Re: Resurface or Metal-on-Metal THR

[Guest guest]

Hi Noah,

It was very nice of Dr. Inglis to take time to discuss resurfacing

and MoM THRs with you, but I question some of his claims.

DR. INGLIS: " There is absolutely no way to get a resurfacing done

NOW in the US. The reason being that there are no studies under way

presently and it is actually illegal for any surgeon to perform a

resurfacing unless part of an approved study. "

COMMENT: I'm pretty sure Dr. Inglis is wrong about this. Perhaps

other surfacehippies can correct me if I'm wrong, but as I understand

the current situation, several--if not all--of the OSs that

participated in the FDA clinical trials of the Medical

Conserve Plus and Corin Cormet 2000 devices have been

granted " continued access " to the devices.

DR. INGLIS: " . . . the main reason to go to a resurfacing type of

hip is for people who are concerned with maintianing very large range

of hip rotation. So, yogis, dancers and martial arts people would

need this but people only interested in conventional team sports or

sports like tennis would have no reason to consider resurfacing. "

COMMENT: It seems to me that a large-diameter MoM THR might actually

offer a greater ROM than a resurfacing of equal dianeter because the

femoral implant of a THR has a narrower neck than does a human femur.

DR. INGLIS: " . . . a resurfaced hip would not be likely to last any

longer than a good THR for all types of conventional activities. "

COMMENT: That remains to be seen, of course, but let's say they're

equally durable. Then, why would anyone consider undergoing a THR

when a resurfacing allows a much less radical surgery when (and if)

the original implant fails? After all, the subsequent surgery if a

resurfacing goes bad is a THR, whereas it's a revised THR after a

failed THR.

DR. INGLIS: " . . . the THR [is] a better choice because the

operation is less brutal and the recovery times are shorter. "

COMMENT: This is a very strange assertion. I don't understand how a

THR--which cuts away so much more of the femur than does resurfacing--

can be considered less brutal and easier to recover from than a

resurfacing.

In summary, I think much of what Dr. Inglis told you is simply his

opinion, and I'd be very surprised if the claims I've challenged

above are actually true. Anyway, you need facts--not opinions--to

help you decide which option is best for you. Before you commit to a

THR, I think you should review the information available in the

SurfaceHippy " Archives " and via the " Links " section of SurfaceHippy

to help you learn more about the pros and cons of resurfacing.

Good Luck,

Jim V.S.

LBHR, De Smet, 11/25/03

> Hello Surface Hippies

>

> I was considering a resurfacing for my badly degenerated hip. I am

48

> years old and have been living with a hip that was operable when I

> was 35. Ruined myself through overindulgence in sports. Anyway, I

put

> this off to wait for improvements in the technology. I really can't

> put it off any longer for reasons that I am sure you are all well

> aware of. Hip resurfacing appealed to my engineer's sensibilities.

> Got the book by Peggy and I am most of the way through it.

I

> noticed in the back of the book that Dr. Alan Inglis was listed as

> one of the Cormet 2000 surgeons and that he is in NYC which is

close

> to where I work. I gave Alan a call and left a message. He called

me

> back the next day talked to me for 15 minutes - he was very

generous

> with his time and advice. Dr. Inglis made the following points to

me:

>

> 1)There is absolutely no way to get a resurfacing done NOW in the

US.

> The reason being that there are no studies under way presently and

it

> is actually illegal for any surgeon to perform a resurfacing unless

> part of an approved study. I think he said that he might be doing

> another study later this year.

>

> 2)Dr. Inglis completed his Cormet 2000 study a couple of years ago

> and said that he had complete success with all 28 patients with no

> complications to date. However, when I asked whether I should

> consider waiting for another study (which would not be covered by

any

> type of insurance), wait for FDA approval (with means insurance

> coverage) or go to Europe, I got a surprising answer. He said that

> there was no point and that I would be better off with a THR using

> the new metal on metal implants.

>

> 3)Dr. Inglis said that the main reason to go to a resurfacing type

of

> hip is for people who are concerned with maintianing very large

range

> of hip rotation. So, yogis, dancers and martial arts people would

> need this but people only interested in conventional team sports or

> sports like tennis would have no reason to consider resurfacing.

> Dr.Inflis was of the opinion that a resurfaced hip would not be

> likely to last any longer than a good THR for all types of

> conventional activities.

>

> 4)Dr. Inglis also said that the THR was a better choice because the

> operation is less brutal and the recovery times are shorter.

>

> So, my thanks to Dr. Inglis for taking time to answer my questions

so

> frankly. I have to say that he definitely caused me to point back

to

> a THR even though I have been spending the last 13 years trying to

> avoid one. There are a number of very good surgeons in the NYC area

> that use the latest in metal on metal THRs and one is even in-

network

> for my insurance. I would like to hear opinions from this group

that

> would either support or challenge what I have just heard. This is

> really a tough thing to decide. Thanks for your support.

>

> Noah