a

> > SROM could last me my lifetime.

>

> In my opinion, any OS who tells you that any implant will last you

a

> lifetime (and you are younger than 70-years) is FULL OF IT. I

would

> run away from this doc as fast as I could.

>

> My resurf doc installs SROM THRs and it is my understanding that he

> also has authored the manufacturers installation instructions. He

> has told me that he can guarantee NOTHING as every hip replacement

> operation is investigational due to many factors, including the

> unique nature of each patient and the skill of each surgeon on any

> given day.

>

> > I would appreciate hearing thoughts and this.

> > thank you kindly

> > happeehip

>

> My advise:

>

> Call Carol at JRI [] and make an appointment with Dr.

> Schmalzried to discuss all of your hip replacement options and

their

> associated tradeoffs. Warning: he will give you unvarnished

> information, pie in the sky utopia BS

>

> , bilat C+ July 01, Dr. S.

January 20, 2004

> By recommendation of my Phy Therapist and Chiropractor I went

> to see Dr. Sampson in S.F. In runs a clinic and performs many

> THR a year.

> He said he has his refined his method and felt a THR with a

> SROM could last me my lifetime. He says the method and

> experience of the sugeon was very important in success and the

> device had many years of research to support it.

> Wondering what others think of this. Having 1 surgury to last a

> lifetime even without some expectations surface replacement

> hopes for seems very desirable.

> I would appreciate hearing thoughts and this.

> thank you kindly

> happeehip

When I first went to compare the THR device to resurface device my

doctor (Dr. Kennedy) took out all the pieces for both devices and

some hip pelvic and femur bones and demonstrated to me how these

devices work. Needless to say it was very enlightening and

convinced me that hip resurface was the way to go. My THR OS

never did this. The THR device will never give you the range

of motion that the hip resurface gives you and you will always

have to worry about dislocation. There are MANY reasons why the

hip resurface is superior to THR. Do your research and believe

what is written about hip resurface. It is not too good to

believe but is really is a wonderful device which all on this site

will attest to. Also, quality of life is important to us all which

is why I got the surgery and continue to post and encourage others

to get the hip resurface if possible. Like many others I have

already pushed my surgery past what I could of hoped to do if I

had a THR. I say that with the knowledge of watching my Dad

suffer after getting his THR and I got the same line from his OS

that you are getting now about a THR.

God Bless

Jeff (C2K 01-03-03)

January 20, 2004

Jeff:

I believe the Conserve Total Hip System with the Big Femoral

Head provides almost the same range of motion as a resurface - both

are metal on metal. I believe the same is true for the other metal on

metal THR systems since the size of the femoral head is the key to

range of motion.

> > By recommendation of my Phy Therapist and Chiropractor I went

> > to see Dr. Sampson in S.F. In runs a clinic and performs many

> > THR a year.

> > He said he has his refined his method and felt a THR with a

> > SROM could last me my lifetime. He says the method and

> > experience of the sugeon was very important in success and the

> > device had many years of research to support it.

> > Wondering what others think of this. Having 1 surgury to last a

> > lifetime even without some expectations surface replacement

> > hopes for seems very desirable.

> > I would appreciate hearing thoughts and this.

> > thank you kindly

> > happeehip

>

> When I first went to compare the THR device to resurface device my

> doctor (Dr. Kennedy) took out all the pieces for both devices and

> some hip pelvic and femur bones and demonstrated to me how these

> devices work. Needless to say it was very enlightening and

> convinced me that hip resurface was the way to go. My THR OS

> never did this. The THR device will never give you the range

> of motion that the hip resurface gives you and you will always

> have to worry about dislocation. There are MANY reasons why the

> hip resurface is superior to THR. Do your research and believe

> what is written about hip resurface. It is not too good to

> believe but is really is a wonderful device which all on this site

> will attest to. Also, quality of life is important to us all which

> is why I got the surgery and continue to post and encourage others

> to get the hip resurface if possible. Like many others I have

> already pushed my surgery past what I could of hoped to do if I

> had a THR. I say that with the knowledge of watching my Dad

> suffer after getting his THR and I got the same line from his OS

> that you are getting now about a THR.

>

> God Bless

>

> Jeff (C2K 01-03-03)

January 20, 2004

I really hope that this talk about THR's not lasting as long as resurfacing

does not include the new MOM THR. I unfortunately had to have a revision of my

resurfacing after 15 months due to the development of AVN under the cap. I

went in for exploratory and came out with the Corin component large ball MOM.

My cup was in great shape and did not have to be replaced. At first I was not

happy. I really believed that loosing my resurf meant disaster for me. After

three weeks I am very encouraged. I have no more pain except a bit of

soreness, and my recovery time has been minimal. I still need to follow the 50%

weight rule for six weeks, but after that I can do what ever I feel I can do. My

surgeon told me that he believes that my THR will have as long a life as the

resurf. I looked at him in the eye and asked him if he was being totally

truthful or if he was trying to make me feel better and he again stated that

this

is what he believes. I know of several others on this list that have also had

revision to a THR and are very happy with the result. I believe all of these

revisions are the large headed component made by Corin or the C+. Please let us

not dismiss the possibility that this new large headed MOM THR may be a

winner and that it may be the best choice for some people. I will have to have

another surgery for my left hip and becasue of my experience will go right to

the THR. I put faith in my surgeon, Dr. Stachniw, and believe him about the

longevity of the device I have. This baby I have right now is going to last my

lifetime.......I just feel that it will.

Jan aka Wannie

> RE: SROM-THR lasts a life time

>

> FAO D Dailey ddailey@...

>

> It would appear that you accept that a novel technique by this surgeon will

> have the performance he expects/envisages, yet you find it difficult to trust

> the data/performance of the resurfacing intervention that has been going on

> in its present guise since 1991 and has a superb record so far (even

> excluding all interventions carried out in the last 12 months, the stats for

the tens

> of thousands of cases are overwhelmingly successful and positive with

> revision rates well under 3%, according to my layman´s research). So, if you

feel

> there is not enough data/history to make a value judgment on resurfacing - a

> somewhat fair point - how can you judge this novel technique (of which, I

> admit, I know nothing).

>

> I would advise you to do more research - it is in your interest. It is true

> that some of the original THR interventions lasted up to four decades.

> However, it is equally true that the shelf-life of THRs has been steadily

coming

> down since. It is now in the 8 - 12 years range. This phenomenon has yet to

> be adequately explained as the materials and the techniques have improved so

> dramatically in the meanwhile that one would expect the opposite result (two

> somewhat convincing arguments have been put forward by the medical

> profession: one, that lifestyles have changed so dramatically in the last 40

years or

> so that the average age THR patient now exerts much more motion/wear &

> tear/demands on the THR device than before thus leading to earlier loosening

of the

> device; and two, that average weight of patients has increased dramatically

> thus exercising much more pressure on the device and femur with the same

> earlier loosening effect).

>

> I must confess, I have not heard of a life-time or 35-40 year life span for

> THR these days. But don´t let my ignorance be a factor - try to find out

> more. Especially as you appear to have longevity in your family. For me the

> decision was easy to make as it was based on logic which can´t be faulted: if

> my resurfacing were to fail early and I am forced to have a revision, I will

en

> d up where I would have been in the first place - with a THR. So,

> resurfacing appears to introduce an additional operation/trauma with

consequent

> scarring at worst. That, in my mind, is a risk worth taking.

>

> I wish you the best of luck.

>

January 21, 2004

Hi Jan

Hope you're making progress with your research - I know how stressful

it is when you're aware of the impact this decision has on what your

life will be like.

One point you should bear in mind when comparing THR and resurf is

that even if the 2 devices last for the same number of years,there

are significant differences when it comes to revision. At least with

a resurf your bone is conserved.

Good luck!

Kathy

> I really hope that this talk about THR's not lasting as long as

resurfacing

> does not include the new MOM THR. I unfortunately had to have a

revision of my

> resurfacing after 15 months due to the development of AVN under the

cap. I

> went in for exploratory and came out with the Corin component large

ball MOM.

> My cup was in great shape and did not have to be replaced. At first

I was not

> happy. I really believed that loosing my resurf meant disaster for

me. After

> three weeks I am very encouraged. I have no more pain except a bit

of

> soreness, and my recovery time has been minimal. I still need to

follow the 50%

> weight rule for six weeks, but after that I can do what ever I feel

I can do. My

> surgeon told me that he believes that my THR will have as long a

life as the

> resurf. I looked at him in the eye and asked him if he was being

totally

> truthful or if he was trying to make me feel better and he again

stated that this

> is what he believes. I know of several others on this list that

have also had

> revision to a THR and are very happy with the result. I believe all

of these

> revisions are the large headed component made by Corin or the C+.

Please let us

> not dismiss the possibility that this new large headed MOM THR may

be a

> winner and that it may be the best choice for some people. I will

have to have

> another surgery for my left hip and becasue of my experience will

go right to

> the THR. I put faith in my surgeon, Dr. Stachniw, and believe him

about the

> longevity of the device I have. This baby I have right now is going

to last my

> lifetime.......I just feel that it will.

>

> Jan aka Wannie

>

> > RE: SROM-THR lasts a life time

> >

> > FAO D Dailey ddailey@e...

> >

> > It would appear that you accept that a novel technique by this

surgeon will

> > have the performance he expects/envisages, yet you find it

difficult to trust

> > the data/performance of the resurfacing intervention that has

been going on

> > in its present guise since 1991 and has a superb record so far

(even

> > excluding all interventions carried out in the last 12 months,

the stats for the tens

> > of thousands of cases are overwhelmingly successful and positive

with

> > revision rates well under 3%, according to my layman´s

research). So, if you feel

> > there is not enough data/history to make a value judgment on

resurfacing - a

> > somewhat fair point - how can you judge this novel technique (of

which, I

> > admit, I know nothing).

> >

> > I would advise you to do more research - it is in your interest.

It is true

> > that some of the original THR interventions lasted up to four

decades.

> > However, it is equally true that the shelf-life of THRs has been

steadily coming

> > down since. It is now in the 8 - 12 years range. This

phenomenon has yet to

> > be adequately explained as the materials and the techniques have

improved so

> > dramatically in the meanwhile that one would expect the opposite

result (two

> > somewhat convincing arguments have been put forward by the

medical

> > profession: one, that lifestyles have changed so dramatically in

the last 40 years or

> > so that the average age THR patient now exerts much more

motion/wear &

> > tear/demands on the THR device than before thus leading to

earlier loosening of the

> > device; and two, that average weight of patients has increased

dramatically

> > thus exercising much more pressure on the device and femur with

the same

> > earlier loosening effect).

> >

> > I must confess, I have not heard of a life-time or 35-40 year

life span for

> > THR these days. But don´t let my ignorance be a factor - try to

find out

> > more. Especially as you appear to have longevity in your

family. For me the

> > decision was easy to make as it was based on logic which can´t be

faulted: if

> > my resurfacing were to fail early and I am forced to have a

revision, I will en

> > d up where I would have been in the first place - with a THR.

So,

> > resurfacing appears to introduce an additional operation/trauma

with consequent

> > scarring at worst. That, in my mind, is a risk worth taking.

> >

> > I wish you the best of luck.

> >

>

January 21, 2004

I think it is a good idea to believe that nothing lasts a lifetime. What

better proof then our own darn hip/s that gave out with OA or AVN or other

problems? Even we, mortal beings, have a lifespan that runs it's course

when destiny says it must. THAT said, let's all be hopeful that our

respective devices (ahem, now that we are a tad older) might perhaps last as

long as our own personal end. I say this with optimism, not grimness.

While I have a resurf, I was just a breath away from a large head MOM. I

have to say I honestly didn't care. While the resurf was my first choice,

the THR large head was my second. What was the most important issue?

That I get something wonderful and extraordinary that was going to give me

back quality of life. I totally put my trust in G-d and a excellent

surgeon and I promised to do my part with exercising, following the

precautions and helping my body heal. I repeat again....getting back

quality of life is primary.

No one can predict the exact future whether it's the stock market or the

weather. When it comes to body part implants all one can do is select what

seems to be the best part as well as an excellent surgeon. Sometimes

" things happen " and we don't know until we get there. I would still choose

resurf first, but other choices are great too. However, logic and research

tells me that resurf makes the best sense, with large ball MOM available if

resurf isn't a possibility.

Lois

C+ 3/27/03 Dr. Mont

RE: SROM-THR lasts a life time

I really hope that this talk about THR's not lasting as long as resurfacing

does not include the new MOM THR. I unfortunately had to have a revision of

my

resurfacing after 15 months due to the development of AVN under the cap. I

went in for exploratory and came out with the Corin component large ball

MOM.

My cup was in great shape and did not have to be replaced. At first I was

not

happy. I really believed that loosing my resurf meant disaster for me.

After

three weeks I am very encouraged. I have no more pain except a bit of

soreness, and my recovery time has been minimal. I still need to follow the

50%

weight rule for six weeks, but after that I can do what ever I feel I can

do. My

surgeon told me that he believes that my THR will have as long a life as the

resurf. I looked at him in the eye and asked him if he was being totally

truthful or if he was trying to make me feel better and he again stated that

this

is what he believes. I know of several others on this list that have also

had

revision to a THR and are very happy with the result. I believe all of these

revisions are the large headed component made by Corin or the C+. Please

let us

not dismiss the possibility that this new large headed MOM THR may be a

winner and that it may be the best choice for some people. I will have to

have

another surgery for my left hip and becasue of my experience will go right

to

the THR. I put faith in my surgeon, Dr. Stachniw, and believe him about the

longevity of the device I have. This baby I have right now is going to last

my

lifetime.......I just feel that it will.

Jan aka Wannie

> RE: SROM-THR lasts a life time

>

> FAO D Dailey ddailey@...

>

> It would appear that you accept that a novel technique by this surgeon

will

> have the performance he expects/envisages, yet you find it difficult to

trust

> the data/performance of the resurfacing intervention that has been going

on

> in its present guise since 1991 and has a superb record so far (even

> excluding all interventions carried out in the last 12 months, the stats

for the tens

> of thousands of cases are overwhelmingly successful and positive with

> revision rates well under 3%, according to my layman´s research). So, if

you feel

> there is not enough data/history to make a value judgment on resurfacing -

a

> somewhat fair point - how can you judge this novel technique (of which, I

> admit, I know nothing).

>

> I would advise you to do more research - it is in your interest. It is

true

> that some of the original THR interventions lasted up to four decades.

> However, it is equally true that the shelf-life of THRs has been steadily

coming

> down since. It is now in the 8 - 12 years range. This phenomenon has yet

to

> be adequately explained as the materials and the techniques have improved

so

> dramatically in the meanwhile that one would expect the opposite result

(two

> somewhat convincing arguments have been put forward by the medical

> profession: one, that lifestyles have changed so dramatically in the last

40 years or

> so that the average age THR patient now exerts much more motion/wear &

> tear/demands on the THR device than before thus leading to earlier

loosening of the

> device; and two, that average weight of patients has increased

dramatically

> thus exercising much more pressure on the device and femur with the same

> earlier loosening effect).

>

> I must confess, I have not heard of a life-time or 35-40 year life span

for

> THR these days. But don´t let my ignorance be a factor - try to find out

> more. Especially as you appear to have longevity in your family. For me

the

> decision was easy to make as it was based on logic which can´t be faulted:

if

> my resurfacing were to fail early and I am forced to have a revision, I

will en

> d up where I would have been in the first place - with a THR. So,

> resurfacing appears to introduce an additional operation/trauma with

consequent

> scarring at worst. That, in my mind, is a risk worth taking.

>

> I wish you the best of luck.

>

January 21, 2004

Happeehip,

There are some things you need to bear in mind:

1) How long a hip lasts depends on a lot of factors, not the least

of which is how much you do with it. We have triathletes, runners,

climbers, martial artists, etc. here. If your idea of vigorous

activity is actually getting up out of your chair to change channels

rather than using the remote, then pretty much *any* hip will last

a long time. Ask your doc about post-recovery activity restrictions.

I really doubt if he'll tell you it's okay to ski moguls. ;-)

To my knowledge, no resurfacing has *ever* " worn out " . They've

failed for other reasons (although still at a much lower rate than

THRs), but they've never worn out. Go to the Midland web site (the

folks who make the BHR). Look at 's case study. He won

the World Championship in Judo in his age division five years

after a resurfacing. He's still competing at a world-class level

(9 years post-op). Ask your doc how many SROM patients are world-class

athletes 9 years after a THR. Ask for their *names*.

2) While it's certainly true that BFH (that's big FEMORAL head) metal-on-

metal THRs have many of the advantages of resurfacing (low wear, more

natural range of motion), the SROM-THR is not such a device. It is

a modular metal-on-plastic or ceramic-on-plastic (depending on which

head you select) device. The largest head size available for the SROM

is 32mm. BFH and resurfacing typically run about 50mm, and they're

available in sizes even larger than that. The larger head provides

two major advantages:

a) better range of motion

Reduced risk of dislocation. The clinical data available suggests

that resurfacings and BFH MoM THRs are 50 to 100 *times* less

likely to dislocate than a metal-on-poly THR

The metal-on-metal articulation in both these devices produces much

less wear, and hence less debris, than a conventional metal on polyethylene

articulation. One of the major causes of failure in conventional

(metal-on-plastic) THRs is osteolysis - a loss of bone around the

implant due to inflammation caused by (plastic) debris.

To my knowledge, there's never been a reported case of

debris-induced osteolysis in a resurfacing or BFH MoM patient.

3) According to the manufacturer's website, the SROM has been on the market

for 10 years and has been implanted in 15,000 patients. That's actually

roughly the same as the BHR. Based on that, I don't think it's

reasonable for *anyone* to claim that the SROM will " last a lifetime " .

I'm sure it's a fine product, but there's just no basis for such

a claim. If you want comparative data for resurfacing and THR, you

might want to check out the Swedish Hip Register data for implant

survival in patients under age 55. It's a real eye-opener.

4) If you have a resurfacing and it fails (unlikely, but it happens), you

can *always* get a *primary* (as opposed to a *revision*) THR. Primary

THRs have a higher success rate than revisions. If all the resurf does

is save you a revision later in life, you will still have done yourself

an enormous favor.

THRs, on the other hand, cannot be revised to resurfacings.

Once they've cut the head off your femur, it's *gone* and there's no

going back.

5) All THRs (even BFH MoM) suffer from a problem called " proximal stress

shielding " . This causes bone at the top of (what's left of) your femur

to atrophy and weaken, which contributes to loosening of the stem.

This is caused by the way load is transferred in a THR (down the

metal stem into the center of the femur) versus a natural or resurfaced

hip (compression on the outside of the bone), and your body's natural

response to this (which is to strengthen bone that's subject to load

and to weaken bone that isn't).

6) Recovery from a resurf is typically 2 to 3 times faster than a THR

Resurfacing is not without its risks: you need good bone quality and it's

possible that the procedure may damage the head of the femur in ways that

will cause the implant to loosen. A couple of people here have had this

happen, but the incidence of these problems has declined dramatically as

surgeons have become more experienced. The incidence of resurfacing failures

is *lower* than the incidence of THR failures - and when such failures

occur they can be revised to a primary THR.

It's your hip, and it's your decision. You owe it to yourself to research

this carefully, because you'll be stuck with the consequences for the

rest of your life. If I were you (and I'm not, of course), I'd find out if

I was a candidate for a resurfacing before I committed to a THR. If not,

I'd see if I could get a BFH MoM THR.

Just my 2 cents worth.

Steve

January 21, 2004

>

>5) All THRs (even BFH MoM) suffer from a problem called " proximal stress

> shielding " . This causes bone at the top of (what's left of) your femur

> to atrophy and weaken, which contributes to loosening of the stem.

> This is caused by the way load is transferred in a THR (down the

> metal stem into the center of the femur) versus a natural or resurfaced

> hip (compression on the outside of the bone), and your body's natural

> response to this (which is to strengthen bone that's subject to load

> and to weaken bone that isn't).

>

January 21, 2004

>5) All THRs (even BFH MoM) suffer from a problem called " proximal stress

> shielding " . This causes bone at the top of (what's left of) your femur

> to atrophy and weaken, which contributes to loosening of the stem.

> This is caused by the way load is transferred in a THR (down the

> metal stem into the center of the femur) versus a natural or resurfaced

> hip (compression on the outside of the bone), and your body's natural

> response to this (which is to strengthen bone that's subject to load

> and to weaken bone that isn't).

My $.02 here: Pre-op I could not move for a couple of years and had marked

loss of bone in the hip and thigh (no or weird loading = bone loss). At the

2 year mark I had a bone density scan and even though part of the hip was

obscured by the implant, I had actually increased my bone density

significantly ( meaning I was back in line with a normal thigh, rather than

falling out the bottom of the normal range). Some years back I had much

thicker thigh bones than most folks because I did long distance running.

The unoperated side still has much thicker bone than the operated side. I'm

just happy that my risk of fracture is more in line with the general

population now.

--> No I did not take Fossamex (sp?) just calcium supplements and I make it

a point of walking 2 miles a day during the week (1 mile each way to and

from work). I am otherwise quite active too, so your mileage may vary.

Bottom line, yes you should take Steve's claim quoted above seriously!

-- Jeff

rBHR Aug. 1, 2001

Mr. McMinn

==================

" Rudeness is the weak man's imitation of strength. "

-- Hoffer, The True Believer: Thoughts on the Nature of Mass

Movements

January 21, 2004

Steve:

Excellent summary!

>

> Happeehip,

>

> There are some things you need to bear in mind:

>

> 1) How long a hip lasts depends on a lot of factors, not the least

> of which is how much you do with it. We have triathletes, runners,

> climbers, martial artists, etc. here. If your idea of vigorous

> activity is actually getting up out of your chair to change channels

> rather than using the remote, then pretty much *any* hip will last

> a long time. Ask your doc about post-recovery activity restrictions.

> I really doubt if he'll tell you it's okay to ski moguls. ;-)

> To my knowledge, no resurfacing has *ever* " worn out " . They've

> failed for other reasons (although still at a much lower rate than

> THRs), but they've never worn out. Go to the Midland web site (the

> folks who make the BHR). Look at 's case study. He won

> the World Championship in Judo in his age division five years

> after a resurfacing. He's still competing at a world-class level

> (9 years post-op). Ask your doc how many SROM patients are

world-class

> athletes 9 years after a THR. Ask for their *names*.

>

> 2) While it's certainly true that BFH (that's big FEMORAL head)

metal-on-

> metal THRs have many of the advantages of resurfacing (low wear, more

> natural range of motion), the SROM-THR is not such a device. It is

> a modular metal-on-plastic or ceramic-on-plastic (depending on which

> head you select) device. The largest head size available for the SROM

> is 32mm. BFH and resurfacing typically run about 50mm, and they're

> available in sizes even larger than that. The larger head provides

> two major advantages:

>

> a) better range of motion

> Reduced risk of dislocation. The clinical data available suggests

> that resurfacings and BFH MoM THRs are 50 to 100 *times* less

> likely to dislocate than a metal-on-poly THR

>

> The metal-on-metal articulation in both these devices produces much

> less wear, and hence less debris, than a conventional metal on

polyethylene

> articulation. One of the major causes of failure in conventional

> (metal-on-plastic) THRs is osteolysis - a loss of bone around the

> implant due to inflammation caused by (plastic) debris.

> To my knowledge, there's never been a reported case of

> debris-induced osteolysis in a resurfacing or BFH MoM patient.

>

> 3) According to the manufacturer's website, the SROM has been on the

market

> for 10 years and has been implanted in 15,000 patients. That's

actually

> roughly the same as the BHR. Based on that, I don't think it's

> reasonable for *anyone* to claim that the SROM will " last a

lifetime " .

> I'm sure it's a fine product, but there's just no basis for such

> a claim. If you want comparative data for resurfacing and THR, you

> might want to check out the Swedish Hip Register data for implant

> survival in patients under age 55. It's a real eye-opener.

>

> 4) If you have a resurfacing and it fails (unlikely, but it

happens), you

> can *always* get a *primary* (as opposed to a *revision*) THR.

Primary

> THRs have a higher success rate than revisions. If all the resurf

does

> is save you a revision later in life, you will still have done

yourself

> an enormous favor.

>

> THRs, on the other hand, cannot be revised to resurfacings.

> Once they've cut the head off your femur, it's *gone* and there's no

> going back.

>

> 5) All THRs (even BFH MoM) suffer from a problem called " proximal stress

> shielding " . This causes bone at the top of (what's left of) your

femur

> to atrophy and weaken, which contributes to loosening of the stem.

> This is caused by the way load is transferred in a THR (down the

> metal stem into the center of the femur) versus a natural or

resurfaced

> hip (compression on the outside of the bone), and your body's natural

> response to this (which is to strengthen bone that's subject to load

> and to weaken bone that isn't).

>

> 6) Recovery from a resurf is typically 2 to 3 times faster than a THR

>

> Resurfacing is not without its risks: you need good bone quality and

it's

> possible that the procedure may damage the head of the femur in ways

that

> will cause the implant to loosen. A couple of people here have had this

> happen, but the incidence of these problems has declined dramatically as

> surgeons have become more experienced. The incidence of resurfacing

failures

> is *lower* than the incidence of THR failures - and when such failures

> occur they can be revised to a primary THR.

>

> It's your hip, and it's your decision. You owe it to yourself to

research

> this carefully, because you'll be stuck with the consequences for the

> rest of your life. If I were you (and I'm not, of course), I'd find

out if

> I was a candidate for a resurfacing before I committed to a THR. If not,

> I'd see if I could get a BFH MoM THR.

>

> Just my 2 cents worth.

>

> Steve

January 22, 2004

hi-

----------------------------------------------------------------------------

steve,

wonderful overview of the hip resurf rationale, in one page

you touch on it all.....it should be a flyer to send all new people

who have managed to stumble across this goldmine of a

message board.

---------------------------------------------------------------------------

happeehip-

trust me, you'll really be a happy-hip after you get your " new " hip.

i think it's important for you to realize that YOU are in the driver's seat

on this issue. you have the benefit of the fact that your hip condition

is not an emergency......it's just that it is necessary, and is on the

horizon. this means that you have the luxury of some time to investigate

all your options.....as you are obviously doing.

i'm sure that your doctor's favorable demeanor is comforting to you as

you have probably been dealing with the way that your hip is affecting

your life. my advice is simply " don't sell yourself short " because you

allowed yourself to be easily led by the words of any guy with " Dr. " in

front of his name.

scrutinize and compare, you have nothing to lose and much to gain.

there is a whole lot of information here, and it's all free and at your

fingertips.

i'm sure you wouldn't buy the first car that the first salesman showed to you.

and, if it's the wrong car, you can't just trade it in for a new one.

bedside manner doesn't have anything to do with experience, skill and

intelligence......but those things have alot to do with a succesful surgery.

happy shopping,

jeff

lbhr desmet (65 days ago and giggling about it)

Re: SROM-THR lasts a life time