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In a message dated 10/5/2003 12:22:40 PM Pacific Daylight Time,

glenchris@... writes:

I would greatly appreciate any information explaining exactly

what cysts on the femoral head are; and, what are the

implications of this condition.

Hi Glen:

As the former owner of an acetabular cyst, I am guessing that the question of

which side of the joint it is on is less critical to answering your question

than is the general explanation.

As I understand it, a cyst is basically a growth that occurs on a joint

surface initially, that burrows into the healthy bone beneath. It happens when

the

normal surface (cartilage) is worn away.

The main problem is that the cyst replaces healthy bone, so that when you

have to attach a prosthesis, there is less healthy bone to attach it to. If the

cyst is smallish, it can be dug out and patched during resurfacing surgery, as

I believe mine was. If it is too big for a successful patch job, then the

surface will not accept the resurfacing prosthesis and you're looking at a THR

because too much digging is needed to clear it out.

This, I understand, is why one can't wait too long for surgery. These cysts

can grow quite rapidly in a bad joint. I apparently made it through the window

for a resurf by about 2 or 3 months for the first one, and made damn sure I

was early on the second.

Hope this helps.

Des Tuck

Bilateral BHR 10/01 and 5/03

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In a message dated 10/5/2003 12:22:40 PM Pacific Daylight Time,

glenchris@... writes:

I would greatly appreciate any information explaining exactly

what cysts on the femoral head are; and, what are the

implications of this condition.

Hi Glen:

As the former owner of an acetabular cyst, I am guessing that the question of

which side of the joint it is on is less critical to answering your question

than is the general explanation.

As I understand it, a cyst is basically a growth that occurs on a joint

surface initially, that burrows into the healthy bone beneath. It happens when

the

normal surface (cartilage) is worn away.

The main problem is that the cyst replaces healthy bone, so that when you

have to attach a prosthesis, there is less healthy bone to attach it to. If the

cyst is smallish, it can be dug out and patched during resurfacing surgery, as

I believe mine was. If it is too big for a successful patch job, then the

surface will not accept the resurfacing prosthesis and you're looking at a THR

because too much digging is needed to clear it out.

This, I understand, is why one can't wait too long for surgery. These cysts

can grow quite rapidly in a bad joint. I apparently made it through the window

for a resurf by about 2 or 3 months for the first one, and made damn sure I

was early on the second.

Hope this helps.

Des Tuck

Bilateral BHR 10/01 and 5/03

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Thank you Des, this helps a lot.

Glen, L.A.

RH-OA/AVN4 Pre-op

> From: destuck@...

> Reply-To: surfacehippy

> Date: Sun, 5 Oct 2003 15:55:48 EDT

> To: surfacehippy

> Subject: Re: Femoral Head Cysts

>

> In a message dated 10/5/2003 12:22:40 PM Pacific Daylight Time,

> glenchris@... writes:

> I would greatly appreciate any information explaining exactly

> what cysts on the femoral head are; and, what are the

> implications of this condition.

> Hi Glen:

>

> As the former owner of an acetabular cyst, I am guessing that the question of

> which side of the joint it is on is less critical to answering your question

> than is the general explanation.

>

> As I understand it, a cyst is basically a growth that occurs on a joint

> surface initially, that burrows into the healthy bone beneath. It happens when

> the

> normal surface (cartilage) is worn away.

>

> The main problem is that the cyst replaces healthy bone, so that when you

> have to attach a prosthesis, there is less healthy bone to attach it to. If

> the

> cyst is smallish, it can be dug out and patched during resurfacing surgery, as

> I believe mine was. If it is too big for a successful patch job, then the

> surface will not accept the resurfacing prosthesis and you're looking at a THR

> because too much digging is needed to clear it out.

>

> This, I understand, is why one can't wait too long for surgery. These cysts

> can grow quite rapidly in a bad joint. I apparently made it through the window

> for a resurf by about 2 or 3 months for the first one, and made damn sure I

> was early on the second.

>

> Hope this helps.

>

> Des Tuck

> Bilateral BHR 10/01 and 5/03

>

>

>

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In a message dated 10/5/2003 4:28:31 PM Pacific Daylight Time,

clatta@... writes:

> have a question on these cysts. I'm scheduled with DeSmet 10-22 hopefully

> to get a BHR. At first he turned me down, but because of the position of

> the cyst he then agreed to do the surgery if I stayed at least three weeks

> after surgery. I sent an xray, he thought it looked like 1/2 of the head of

> the femur was involved. How big were your cysts that didn't stop you from

> getting the resurface? Do I really need to get prepared to wake up with a

> THR? Ekkk, I'm praying for the chance at a Resurface!

>

Dear Carol:

I'm afraid I really can't add much to what I said before. Not being a doctor,

I really can't describe how big my cyst on the acetabular side was or what

the " cut-off " size might be. You really have to rely on your surgeon here.

Best of luck

Des Tuck

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The femoral head isn't the only site where cyst formation can complicate

issues. The fracture of the femoral neck that started my hip problems had

cyst formation by the time I finally went for hip x-rays. (The injury was

masked by an old back problem.) In my case, I apparently would have had to

have the neck of femur cut away, in any case, but not only because of the

cyst. It worked out okay in the end. I had to have the THR " stem " , but had

the BHR acetabular cup and a Birmingham *complete* metal " head " . Sure, I

have a stem going down into the shaft of my femur, and this is not ideal,

but I'd have had to have this, anyway. The huge bonus is having the BHR

components at the ball and socket joint.

Virginia (right hip, 27/08/03)

>From: destuck@...

>Reply-To: surfacehippy

>To: surfacehippy

>Subject: Re: Femoral Head Cysts

>Date: Sun, 5 Oct 2003 15:55:48 EDT

>

>In a message dated 10/5/2003 12:22:40 PM Pacific Daylight Time,

>glenchris@... writes:

>I would greatly appreciate any information explaining exactly

>what cysts on the femoral head are; and, what are the

>implications of this condition.

>Hi Glen:

>

>As the former owner of an acetabular cyst, I am guessing that the question

>of

>which side of the joint it is on is less critical to answering your

>question

>than is the general explanation.

>

>As I understand it, a cyst is basically a growth that occurs on a joint

>surface initially, that burrows into the healthy bone beneath. It happens

>when the

>normal surface (cartilage) is worn away.

>

>The main problem is that the cyst replaces healthy bone, so that when you

>have to attach a prosthesis, there is less healthy bone to attach it to. If

>the

>cyst is smallish, it can be dug out and patched during resurfacing surgery,

>as

>I believe mine was. If it is too big for a successful patch job, then the

>surface will not accept the resurfacing prosthesis and you're looking at a

>THR

>because too much digging is needed to clear it out.

>

>This, I understand, is why one can't wait too long for surgery. These cysts

>can grow quite rapidly in a bad joint. I apparently made it through the

>window

>for a resurf by about 2 or 3 months for the first one, and made damn sure I

>was early on the second.

>

>Hope this helps.

>

>Des Tuck

>Bilateral BHR 10/01 and 5/03

>

>

>

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The femoral head isn't the only site where cyst formation can complicate

issues. The fracture of the femoral neck that started my hip problems had

cyst formation by the time I finally went for hip x-rays. (The injury was

masked by an old back problem.) In my case, I apparently would have had to

have the neck of femur cut away, in any case, but not only because of the

cyst. It worked out okay in the end. I had to have the THR " stem " , but had

the BHR acetabular cup and a Birmingham *complete* metal " head " . Sure, I

have a stem going down into the shaft of my femur, and this is not ideal,

but I'd have had to have this, anyway. The huge bonus is having the BHR

components at the ball and socket joint.

Virginia (right hip, 27/08/03)

>From: destuck@...

>Reply-To: surfacehippy

>To: surfacehippy

>Subject: Re: Femoral Head Cysts

>Date: Sun, 5 Oct 2003 15:55:48 EDT

>

>In a message dated 10/5/2003 12:22:40 PM Pacific Daylight Time,

>glenchris@... writes:

>I would greatly appreciate any information explaining exactly

>what cysts on the femoral head are; and, what are the

>implications of this condition.

>Hi Glen:

>

>As the former owner of an acetabular cyst, I am guessing that the question

>of

>which side of the joint it is on is less critical to answering your

>question

>than is the general explanation.

>

>As I understand it, a cyst is basically a growth that occurs on a joint

>surface initially, that burrows into the healthy bone beneath. It happens

>when the

>normal surface (cartilage) is worn away.

>

>The main problem is that the cyst replaces healthy bone, so that when you

>have to attach a prosthesis, there is less healthy bone to attach it to. If

>the

>cyst is smallish, it can be dug out and patched during resurfacing surgery,

>as

>I believe mine was. If it is too big for a successful patch job, then the

>surface will not accept the resurfacing prosthesis and you're looking at a

>THR

>because too much digging is needed to clear it out.

>

>This, I understand, is why one can't wait too long for surgery. These cysts

>can grow quite rapidly in a bad joint. I apparently made it through the

>window

>for a resurf by about 2 or 3 months for the first one, and made damn sure I

>was early on the second.

>

>Hope this helps.

>

>Des Tuck

>Bilateral BHR 10/01 and 5/03

>

>

>

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The femoral head isn't the only site where cyst formation can complicate

issues. The fracture of the femoral neck that started my hip problems had

cyst formation by the time I finally went for hip x-rays. (The injury was

masked by an old back problem.) In my case, I apparently would have had to

have the neck of femur cut away, in any case, but not only because of the

cyst. It worked out okay in the end. I had to have the THR " stem " , but had

the BHR acetabular cup and a Birmingham *complete* metal " head " . Sure, I

have a stem going down into the shaft of my femur, and this is not ideal,

but I'd have had to have this, anyway. The huge bonus is having the BHR

components at the ball and socket joint.

Virginia (right hip, 27/08/03)

>From: destuck@...

>Reply-To: surfacehippy

>To: surfacehippy

>Subject: Re: Femoral Head Cysts

>Date: Sun, 5 Oct 2003 15:55:48 EDT

>

>In a message dated 10/5/2003 12:22:40 PM Pacific Daylight Time,

>glenchris@... writes:

>I would greatly appreciate any information explaining exactly

>what cysts on the femoral head are; and, what are the

>implications of this condition.

>Hi Glen:

>

>As the former owner of an acetabular cyst, I am guessing that the question

>of

>which side of the joint it is on is less critical to answering your

>question

>than is the general explanation.

>

>As I understand it, a cyst is basically a growth that occurs on a joint

>surface initially, that burrows into the healthy bone beneath. It happens

>when the

>normal surface (cartilage) is worn away.

>

>The main problem is that the cyst replaces healthy bone, so that when you

>have to attach a prosthesis, there is less healthy bone to attach it to. If

>the

>cyst is smallish, it can be dug out and patched during resurfacing surgery,

>as

>I believe mine was. If it is too big for a successful patch job, then the

>surface will not accept the resurfacing prosthesis and you're looking at a

>THR

>because too much digging is needed to clear it out.

>

>This, I understand, is why one can't wait too long for surgery. These cysts

>can grow quite rapidly in a bad joint. I apparently made it through the

>window

>for a resurf by about 2 or 3 months for the first one, and made damn sure I

>was early on the second.

>

>Hope this helps.

>

>Des Tuck

>Bilateral BHR 10/01 and 5/03

>

>

>

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Des Tuck, and all,

I have a question on these cysts. I'm scheduled with DeSmet 10-22 hopefully

to get a BHR. At first he turned me down, but because of the position of

the cyst he then agreed to do the surgery if I stayed at least three weeks

after surgery. I sent an xray, he thought it looked like 1/2 of the head of

the femur was involved. How big were your cysts that didn't stop you from

getting the resurface? Do I really need to get prepared to wake up with a

THR? Ekkk, I'm praying for the chance at a Resurface!

Dr. Klapper told me that cysts are basically holes in the bone filled with

joint fluid. When you wear away the cartillage and expose the bone it

begins to erode. The " hydrolic " action is natures way of keeping you moving

longer, but with each step it is eroded more. They have to scrape down to

healthy bone. With other surgerys (like the jaw) they can then graft in new

bone that will grow once the hydrolic action stops. Grafting was to

dangerous according to DeSmet as you can't monitor it's progress and it

would always be a weak spot.

This topic is very near my heart right now! Thanks!

Carol in CA

Desmet BHR? 10-22-03

>

> Reply-To: surfacehippy

> Date: Mon, 06 Oct 2003 08:04:11 +1000

> To: surfacehippy

> Subject: Re: Femoral Head Cysts

>

> The femoral head isn't the only site where cyst formation can complicate

> issues. The fracture of the femoral neck that started my hip problems had

> cyst formation by the time I finally went for hip x-rays. (The injury was

> masked by an old back problem.) In my case, I apparently would have had to

> have the neck of femur cut away, in any case, but not only because of the

> cyst. It worked out okay in the end. I had to have the THR " stem " , but had

> the BHR acetabular cup and a Birmingham *complete* metal " head " . Sure, I

> have a stem going down into the shaft of my femur, and this is not ideal,

> but I'd have had to have this, anyway. The huge bonus is having the BHR

> components at the ball and socket joint.

> Virginia (right hip, 27/08/03)

>

>> From: destuck@...

>> Reply-To: surfacehippy

>> To: surfacehippy

>> Subject: Re: Femoral Head Cysts

>> Date: Sun, 5 Oct 2003 15:55:48 EDT

>>

>> In a message dated 10/5/2003 12:22:40 PM Pacific Daylight Time,

>> glenchris@... writes:

>> I would greatly appreciate any information explaining exactly

>> what cysts on the femoral head are; and, what are the

>> implications of this condition.

>> Hi Glen:

>>

>> As the former owner of an acetabular cyst, I am guessing that the question

>> of

>> which side of the joint it is on is less critical to answering your

>> question

>> than is the general explanation.

>>

>> As I understand it, a cyst is basically a growth that occurs on a joint

>> surface initially, that burrows into the healthy bone beneath. It happens

>> when the

>> normal surface (cartilage) is worn away.

>>

>> The main problem is that the cyst replaces healthy bone, so that when you

>> have to attach a prosthesis, there is less healthy bone to attach it to. If

>> the

>> cyst is smallish, it can be dug out and patched during resurfacing surgery,

>> as

>> I believe mine was. If it is too big for a successful patch job, then the

>> surface will not accept the resurfacing prosthesis and you're looking at a

>> THR

>> because too much digging is needed to clear it out.

>>

>> This, I understand, is why one can't wait too long for surgery. These cysts

>> can grow quite rapidly in a bad joint. I apparently made it through the

>> window

>> for a resurf by about 2 or 3 months for the first one, and made damn sure I

>> was early on the second.

>>

>> Hope this helps.

>>

>> Des Tuck

>> Bilateral BHR 10/01 and 5/03

>>

>>

>>

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Hi Carol,

I think so much of this has to do with just where the cyst is, the skill of

the surgeon and the risks you wish to take.......... Various areas of the

femoral head matter more and the neck bit is critical......... for that

appears to supply the blood to the head to keep that bone healthy..........

and thus viable.............. I have seen people go to one OS and be told

that they had a low chance of sucessful Resurface and another state a low

chance of needing a THR............. How many they have seen/done and how

they personally figure odds seems to matter a lot......... And I thought

DeSmet, from all written here, was one who did take on causes others found

lost.........and do these successfully..........

My OS had to chip a semblance of a femur head out of fused bones...........

When I look at the xrays closely the shape left going under the BHR cap does

seem quite different to my normal femoral head.........and the BHR cap sits

well down the neck........ this looks a bit different to pictures I have

seen of others on the web........ and may serve me well later when it comes

to osteoporosis........... I was told that there wasn't anything this guy

couldn't do with a hip joint and I guess I am walking proof of

that..........

May all go well and perhaps now just isn't the time to get yourself too

worried about all this...........

Edith LBHR Dr. L Walter Syd Aust 8/02

>

> I have a question on these cysts. I'm scheduled with DeSmet 10-22

hopefully

> to get a BHR. At first he turned me down, but because of the position of

> the cyst he then agreed to do the surgery if I stayed at least three weeks

> after surgery. I sent an xray, he thought it looked like 1/2 of the head

of

> the femur was involved. How big were your cysts that didn't stop you from

> getting the resurface? Do I really need to get prepared to wake up with a

> THR? Ekkk, I'm praying for the chance at a Resurface!

>

> Dr. Klapper told me that cysts are basically holes in the bone filled with

> joint fluid. When you wear away the cartillage and expose the bone it

> begins to erode. The " hydrolic " action is natures way of keeping you

moving

> longer, but with each step it is eroded more. They have to scrape down to

> healthy bone. With other surgerys (like the jaw) they can then graft in

new

> bone that will grow once the hydrolic action stops. Grafting was to

> dangerous according to DeSmet as you can't monitor it's progress and it

> would always be a weak spot.

>

> This topic is very near my heart right now! Thanks!

>

> Carol in CA

> Desmet BHR? 10-22-03

>

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Edith, you're so right. The reason I had to lose my fractured neck

of femur (and consequently the head with it) was because of lack of

blood supply through the femoral neck. I was told it was impossible

to plate and screw it, because of this.

Virginia (BRH on THR stem, 27/08/03)

> Hi Carol,

>

> I think so much of this has to do with just where the cyst is, the

skill of

> the surgeon and the risks you wish to take.......... Various

areas of the

> femoral head matter more and the neck bit is critical......... for

that

> appears to supply the blood to the head to keep that bone

healthy..........

> and thus viable.............. I have seen people go to one OS and

be told

> that they had a low chance of sucessful Resurface and another state

a low

> chance of needing a THR............. How many they have seen/done

and how

> they personally figure odds seems to matter a lot......... And I

thought

> DeSmet, from all written here, was one who did take on causes

others found

> lost.........and do these successfully..........

>

> My OS had to chip a semblance of a femur head out of fused

bones...........

> When I look at the xrays closely the shape left going under the BHR

cap does

> seem quite different to my normal femoral head.........and the BHR

cap sits

> well down the neck........ this looks a bit different to pictures I

have

> seen of others on the web........ and may serve me well later when

it comes

> to osteoporosis........... I was told that there wasn't anything

this guy

> couldn't do with a hip joint and I guess I am walking proof of

> that..........

>

> May all go well and perhaps now just isn't the time to get yourself

too

> worried about all this...........

>

> Edith LBHR Dr. L Walter Syd Aust 8/02

>

>

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Carol

I hope some details about my hip might make you more confident. I was

turned down by the first surgeon I approached due to cysts. About 1/4

of my femoral head (by volume) had apparently turned 'to jelly' and I

also had a couple of acetabular cysts. The largest femoral cyst was

directly in line with the 'pin' that holds the BHR component in

place. Mr Treacy resurfaced it in June 2002. I think his technique

differs somewhat from Dr de Smet. I had bone grafts in the cysts

which take around a year to fully harden. This also meant a v. long

recovery time. He estimated chance of failure as 5% in the first year

and thereafter 1% - the same as all his other patients. A few months

ago I had the all clear to 'forget about the hip', run, dance....

whatever I like.

So the very best of luck on the 22nd. I remember v. clearly how

painful those cysts were, and the amazing sensation the day after

surgery of the pain no longer being there.

Kathy

> Des Tuck, and all,

>

> I have a question on these cysts. I'm scheduled with DeSmet 10-22

hopefully

> to get a BHR. At first he turned me down, but because of the

position of

> the cyst he then agreed to do the surgery if I stayed at least

three weeks

> after surgery. I sent an xray, he thought it looked like 1/2 of

the head of

> the femur was involved. How big were your cysts that didn't stop

you from

> getting the resurface? Do I really need to get prepared to wake up

with a

> THR? Ekkk, I'm praying for the chance at a Resurface!

>

> Dr. Klapper told me that cysts are basically holes in the bone

filled with

> joint fluid. When you wear away the cartillage and expose the bone

it

> begins to erode. The " hydrolic " action is natures way of keeping

you moving

> longer, but with each step it is eroded more. They have to scrape

down to

> healthy bone. With other surgerys (like the jaw) they can then

graft in new

> bone that will grow once the hydrolic action stops. Grafting was to

> dangerous according to DeSmet as you can't monitor it's progress

and it

> would always be a weak spot.

>

> This topic is very near my heart right now! Thanks!

>

> Carol in CA

> Desmet BHR? 10-22-03

>

>

> > From: " Virginia Thorley "

> > Reply-To: surfacehippy

> > Date: Mon, 06 Oct 2003 08:04:11 +1000

> > To: surfacehippy

> > Subject: Re: Femoral Head Cysts

> >

> > The femoral head isn't the only site where cyst formation can

complicate

> > issues. The fracture of the femoral neck that started my hip

problems had

> > cyst formation by the time I finally went for hip x-rays. (The

injury was

> > masked by an old back problem.) In my case, I apparently would

have had to

> > have the neck of femur cut away, in any case, but not only

because of the

> > cyst. It worked out okay in the end. I had to have the

THR " stem " , but had

> > the BHR acetabular cup and a Birmingham *complete* metal " head " .

Sure, I

> > have a stem going down into the shaft of my femur, and this is

not ideal,

> > but I'd have had to have this, anyway. The huge bonus is having

the BHR

> > components at the ball and socket joint.

> > Virginia (right hip, 27/08/03)

> >

> >> From: destuck@a...

> >> Reply-To: surfacehippy

> >> To: surfacehippy

> >> Subject: Re: Femoral Head Cysts

> >> Date: Sun, 5 Oct 2003 15:55:48 EDT

> >>

> >> In a message dated 10/5/2003 12:22:40 PM Pacific Daylight Time,

> >> glenchris@e... writes:

> >> I would greatly appreciate any information explaining exactly

> >> what cysts on the femoral head are; and, what are the

> >> implications of this condition.

> >> Hi Glen:

> >>

> >> As the former owner of an acetabular cyst, I am guessing that

the question

> >> of

> >> which side of the joint it is on is less critical to answering

your

> >> question

> >> than is the general explanation.

> >>

> >> As I understand it, a cyst is basically a growth that occurs on

a joint

> >> surface initially, that burrows into the healthy bone beneath.

It happens

> >> when the

> >> normal surface (cartilage) is worn away.

> >>

> >> The main problem is that the cyst replaces healthy bone, so that

when you

> >> have to attach a prosthesis, there is less healthy bone to

attach it to. If

> >> the

> >> cyst is smallish, it can be dug out and patched during

resurfacing surgery,

> >> as

> >> I believe mine was. If it is too big for a successful patch job,

then the

> >> surface will not accept the resurfacing prosthesis and you're

looking at a

> >> THR

> >> because too much digging is needed to clear it out.

> >>

> >> This, I understand, is why one can't wait too long for surgery.

These cysts

> >> can grow quite rapidly in a bad joint. I apparently made it

through the

> >> window

> >> for a resurf by about 2 or 3 months for the first one, and made

damn sure I

> >> was early on the second.

> >>

> >> Hope this helps.

> >>

> >> Des Tuck

> >> Bilateral BHR 10/01 and 5/03

> >>

> >>

> >>

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