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Ten Questions - Anyone Returning to Skiing or Running?

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Posted
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Thank you to those of you who share your experiences. It has been

very informative as I am new to researching my recently diagnosed

condition.

History:

I recently turned forty, however, I feel much older. I have lived in

consistent pain for more than four years and often get discouraged

and depressed as I attempt to do things that are now physically

impossible or too painful. I am unaccustomed to these limitations.

I am a former Member of the US Ski Team, US National and NCAA

champion, member of World Cup Team and World Pro Tour. After

retirement from skiing and unaware of this condition, I got involved

in many sports recreationally, including cycling and running several

marathons, including Boston three times usually between 2:30 and

2:40. My athletic career was pretty mediocre as I did not achieve my

objective of becoming a world or Olympic champion and I was injured

on several occasions. I had five major reconstructive knee

operations while I was competing. Thanks to our team doctor who

consistently and effectively pieced me together I have not had any

significant reoccurring knee problems. I share this because I am

interested to know more about those who have returned to any

significant level of sport. I no longer have crazy ambitions to

compete at any real athletic level; however, I have two aspiring

little athletes seven and four who still believe their daddy is

superman. I am looking at doing something because I owe it to them

to remain as active as possible and seek the alternatives (the

ability to get my socks on in the morning may also be an added

benefit). I continue to ski, play hockey, soccer and teach my kids

many other sports, however, the pain and repercussions are unbearable.

Diagnosis:

I recently went to two well-known OS in Boston. They have done THRs

on some very famous people with a stated high success rate. I was

diagnosed with late stage bone on bone OA worse in the right hip

relative to the left. After looking into BHR and resurfacing, I was

very disappointed to find that they both spoke very negatively about

resurfacing when it seemed so intuitive to me to consider this

approach. I am unfamiliar with the medical vernacular, however, in

summary they both were adamantly opposed to the procedure. They

viewed it as a " romantic " alternative that has a poor track

record

and limited data to make any judgment relative to future success. It

was referred to as an unsubstantiated short-term alternative to the

inevitable THR. I was drawn diagrams showing how the thickness of

the covered joint was physiologically incompatible, limiting range of

motion and will create impingement and thus a higher incidence of

dislocation and/or fracture. I was also told about the fallacy of

bone stock retention and the argument was invalid due to the fact

that the head of the femur will fracture and the inside piece will

need to be further reamed in the soon and certain revision to THR. I

left feeling rejected at the overwhelming lack of enthusiasm for this

alternative approach. In my estimation, the best of the best in THR

seemed very myopic and uninterested in my quest for a better life.

That is when I moved on and found you.

Questions: (sorry for the delay in getting here)

1. What can be anticipated in the near term future (two years)

for alternatives to treat this condition? Is it worth waiting? How

do you decide?

2. Am I jeopardizing being a candidate for this procedure if I

remain active given my current state?

3. Are better materials being considered and when will they be

available?

4. Is anyone able to do this in a minimally invasive approach?

Is it possible?

5. Will I regain some range of motion? Currently it is dismal.

6. Is it possible to get back to some level of rigorous activity

and sport?

7. Are there data points to suggest that the results or

procedures are more effective in Europe compared to the US?

8. Are there any studies or is data available relative to the

effectiveness of this procedure generally? How long will it last?

9. Can a joint be resurfaced more that one time?

10. How long does recovery take?

Thank you for your time and potential response to my questions.

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Posted
Posted

Hi Aleks, very sorry to hear your story, but selfishly also glad to hear

that someone like you, superior athlete, got into this " mess. " I experienced

the same " landing " about 3 years ago, and thought that I was the only

athlete on earth, 35 years of age with this problem. All I can suggest is to

call Dr. Gross in Columbia, SC at Midlands Ortho. and present to him your

case...you can't lose anything, believe me. He " fixed " both of my hips back

in may of 2003, today I ran about 50 min at about 9 mph pace. Give him a try

+ he can give you all the answers as an expert. You can find them at

. Tell them Miren send you.

Good luck!

Miren

Ten Questions - Anyone Returning to Skiing or

Running?

Thank you to those of you who share your experiences. It has been

very informative as I am new to researching my recently diagnosed

condition.

History:

I recently turned forty, however, I feel much older. I have lived in

consistent pain for more than four years and often get discouraged

and depressed as I attempt to do things that are now physically

impossible or too painful. I am unaccustomed to these limitations.

I am a former Member of the US Ski Team, US National and NCAA

champion, member of World Cup Team and World Pro Tour. After

retirement from skiing and unaware of this condition, I got involved

in many sports recreationally, including cycling and running several

marathons, including Boston three times usually between 2:30 and

2:40. My athletic career was pretty mediocre as I did not achieve my

objective of becoming a world or Olympic champion and I was injured

on several occasions. I had five major reconstructive knee

operations while I was competing. Thanks to our team doctor who

consistently and effectively pieced me together I have not had any

significant reoccurring knee problems. I share this because I am

interested to know more about those who have returned to any

significant level of sport. I no longer have crazy ambitions to

compete at any real athletic level; however, I have two aspiring

little athletes seven and four who still believe their daddy is

superman. I am looking at doing something because I owe it to them

to remain as active as possible and seek the alternatives (the

ability to get my socks on in the morning may also be an added

benefit). I continue to ski, play hockey, soccer and teach my kids

many other sports, however, the pain and repercussions are unbearable.

Diagnosis:

I recently went to two well-known OS in Boston. They have done THRs

on some very famous people with a stated high success rate. I was

diagnosed with late stage bone on bone OA worse in the right hip

relative to the left. After looking into BHR and resurfacing, I was

very disappointed to find that they both spoke very negatively about

resurfacing when it seemed so intuitive to me to consider this

approach. I am unfamiliar with the medical vernacular, however, in

summary they both were adamantly opposed to the procedure. They

viewed it as a " romantic " alternative that has a poor track

record

and limited data to make any judgment relative to future success. It

was referred to as an unsubstantiated short-term alternative to the

inevitable THR. I was drawn diagrams showing how the thickness of

the covered joint was physiologically incompatible, limiting range of

motion and will create impingement and thus a higher incidence of

dislocation and/or fracture. I was also told about the fallacy of

bone stock retention and the argument was invalid due to the fact

that the head of the femur will fracture and the inside piece will

need to be further reamed in the soon and certain revision to THR. I

left feeling rejected at the overwhelming lack of enthusiasm for this

alternative approach. In my estimation, the best of the best in THR

seemed very myopic and uninterested in my quest for a better life.

That is when I moved on and found you.

Questions: (sorry for the delay in getting here)

1. What can be anticipated in the near term future (two years)

for alternatives to treat this condition? Is it worth waiting? How

do you decide?

2. Am I jeopardizing being a candidate for this procedure if I

remain active given my current state?

3. Are better materials being considered and when will they be

available?

4. Is anyone able to do this in a minimally invasive approach?

Is it possible?

5. Will I regain some range of motion? Currently it is dismal.

6. Is it possible to get back to some level of rigorous activity

and sport?

7. Are there data points to suggest that the results or

procedures are more effective in Europe compared to the US?

8. Are there any studies or is data available relative to the

effectiveness of this procedure generally? How long will it last?

9. Can a joint be resurfaced more that one time?

10. How long does recovery take?

Thank you for your time and potential response to my questions.

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Posted
Posted

Hi Aleks, very sorry to hear your story, but selfishly also glad to hear

that someone like you, superior athlete, got into this " mess. " I experienced

the same " landing " about 3 years ago, and thought that I was the only

athlete on earth, 35 years of age with this problem. All I can suggest is to

call Dr. Gross in Columbia, SC at Midlands Ortho. and present to him your

case...you can't lose anything, believe me. He " fixed " both of my hips back

in may of 2003, today I ran about 50 min at about 9 mph pace. Give him a try

+ he can give you all the answers as an expert. You can find them at

. Tell them Miren send you.

Good luck!

Miren

Ten Questions - Anyone Returning to Skiing or

Running?

Thank you to those of you who share your experiences. It has been

very informative as I am new to researching my recently diagnosed

condition.

History:

I recently turned forty, however, I feel much older. I have lived in

consistent pain for more than four years and often get discouraged

and depressed as I attempt to do things that are now physically

impossible or too painful. I am unaccustomed to these limitations.

I am a former Member of the US Ski Team, US National and NCAA

champion, member of World Cup Team and World Pro Tour. After

retirement from skiing and unaware of this condition, I got involved

in many sports recreationally, including cycling and running several

marathons, including Boston three times usually between 2:30 and

2:40. My athletic career was pretty mediocre as I did not achieve my

objective of becoming a world or Olympic champion and I was injured

on several occasions. I had five major reconstructive knee

operations while I was competing. Thanks to our team doctor who

consistently and effectively pieced me together I have not had any

significant reoccurring knee problems. I share this because I am

interested to know more about those who have returned to any

significant level of sport. I no longer have crazy ambitions to

compete at any real athletic level; however, I have two aspiring

little athletes seven and four who still believe their daddy is

superman. I am looking at doing something because I owe it to them

to remain as active as possible and seek the alternatives (the

ability to get my socks on in the morning may also be an added

benefit). I continue to ski, play hockey, soccer and teach my kids

many other sports, however, the pain and repercussions are unbearable.

Diagnosis:

I recently went to two well-known OS in Boston. They have done THRs

on some very famous people with a stated high success rate. I was

diagnosed with late stage bone on bone OA worse in the right hip

relative to the left. After looking into BHR and resurfacing, I was

very disappointed to find that they both spoke very negatively about

resurfacing when it seemed so intuitive to me to consider this

approach. I am unfamiliar with the medical vernacular, however, in

summary they both were adamantly opposed to the procedure. They

viewed it as a " romantic " alternative that has a poor track

record

and limited data to make any judgment relative to future success. It

was referred to as an unsubstantiated short-term alternative to the

inevitable THR. I was drawn diagrams showing how the thickness of

the covered joint was physiologically incompatible, limiting range of

motion and will create impingement and thus a higher incidence of

dislocation and/or fracture. I was also told about the fallacy of

bone stock retention and the argument was invalid due to the fact

that the head of the femur will fracture and the inside piece will

need to be further reamed in the soon and certain revision to THR. I

left feeling rejected at the overwhelming lack of enthusiasm for this

alternative approach. In my estimation, the best of the best in THR

seemed very myopic and uninterested in my quest for a better life.

That is when I moved on and found you.

Questions: (sorry for the delay in getting here)

1. What can be anticipated in the near term future (two years)

for alternatives to treat this condition? Is it worth waiting? How

do you decide?

2. Am I jeopardizing being a candidate for this procedure if I

remain active given my current state?

3. Are better materials being considered and when will they be

available?

4. Is anyone able to do this in a minimally invasive approach?

Is it possible?

5. Will I regain some range of motion? Currently it is dismal.

6. Is it possible to get back to some level of rigorous activity

and sport?

7. Are there data points to suggest that the results or

procedures are more effective in Europe compared to the US?

8. Are there any studies or is data available relative to the

effectiveness of this procedure generally? How long will it last?

9. Can a joint be resurfaced more that one time?

10. How long does recovery take?

Thank you for your time and potential response to my questions.

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Guest guest

Guest guest

Posted
Posted

Hi Aleks, very sorry to hear your story, but selfishly also glad to hear

that someone like you, superior athlete, got into this " mess. " I experienced

the same " landing " about 3 years ago, and thought that I was the only

athlete on earth, 35 years of age with this problem. All I can suggest is to

call Dr. Gross in Columbia, SC at Midlands Ortho. and present to him your

case...you can't lose anything, believe me. He " fixed " both of my hips back

in may of 2003, today I ran about 50 min at about 9 mph pace. Give him a try

+ he can give you all the answers as an expert. You can find them at

. Tell them Miren send you.

Good luck!

Miren

Ten Questions - Anyone Returning to Skiing or

Running?

Thank you to those of you who share your experiences. It has been

very informative as I am new to researching my recently diagnosed

condition.

History:

I recently turned forty, however, I feel much older. I have lived in

consistent pain for more than four years and often get discouraged

and depressed as I attempt to do things that are now physically

impossible or too painful. I am unaccustomed to these limitations.

I am a former Member of the US Ski Team, US National and NCAA

champion, member of World Cup Team and World Pro Tour. After

retirement from skiing and unaware of this condition, I got involved

in many sports recreationally, including cycling and running several

marathons, including Boston three times usually between 2:30 and

2:40. My athletic career was pretty mediocre as I did not achieve my

objective of becoming a world or Olympic champion and I was injured

on several occasions. I had five major reconstructive knee

operations while I was competing. Thanks to our team doctor who

consistently and effectively pieced me together I have not had any

significant reoccurring knee problems. I share this because I am

interested to know more about those who have returned to any

significant level of sport. I no longer have crazy ambitions to

compete at any real athletic level; however, I have two aspiring

little athletes seven and four who still believe their daddy is

superman. I am looking at doing something because I owe it to them

to remain as active as possible and seek the alternatives (the

ability to get my socks on in the morning may also be an added

benefit). I continue to ski, play hockey, soccer and teach my kids

many other sports, however, the pain and repercussions are unbearable.

Diagnosis:

I recently went to two well-known OS in Boston. They have done THRs

on some very famous people with a stated high success rate. I was

diagnosed with late stage bone on bone OA worse in the right hip

relative to the left. After looking into BHR and resurfacing, I was

very disappointed to find that they both spoke very negatively about

resurfacing when it seemed so intuitive to me to consider this

approach. I am unfamiliar with the medical vernacular, however, in

summary they both were adamantly opposed to the procedure. They

viewed it as a " romantic " alternative that has a poor track

record

and limited data to make any judgment relative to future success. It

was referred to as an unsubstantiated short-term alternative to the

inevitable THR. I was drawn diagrams showing how the thickness of

the covered joint was physiologically incompatible, limiting range of

motion and will create impingement and thus a higher incidence of

dislocation and/or fracture. I was also told about the fallacy of

bone stock retention and the argument was invalid due to the fact

that the head of the femur will fracture and the inside piece will

need to be further reamed in the soon and certain revision to THR. I

left feeling rejected at the overwhelming lack of enthusiasm for this

alternative approach. In my estimation, the best of the best in THR

seemed very myopic and uninterested in my quest for a better life.

That is when I moved on and found you.

Questions: (sorry for the delay in getting here)

1. What can be anticipated in the near term future (two years)

for alternatives to treat this condition? Is it worth waiting? How

do you decide?

2. Am I jeopardizing being a candidate for this procedure if I

remain active given my current state?

3. Are better materials being considered and when will they be

available?

4. Is anyone able to do this in a minimally invasive approach?

Is it possible?

5. Will I regain some range of motion? Currently it is dismal.

6. Is it possible to get back to some level of rigorous activity

and sport?

7. Are there data points to suggest that the results or

procedures are more effective in Europe compared to the US?

8. Are there any studies or is data available relative to the

effectiveness of this procedure generally? How long will it last?

9. Can a joint be resurfaced more that one time?

10. How long does recovery take?

Thank you for your time and potential response to my questions.

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Posted
Posted

>

> I recently went to two well-known OS in Boston.

Was one of them Dr. B???

>They have done THRs

> on some very famous people with a stated high success rate.

Famous people always have the best judgement!

> That is when I moved on and found you.

>

> Questions: (sorry for the delay in getting here)

> 1. What can be anticipated in the near term future (two years)

> for alternatives to treat this condition? Is it worth waiting?

How

> do you decide?

No near-term alternative, if you mean fake cartilage. Perhaps new

bearing surfaces within 2-years. Ask a resurf doc. The longer you

wait, the less likely you will be able to have a resurf. Also, you

will have a longer and more painful recovery.

> 2. Am I jeopardizing being a candidate for this procedure if I

> remain active given my current state?

Only a resurf doc can tell. If you don't have cysts or AVN, then

staying as active as possible may be better than being a couch

potato.

> 3. Are better materials being considered and when will they be

> available?

Yes and who knows. The metal alloy currently being used has been

tested for over 35-years. I would not want to be a test case for a

new and improved material.

> 4. Is anyone able to do this in a minimally invasive approach?

> Is it possible?

From the postings here Dr Gross in South Carolina makes the shortest

incision. My scars are over 15-inches long and have never been a

problem. They have faded to thin lines and the underlying tissue is

normal. IMO, this is a non-issue.

> 5. Will I regain some range of motion? Currently it is dismal.

I have surpassed my previous ROM when 20 and a varsity athlete.

Since you were a world class athlete, I would imagine you will regain

all of your previous ROM, maybe more. One of the first USA resurfers

was/is a ballet dancer who was able to go back to ballet.

> 6. Is it possible to get back to some level of rigorous activity

> and sport?

Absolutely. I regularly mtn bike sea kayak and hike. I have not

started serious running, but do some hill running (less impact). My

doc told me that I should be limited by my own instincts as they

really don't know how hard you can push it. One Brit Doc says to

hammer it in.

> 7. Are there data points to suggest that the results or

> procedures are more effective in Europe compared to the US?

No. We are the crop of folks that in 10 to 30 years will determine

that.

> 8. Are there any studies or is data available relative to the

> effectiveness of this procedure generally? How long will it last?

There is a recent study of the USA trials. Also there is some data

on the BHR MMT site. Follow the links provided on the left side of

this page.

> 9. Can a joint be resurfaced more that one time?

Yes, depending on the cause of failure and the remaining bone quality.

> 10. How long does recovery take?

It depends on your pre-op condition and your work ethic. I am 2.5-

years post op and am still gaining ROM and strength, however, I

waited until the last moment to go for surgery. I had lots of

atrophy and very twisted muscles.

From the sounds of your condition, you are not too bad off

(comparitively speaking). I guess that if you had it done in the

next couple months, you could be skiing next season.

bilat C+, July 2001, Dr. Schmalzried

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Posted
Posted

>

> I recently went to two well-known OS in Boston.

Was one of them Dr. B???

>They have done THRs

> on some very famous people with a stated high success rate.

Famous people always have the best judgement!

> That is when I moved on and found you.

>

> Questions: (sorry for the delay in getting here)

> 1. What can be anticipated in the near term future (two years)

> for alternatives to treat this condition? Is it worth waiting?

How

> do you decide?

No near-term alternative, if you mean fake cartilage. Perhaps new

bearing surfaces within 2-years. Ask a resurf doc. The longer you

wait, the less likely you will be able to have a resurf. Also, you

will have a longer and more painful recovery.

> 2. Am I jeopardizing being a candidate for this procedure if I

> remain active given my current state?

Only a resurf doc can tell. If you don't have cysts or AVN, then

staying as active as possible may be better than being a couch

potato.

> 3. Are better materials being considered and when will they be

> available?

Yes and who knows. The metal alloy currently being used has been

tested for over 35-years. I would not want to be a test case for a

new and improved material.

> 4. Is anyone able to do this in a minimally invasive approach?

> Is it possible?

From the postings here Dr Gross in South Carolina makes the shortest

incision. My scars are over 15-inches long and have never been a

problem. They have faded to thin lines and the underlying tissue is

normal. IMO, this is a non-issue.

> 5. Will I regain some range of motion? Currently it is dismal.

I have surpassed my previous ROM when 20 and a varsity athlete.

Since you were a world class athlete, I would imagine you will regain

all of your previous ROM, maybe more. One of the first USA resurfers

was/is a ballet dancer who was able to go back to ballet.

> 6. Is it possible to get back to some level of rigorous activity

> and sport?

Absolutely. I regularly mtn bike sea kayak and hike. I have not

started serious running, but do some hill running (less impact). My

doc told me that I should be limited by my own instincts as they

really don't know how hard you can push it. One Brit Doc says to

hammer it in.

> 7. Are there data points to suggest that the results or

> procedures are more effective in Europe compared to the US?

No. We are the crop of folks that in 10 to 30 years will determine

that.

> 8. Are there any studies or is data available relative to the

> effectiveness of this procedure generally? How long will it last?

There is a recent study of the USA trials. Also there is some data

on the BHR MMT site. Follow the links provided on the left side of

this page.

> 9. Can a joint be resurfaced more that one time?

Yes, depending on the cause of failure and the remaining bone quality.

> 10. How long does recovery take?

It depends on your pre-op condition and your work ethic. I am 2.5-

years post op and am still gaining ROM and strength, however, I

waited until the last moment to go for surgery. I had lots of

atrophy and very twisted muscles.

From the sounds of your condition, you are not too bad off

(comparitively speaking). I guess that if you had it done in the

next couple months, you could be skiing next season.

bilat C+, July 2001, Dr. Schmalzried

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Posted
Posted

>

> I recently went to two well-known OS in Boston.

Was one of them Dr. B???

>They have done THRs

> on some very famous people with a stated high success rate.

Famous people always have the best judgement!

> That is when I moved on and found you.

>

> Questions: (sorry for the delay in getting here)

> 1. What can be anticipated in the near term future (two years)

> for alternatives to treat this condition? Is it worth waiting?

How

> do you decide?

No near-term alternative, if you mean fake cartilage. Perhaps new

bearing surfaces within 2-years. Ask a resurf doc. The longer you

wait, the less likely you will be able to have a resurf. Also, you

will have a longer and more painful recovery.

> 2. Am I jeopardizing being a candidate for this procedure if I

> remain active given my current state?

Only a resurf doc can tell. If you don't have cysts or AVN, then

staying as active as possible may be better than being a couch

potato.

> 3. Are better materials being considered and when will they be

> available?

Yes and who knows. The metal alloy currently being used has been

tested for over 35-years. I would not want to be a test case for a

new and improved material.

> 4. Is anyone able to do this in a minimally invasive approach?

> Is it possible?

From the postings here Dr Gross in South Carolina makes the shortest

incision. My scars are over 15-inches long and have never been a

problem. They have faded to thin lines and the underlying tissue is

normal. IMO, this is a non-issue.

> 5. Will I regain some range of motion? Currently it is dismal.

I have surpassed my previous ROM when 20 and a varsity athlete.

Since you were a world class athlete, I would imagine you will regain

all of your previous ROM, maybe more. One of the first USA resurfers

was/is a ballet dancer who was able to go back to ballet.

> 6. Is it possible to get back to some level of rigorous activity

> and sport?

Absolutely. I regularly mtn bike sea kayak and hike. I have not

started serious running, but do some hill running (less impact). My

doc told me that I should be limited by my own instincts as they

really don't know how hard you can push it. One Brit Doc says to

hammer it in.

> 7. Are there data points to suggest that the results or

> procedures are more effective in Europe compared to the US?

No. We are the crop of folks that in 10 to 30 years will determine

that.

> 8. Are there any studies or is data available relative to the

> effectiveness of this procedure generally? How long will it last?

There is a recent study of the USA trials. Also there is some data

on the BHR MMT site. Follow the links provided on the left side of

this page.

> 9. Can a joint be resurfaced more that one time?

Yes, depending on the cause of failure and the remaining bone quality.

> 10. How long does recovery take?

It depends on your pre-op condition and your work ethic. I am 2.5-

years post op and am still gaining ROM and strength, however, I

waited until the last moment to go for surgery. I had lots of

atrophy and very twisted muscles.

From the sounds of your condition, you are not too bad off

(comparitively speaking). I guess that if you had it done in the

next couple months, you could be skiing next season.

bilat C+, July 2001, Dr. Schmalzried

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Posted
Posted

Hi Aleks!

Don't wait any longer! Like you, the first OS I consulted 3 years ago told

me to wait until I couldn't stand the pain anymore, and then we'd do a THR.

At the time, the pain was just an occasional ache, so I waited another 2

years until I was having significant pain to look into THRs. The more I

learned, the less I liked what I found. When I went to the internet and

started looking for alternatives, I found out about the hip resurfacing

clinical trials. Resurfacing looked like a much more reasonable procedure,

so I eventually contacted the JRI and was accepted as a patient by Dr.

Amstutz back in June of last year. I wasted 8 months battling for insurance

coverage because at the time the JHR wasn't coding resurfacing as a THR the

way virtually all the other surgeons in the clinical trials of the Conserve

+ and Corin devices have been doing all along. JHR's change in policy came

too late for me.

I've heard wonderful things about Dr. Gross on this site. In fact, I had

sent my x-rays to him, too, but with several denials in my file, I was

afraid the insurance company would question a request for coverage from his

office, too. I've not heard back from him yet, so I don't know if he thinks

he could still do a resurfacing on me. Fortunately, through this site, I

had also found Dr.De Smet in Belgium. I FedExed him my x-rays last week,

and he e-mailed me back within 3 days (over the weekend!). He says that I

have such significant damage to my right hip by now that I will need a

dysplasia cup with screws, and that my window of opportunity to do this is

now very short. Dr. Smet uses the BHR device, which has this option. I don't

think either of the 2 US devices have screws. He was able to work me in on

March 3rd, and I can hardly wait!

I will be paying for this out of pocket because I don't have any time left

to ditz around with insurance claims anymore. Fortunately, resurfacing in

Belgium costs about half what it does here. I'll just submit the bill after

the fact and see if they pay for any of it. Some of Dr. De Smet's patients

have received partial reimbursement (maybe because it's not an

Investigational Procedure in Europe).

Don't lose any more bone or spend any more time in pain! If Dr.Gross thinks

you have too much bone damage to be a suitable candidate for resurfacing,

send those films to Belgium! Dr. De Smet has done over 1200 resurfacings

and has taken on many difficult cases, mine included. You'll find many

positive postings about both of them on this site. Let us know what Dr.

Gross says.

Przygoda

Ten Questions - Anyone Returning to Skiing or

> Running?

>

>

> Thank you to those of you who share your experiences. It has been

> very informative as I am new to researching my recently diagnosed

> condition.

>

> History:

> I recently turned forty, however, I feel much older. I have lived in

> consistent pain for more than four years and often get discouraged

> and depressed as I attempt to do things that are now physically

> impossible or too painful. I am unaccustomed to these limitations.

> I am a former Member of the US Ski Team, US National and NCAA

> champion, member of World Cup Team and World Pro Tour. After

> retirement from skiing and unaware of this condition, I got involved

> in many sports recreationally, including cycling and running several

> marathons, including Boston three times usually between 2:30 and

> 2:40. My athletic career was pretty mediocre as I did not achieve my

> objective of becoming a world or Olympic champion and I was injured

> on several occasions. I had five major reconstructive knee

> operations while I was competing. Thanks to our team doctor who

> consistently and effectively pieced me together I have not had any

> significant reoccurring knee problems. I share this because I am

> interested to know more about those who have returned to any

> significant level of sport. I no longer have crazy ambitions to

> compete at any real athletic level; however, I have two aspiring

> little athletes seven and four who still believe their daddy is

> superman. I am looking at doing something because I owe it to them

> to remain as active as possible and seek the alternatives (the

> ability to get my socks on in the morning may also be an added

> benefit). I continue to ski, play hockey, soccer and teach my kids

> many other sports, however, the pain and repercussions are unbearable.

>

> Diagnosis:

> I recently went to two well-known OS in Boston. They have done THRs

> on some very famous people with a stated high success rate. I was

> diagnosed with late stage bone on bone OA worse in the right hip

> relative to the left. After looking into BHR and resurfacing, I was

> very disappointed to find that they both spoke very negatively about

> resurfacing when it seemed so intuitive to me to consider this

> approach. I am unfamiliar with the medical vernacular, however, in

> summary they both were adamantly opposed to the procedure. They

> viewed it as a " romantic " alternative that has a poor track

> record

> and limited data to make any judgment relative to future success. It

> was referred to as an unsubstantiated short-term alternative to the

> inevitable THR. I was drawn diagrams showing how the thickness of

> the covered joint was physiologically incompatible, limiting range of

> motion and will create impingement and thus a higher incidence of

> dislocation and/or fracture. I was also told about the fallacy of

> bone stock retention and the argument was invalid due to the fact

> that the head of the femur will fracture and the inside piece will

> need to be further reamed in the soon and certain revision to THR. I

> left feeling rejected at the overwhelming lack of enthusiasm for this

> alternative approach. In my estimation, the best of the best in THR

> seemed very myopic and uninterested in my quest for a better life.

> That is when I moved on and found you.

>

> Questions: (sorry for the delay in getting here)

> 1. What can be anticipated in the near term future (two years)

> for alternatives to treat this condition? Is it worth waiting? How

> do you decide?

> 2. Am I jeopardizing being a candidate for this procedure if I

> remain active given my current state?

> 3. Are better materials being considered and when will they be

> available?

> 4. Is anyone able to do this in a minimally invasive approach?

> Is it possible?

> 5. Will I regain some range of motion? Currently it is dismal.

> 6. Is it possible to get back to some level of rigorous activity

> and sport?

> 7. Are there data points to suggest that the results or

> procedures are more effective in Europe compared to the US?

> 8. Are there any studies or is data available relative to the

> effectiveness of this procedure generally? How long will it last?

> 9. Can a joint be resurfaced more that one time?

> 10. How long does recovery take?

>

> Thank you for your time and potential response to my questions.

>

>

>

>

>

>

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Share on other sites
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Guest guest

Posted
Posted

Hi Aleks!

Don't wait any longer! Like you, the first OS I consulted 3 years ago told

me to wait until I couldn't stand the pain anymore, and then we'd do a THR.

At the time, the pain was just an occasional ache, so I waited another 2

years until I was having significant pain to look into THRs. The more I

learned, the less I liked what I found. When I went to the internet and

started looking for alternatives, I found out about the hip resurfacing

clinical trials. Resurfacing looked like a much more reasonable procedure,

so I eventually contacted the JRI and was accepted as a patient by Dr.

Amstutz back in June of last year. I wasted 8 months battling for insurance

coverage because at the time the JHR wasn't coding resurfacing as a THR the

way virtually all the other surgeons in the clinical trials of the Conserve

+ and Corin devices have been doing all along. JHR's change in policy came

too late for me.

I've heard wonderful things about Dr. Gross on this site. In fact, I had

sent my x-rays to him, too, but with several denials in my file, I was

afraid the insurance company would question a request for coverage from his

office, too. I've not heard back from him yet, so I don't know if he thinks

he could still do a resurfacing on me. Fortunately, through this site, I

had also found Dr.De Smet in Belgium. I FedExed him my x-rays last week,

and he e-mailed me back within 3 days (over the weekend!). He says that I

have such significant damage to my right hip by now that I will need a

dysplasia cup with screws, and that my window of opportunity to do this is

now very short. Dr. Smet uses the BHR device, which has this option. I don't

think either of the 2 US devices have screws. He was able to work me in on

March 3rd, and I can hardly wait!

I will be paying for this out of pocket because I don't have any time left

to ditz around with insurance claims anymore. Fortunately, resurfacing in

Belgium costs about half what it does here. I'll just submit the bill after

the fact and see if they pay for any of it. Some of Dr. De Smet's patients

have received partial reimbursement (maybe because it's not an

Investigational Procedure in Europe).

Don't lose any more bone or spend any more time in pain! If Dr.Gross thinks

you have too much bone damage to be a suitable candidate for resurfacing,

send those films to Belgium! Dr. De Smet has done over 1200 resurfacings

and has taken on many difficult cases, mine included. You'll find many

positive postings about both of them on this site. Let us know what Dr.

Gross says.

Przygoda

Ten Questions - Anyone Returning to Skiing or

> Running?

>

>

> Thank you to those of you who share your experiences. It has been

> very informative as I am new to researching my recently diagnosed

> condition.

>

> History:

> I recently turned forty, however, I feel much older. I have lived in

> consistent pain for more than four years and often get discouraged

> and depressed as I attempt to do things that are now physically

> impossible or too painful. I am unaccustomed to these limitations.

> I am a former Member of the US Ski Team, US National and NCAA

> champion, member of World Cup Team and World Pro Tour. After

> retirement from skiing and unaware of this condition, I got involved

> in many sports recreationally, including cycling and running several

> marathons, including Boston three times usually between 2:30 and

> 2:40. My athletic career was pretty mediocre as I did not achieve my

> objective of becoming a world or Olympic champion and I was injured

> on several occasions. I had five major reconstructive knee

> operations while I was competing. Thanks to our team doctor who

> consistently and effectively pieced me together I have not had any

> significant reoccurring knee problems. I share this because I am

> interested to know more about those who have returned to any

> significant level of sport. I no longer have crazy ambitions to

> compete at any real athletic level; however, I have two aspiring

> little athletes seven and four who still believe their daddy is

> superman. I am looking at doing something because I owe it to them

> to remain as active as possible and seek the alternatives (the

> ability to get my socks on in the morning may also be an added

> benefit). I continue to ski, play hockey, soccer and teach my kids

> many other sports, however, the pain and repercussions are unbearable.

>

> Diagnosis:

> I recently went to two well-known OS in Boston. They have done THRs

> on some very famous people with a stated high success rate. I was

> diagnosed with late stage bone on bone OA worse in the right hip

> relative to the left. After looking into BHR and resurfacing, I was

> very disappointed to find that they both spoke very negatively about

> resurfacing when it seemed so intuitive to me to consider this

> approach. I am unfamiliar with the medical vernacular, however, in

> summary they both were adamantly opposed to the procedure. They

> viewed it as a " romantic " alternative that has a poor track

> record

> and limited data to make any judgment relative to future success. It

> was referred to as an unsubstantiated short-term alternative to the

> inevitable THR. I was drawn diagrams showing how the thickness of

> the covered joint was physiologically incompatible, limiting range of

> motion and will create impingement and thus a higher incidence of

> dislocation and/or fracture. I was also told about the fallacy of

> bone stock retention and the argument was invalid due to the fact

> that the head of the femur will fracture and the inside piece will

> need to be further reamed in the soon and certain revision to THR. I

> left feeling rejected at the overwhelming lack of enthusiasm for this

> alternative approach. In my estimation, the best of the best in THR

> seemed very myopic and uninterested in my quest for a better life.

> That is when I moved on and found you.

>

> Questions: (sorry for the delay in getting here)

> 1. What can be anticipated in the near term future (two years)

> for alternatives to treat this condition? Is it worth waiting? How

> do you decide?

> 2. Am I jeopardizing being a candidate for this procedure if I

> remain active given my current state?

> 3. Are better materials being considered and when will they be

> available?

> 4. Is anyone able to do this in a minimally invasive approach?

> Is it possible?

> 5. Will I regain some range of motion? Currently it is dismal.

> 6. Is it possible to get back to some level of rigorous activity

> and sport?

> 7. Are there data points to suggest that the results or

> procedures are more effective in Europe compared to the US?

> 8. Are there any studies or is data available relative to the

> effectiveness of this procedure generally? How long will it last?

> 9. Can a joint be resurfaced more that one time?

> 10. How long does recovery take?

>

> Thank you for your time and potential response to my questions.

>

>

>

>

>

>

Link to comment
Share on other sites
Guest guest

Guest guest

Posted
Posted

Hi Aleks!

Don't wait any longer! Like you, the first OS I consulted 3 years ago told

me to wait until I couldn't stand the pain anymore, and then we'd do a THR.

At the time, the pain was just an occasional ache, so I waited another 2

years until I was having significant pain to look into THRs. The more I

learned, the less I liked what I found. When I went to the internet and

started looking for alternatives, I found out about the hip resurfacing

clinical trials. Resurfacing looked like a much more reasonable procedure,

so I eventually contacted the JRI and was accepted as a patient by Dr.

Amstutz back in June of last year. I wasted 8 months battling for insurance

coverage because at the time the JHR wasn't coding resurfacing as a THR the

way virtually all the other surgeons in the clinical trials of the Conserve

+ and Corin devices have been doing all along. JHR's change in policy came

too late for me.

I've heard wonderful things about Dr. Gross on this site. In fact, I had

sent my x-rays to him, too, but with several denials in my file, I was

afraid the insurance company would question a request for coverage from his

office, too. I've not heard back from him yet, so I don't know if he thinks

he could still do a resurfacing on me. Fortunately, through this site, I

had also found Dr.De Smet in Belgium. I FedExed him my x-rays last week,

and he e-mailed me back within 3 days (over the weekend!). He says that I

have such significant damage to my right hip by now that I will need a

dysplasia cup with screws, and that my window of opportunity to do this is

now very short. Dr. Smet uses the BHR device, which has this option. I don't

think either of the 2 US devices have screws. He was able to work me in on

March 3rd, and I can hardly wait!

I will be paying for this out of pocket because I don't have any time left

to ditz around with insurance claims anymore. Fortunately, resurfacing in

Belgium costs about half what it does here. I'll just submit the bill after

the fact and see if they pay for any of it. Some of Dr. De Smet's patients

have received partial reimbursement (maybe because it's not an

Investigational Procedure in Europe).

Don't lose any more bone or spend any more time in pain! If Dr.Gross thinks

you have too much bone damage to be a suitable candidate for resurfacing,

send those films to Belgium! Dr. De Smet has done over 1200 resurfacings

and has taken on many difficult cases, mine included. You'll find many

positive postings about both of them on this site. Let us know what Dr.

Gross says.

Przygoda

Ten Questions - Anyone Returning to Skiing or

> Running?

>

>

> Thank you to those of you who share your experiences. It has been

> very informative as I am new to researching my recently diagnosed

> condition.

>

> History:

> I recently turned forty, however, I feel much older. I have lived in

> consistent pain for more than four years and often get discouraged

> and depressed as I attempt to do things that are now physically

> impossible or too painful. I am unaccustomed to these limitations.

> I am a former Member of the US Ski Team, US National and NCAA

> champion, member of World Cup Team and World Pro Tour. After

> retirement from skiing and unaware of this condition, I got involved

> in many sports recreationally, including cycling and running several

> marathons, including Boston three times usually between 2:30 and

> 2:40. My athletic career was pretty mediocre as I did not achieve my

> objective of becoming a world or Olympic champion and I was injured

> on several occasions. I had five major reconstructive knee

> operations while I was competing. Thanks to our team doctor who

> consistently and effectively pieced me together I have not had any

> significant reoccurring knee problems. I share this because I am

> interested to know more about those who have returned to any

> significant level of sport. I no longer have crazy ambitions to

> compete at any real athletic level; however, I have two aspiring

> little athletes seven and four who still believe their daddy is

> superman. I am looking at doing something because I owe it to them

> to remain as active as possible and seek the alternatives (the

> ability to get my socks on in the morning may also be an added

> benefit). I continue to ski, play hockey, soccer and teach my kids

> many other sports, however, the pain and repercussions are unbearable.

>

> Diagnosis:

> I recently went to two well-known OS in Boston. They have done THRs

> on some very famous people with a stated high success rate. I was

> diagnosed with late stage bone on bone OA worse in the right hip

> relative to the left. After looking into BHR and resurfacing, I was

> very disappointed to find that they both spoke very negatively about

> resurfacing when it seemed so intuitive to me to consider this

> approach. I am unfamiliar with the medical vernacular, however, in

> summary they both were adamantly opposed to the procedure. They

> viewed it as a " romantic " alternative that has a poor track

> record

> and limited data to make any judgment relative to future success. It

> was referred to as an unsubstantiated short-term alternative to the

> inevitable THR. I was drawn diagrams showing how the thickness of

> the covered joint was physiologically incompatible, limiting range of

> motion and will create impingement and thus a higher incidence of

> dislocation and/or fracture. I was also told about the fallacy of

> bone stock retention and the argument was invalid due to the fact

> that the head of the femur will fracture and the inside piece will

> need to be further reamed in the soon and certain revision to THR. I

> left feeling rejected at the overwhelming lack of enthusiasm for this

> alternative approach. In my estimation, the best of the best in THR

> seemed very myopic and uninterested in my quest for a better life.

> That is when I moved on and found you.

>

> Questions: (sorry for the delay in getting here)

> 1. What can be anticipated in the near term future (two years)

> for alternatives to treat this condition? Is it worth waiting? How

> do you decide?

> 2. Am I jeopardizing being a candidate for this procedure if I

> remain active given my current state?

> 3. Are better materials being considered and when will they be

> available?

> 4. Is anyone able to do this in a minimally invasive approach?

> Is it possible?

> 5. Will I regain some range of motion? Currently it is dismal.

> 6. Is it possible to get back to some level of rigorous activity

> and sport?

> 7. Are there data points to suggest that the results or

> procedures are more effective in Europe compared to the US?

> 8. Are there any studies or is data available relative to the

> effectiveness of this procedure generally? How long will it last?

> 9. Can a joint be resurfaced more that one time?

> 10. How long does recovery take?

>

> Thank you for your time and potential response to my questions.

>

>

>

>

>

>

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Posted
Posted

Great questions, I'll share my knowledge and opinions in-line with

your questions -

> Questions: (sorry for the delay in getting here)

> 1. What can be anticipated in the near term future (two years)

> for alternatives to treat this condition? Is it worth waiting?

How

> do you decide?

There are new devices coming out every few weeks but the really

dramatic research (like being able to regrow cartilage cells) is in

its infancy. I doubt you will see any huge changes in the treatments

in such a short period as 2 years.

> 2. Am I jeopardizing being a candidate for this procedure if I

> remain active given my current state?

Possibly. It is possible to do enough damage that some options may

not be available to you.

> 3. Are better materials being considered and when will they be

> available?

Metal-on-Metal, Ceramic-on-Ceramic, Ceramic-on-Crosslinked (or

non-crosslinked) Polyethylene, Metal-on-Crosslinked (or

non-crosslinked) Polyethylene are all available now in THR systems.

I believe only Metal-on-Metal is being used for resurfacing because of

the requirement in a resurf to make the femoral head nearly natural

size (this results in the acetabular shell having to be large enough

to accomodate this head, which requires the shell assembly to be thin,

which means it pretty much has to be made out of steel).

I am not aware of any research into dramatically different materials

that would be available in the 2 year time frame.

> 4. Is anyone able to do this in a minimally invasive approach?

> Is it possible?

Maybe, but the real question is - is that advantageous? The scar is

really the least of your worries. Surgeons are perfecting their

techniques every day and each surgery they do is probably a little bit

less invasive than the last. When you think about invasive, think

about the damage to your body parts, not just the size of the

incision. Resurfacing causes much less trauma to your body by not

cutting off and reaming out your femur. This would seem to be a good

thing.

> 5. Will I regain some range of motion? Currently it is dismal.

With work (which it doesn't sound like you are afraid of). The large

head devices, both THR and resurfacing, can technically provide very

good range of motion - you'll have to retrain your muscles to support

that range of motion. Medical Technologies has some great

charts comparing range of motion for various devices at their site

http://www.wmt.com - check it out.

> 6. Is it possible to get back to some level of rigorous activity

> and sport?

Clearly. Just peruse the archives of this list.

> 7. Are there data points to suggest that the results or

> procedures are more effective in Europe compared to the US?

All the resurfacing procedures in the US to-date have been part of

clinical trials. They are limited and very controlled. In the UK and

Belgium, resurfacing are mainstream procedures. While the US doctors

in the studies are fantastic, for best results I would go with the guy

who had the most experience - if I had that choice (I don't have that

choice but I am more than satisfied that a stateside doctor will do a

good job for me).

> 8. Are there any studies or is data available relative to the

> effectiveness of this procedure generally? How long will it last?

The results from the first 400 done out at JRI in Los Angeles were

just published in a paper that is available from the Journal of bone

and Joint Surgery (JBJS) at http://www.jbjs.org. They report very

encouraging results. There are longer term results available in the

U.K. and Belgium because they have been doing the procedures longer.

It does look like the metal-on-metal bearing surfaces will have a very

long lifetime.

> 9. Can a joint be resurfaced more that one time?

You have to look at why you would need another resurf. If the

material doesn't wear out, the major problem is loosening or bone

deterioration. Typically one would think it would be the femoral

component that would fail and that can be converted to a THR-style

stem that will fit the existing acetabular cup.

> 10. How long does recovery take?

It varies. You can read lots of stories on this board. Most people

are up and around after 6 weeks. Full recovery takes a long time.

That really depends on how bad it was prior to surgery. My friends

that have had it done say it takes over a year to really feel natural

and comfortable.

>

> Thank you for your time and potential response to my questions.

Best of luck. Like so many things, there are no easy answers. You

have tapped into a resource with loads of experience in this board.

Link to comment
Share on other sites
Guest guest

Guest guest

Posted
Posted

Great questions, I'll share my knowledge and opinions in-line with

your questions -

> Questions: (sorry for the delay in getting here)

> 1. What can be anticipated in the near term future (two years)

> for alternatives to treat this condition? Is it worth waiting?

How

> do you decide?

There are new devices coming out every few weeks but the really

dramatic research (like being able to regrow cartilage cells) is in

its infancy. I doubt you will see any huge changes in the treatments

in such a short period as 2 years.

> 2. Am I jeopardizing being a candidate for this procedure if I

> remain active given my current state?

Possibly. It is possible to do enough damage that some options may

not be available to you.

> 3. Are better materials being considered and when will they be

> available?

Metal-on-Metal, Ceramic-on-Ceramic, Ceramic-on-Crosslinked (or

non-crosslinked) Polyethylene, Metal-on-Crosslinked (or

non-crosslinked) Polyethylene are all available now in THR systems.

I believe only Metal-on-Metal is being used for resurfacing because of

the requirement in a resurf to make the femoral head nearly natural

size (this results in the acetabular shell having to be large enough

to accomodate this head, which requires the shell assembly to be thin,

which means it pretty much has to be made out of steel).

I am not aware of any research into dramatically different materials

that would be available in the 2 year time frame.

> 4. Is anyone able to do this in a minimally invasive approach?

> Is it possible?

Maybe, but the real question is - is that advantageous? The scar is

really the least of your worries. Surgeons are perfecting their

techniques every day and each surgery they do is probably a little bit

less invasive than the last. When you think about invasive, think

about the damage to your body parts, not just the size of the

incision. Resurfacing causes much less trauma to your body by not

cutting off and reaming out your femur. This would seem to be a good

thing.

> 5. Will I regain some range of motion? Currently it is dismal.

With work (which it doesn't sound like you are afraid of). The large

head devices, both THR and resurfacing, can technically provide very

good range of motion - you'll have to retrain your muscles to support

that range of motion. Medical Technologies has some great

charts comparing range of motion for various devices at their site

http://www.wmt.com - check it out.

> 6. Is it possible to get back to some level of rigorous activity

> and sport?

Clearly. Just peruse the archives of this list.

> 7. Are there data points to suggest that the results or

> procedures are more effective in Europe compared to the US?

All the resurfacing procedures in the US to-date have been part of

clinical trials. They are limited and very controlled. In the UK and

Belgium, resurfacing are mainstream procedures. While the US doctors

in the studies are fantastic, for best results I would go with the guy

who had the most experience - if I had that choice (I don't have that

choice but I am more than satisfied that a stateside doctor will do a

good job for me).

> 8. Are there any studies or is data available relative to the

> effectiveness of this procedure generally? How long will it last?

The results from the first 400 done out at JRI in Los Angeles were

just published in a paper that is available from the Journal of bone

and Joint Surgery (JBJS) at http://www.jbjs.org. They report very

encouraging results. There are longer term results available in the

U.K. and Belgium because they have been doing the procedures longer.

It does look like the metal-on-metal bearing surfaces will have a very

long lifetime.

> 9. Can a joint be resurfaced more that one time?

You have to look at why you would need another resurf. If the

material doesn't wear out, the major problem is loosening or bone

deterioration. Typically one would think it would be the femoral

component that would fail and that can be converted to a THR-style

stem that will fit the existing acetabular cup.

> 10. How long does recovery take?

It varies. You can read lots of stories on this board. Most people

are up and around after 6 weeks. Full recovery takes a long time.

That really depends on how bad it was prior to surgery. My friends

that have had it done say it takes over a year to really feel natural

and comfortable.

>

> Thank you for your time and potential response to my questions.

Best of luck. Like so many things, there are no easy answers. You

have tapped into a resource with loads of experience in this board.

Link to comment
Share on other sites
Guest guest

Guest guest

Posted
Posted

Great questions, I'll share my knowledge and opinions in-line with

your questions -

> Questions: (sorry for the delay in getting here)

> 1. What can be anticipated in the near term future (two years)

> for alternatives to treat this condition? Is it worth waiting?

How

> do you decide?

There are new devices coming out every few weeks but the really

dramatic research (like being able to regrow cartilage cells) is in

its infancy. I doubt you will see any huge changes in the treatments

in such a short period as 2 years.

> 2. Am I jeopardizing being a candidate for this procedure if I

> remain active given my current state?

Possibly. It is possible to do enough damage that some options may

not be available to you.

> 3. Are better materials being considered and when will they be

> available?

Metal-on-Metal, Ceramic-on-Ceramic, Ceramic-on-Crosslinked (or

non-crosslinked) Polyethylene, Metal-on-Crosslinked (or

non-crosslinked) Polyethylene are all available now in THR systems.

I believe only Metal-on-Metal is being used for resurfacing because of

the requirement in a resurf to make the femoral head nearly natural

size (this results in the acetabular shell having to be large enough

to accomodate this head, which requires the shell assembly to be thin,

which means it pretty much has to be made out of steel).

I am not aware of any research into dramatically different materials

that would be available in the 2 year time frame.

> 4. Is anyone able to do this in a minimally invasive approach?

> Is it possible?

Maybe, but the real question is - is that advantageous? The scar is

really the least of your worries. Surgeons are perfecting their

techniques every day and each surgery they do is probably a little bit

less invasive than the last. When you think about invasive, think

about the damage to your body parts, not just the size of the

incision. Resurfacing causes much less trauma to your body by not

cutting off and reaming out your femur. This would seem to be a good

thing.

> 5. Will I regain some range of motion? Currently it is dismal.

With work (which it doesn't sound like you are afraid of). The large

head devices, both THR and resurfacing, can technically provide very

good range of motion - you'll have to retrain your muscles to support

that range of motion. Medical Technologies has some great

charts comparing range of motion for various devices at their site

http://www.wmt.com - check it out.

> 6. Is it possible to get back to some level of rigorous activity

> and sport?

Clearly. Just peruse the archives of this list.

> 7. Are there data points to suggest that the results or

> procedures are more effective in Europe compared to the US?

All the resurfacing procedures in the US to-date have been part of

clinical trials. They are limited and very controlled. In the UK and

Belgium, resurfacing are mainstream procedures. While the US doctors

in the studies are fantastic, for best results I would go with the guy

who had the most experience - if I had that choice (I don't have that

choice but I am more than satisfied that a stateside doctor will do a

good job for me).

> 8. Are there any studies or is data available relative to the

> effectiveness of this procedure generally? How long will it last?

The results from the first 400 done out at JRI in Los Angeles were

just published in a paper that is available from the Journal of bone

and Joint Surgery (JBJS) at http://www.jbjs.org. They report very

encouraging results. There are longer term results available in the

U.K. and Belgium because they have been doing the procedures longer.

It does look like the metal-on-metal bearing surfaces will have a very

long lifetime.

> 9. Can a joint be resurfaced more that one time?

You have to look at why you would need another resurf. If the

material doesn't wear out, the major problem is loosening or bone

deterioration. Typically one would think it would be the femoral

component that would fail and that can be converted to a THR-style

stem that will fit the existing acetabular cup.

> 10. How long does recovery take?

It varies. You can read lots of stories on this board. Most people

are up and around after 6 weeks. Full recovery takes a long time.

That really depends on how bad it was prior to surgery. My friends

that have had it done say it takes over a year to really feel natural

and comfortable.

>

> Thank you for your time and potential response to my questions.

Best of luck. Like so many things, there are no easy answers. You

have tapped into a resource with loads of experience in this board.

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Posted
Posted

Dear Aleks - I agree with below – do not wait a minute longer.

My OA came on suddenly - in July 2003 I was told I had mild OA of the

right hip and by 5/03 it was diagnosed as severe. I ignored it for a

while then decided to see what my options were with an OS specializing

in hips. The appt was July 03 and he told me (at the age of 55) he

could schedule me for a THR the next week. He also mentioned I would

never ski again, never run again, never play tennis again and needed to

plan on having it done again in 10 years. He never said anything about

any other options here or in Europe, Australia, India, etc. He just

said if I did not want to have the THR next week to just take

anti-inflammatory medications, continue until I could not walk anymore

then come in and he’d do a THR.

I almost ran out of his office (actually limped is a better term)

spending the next 5 months in denial sure I could beat this with diet,

vitamins, exercise, etc. By December 03 I knew I had to do something.

Between hearing from a friend who had a friend successfully resurfaced

by Dr. De Smet in the Summer 03, finding the Yahoo chat room (with

wonderful people willing to go out of their way to support me) and

reading Dr. De Smet’s web site I knew if anyone could do this surgery on

someone so far gone it would be Dr. De Smet and resurfacing. I was

afraid to waste anymore time looking for local physicians who’d not done

as many, did not specialize in hips only and were probably more

interested in positive outcomes for their clinical trials than in

helping me. I also did not look into Insurance coverage. I got some

good advice from this chat group that it’s better to wait and let your

surgeon communicate with the insurance company after the fact than to

send up red flags and cause a possible denial before hand. Even if I am

not covered I feel I’m ahead – I have a chance at an active life for

less than the price of a car. Going to Belgium was also significantly

cheaper than resurfacing in the US if I end up paying - even with

travel/hotel/food/surgery/hospital etc. going to Belgium ends up being

1/3 to ½ the price of resurfacing in the US.

So two days after I found this site I sent my x-rays to Dr. De Smet. .

Six days later I confirmed surgery six weeks into the future and today

I’ve been home less than a week, already walking and with better

posture than prior to surgery. Good luck with your decision – act now.

I wish I’d done this earlier like the others who’ve posted.

RBHR Dr. De Smet 2/4/04

Re: Ten Questions - Anyone Returning to Skiing

or Running?

Hi Aleks!

Don't wait any longer! Like you, the first OS I consulted 3 years ago

told

me to wait until I couldn't stand the pain anymore, and then we'd do a

THR.

At the time, the pain was just an occasional ache, so I waited another 2

years until I was having significant pain to look into THRs. The more I

learned, the less I liked what I found. When I went to the internet and

started looking for alternatives, I found out about the hip resurfacing

clinical trials. Resurfacing looked like a much more reasonable

procedure,

so I eventually contacted the JRI and was accepted as a patient by Dr.

Amstutz back in June of last year. I wasted 8 months battling for

insurance

coverage because at the time the JHR wasn't coding resurfacing as a THR

the

way virtually all the other surgeons in the clinical trials of the

Conserve

+ and Corin devices have been doing all along. JHR's change in policy

came

too late for me.

I've heard wonderful things about Dr. Gross on this site. In fact, I

had

sent my x-rays to him, too, but with several denials in my file, I was

afraid the insurance company would question a request for coverage from

his

office, too. I've not heard back from him yet, so I don't know if he

thinks

he could still do a resurfacing on me. Fortunately, through this site,

I

had also found Dr.De Smet in Belgium. I FedExed him my x-rays last

week,

and he e-mailed me back within 3 days (over the weekend!). He says that

I

have such significant damage to my right hip by now that I will need a

dysplasia cup with screws, and that my window of opportunity to do this

is

now very short. Dr. Smet uses the BHR device, which has this option. I

don't

think either of the 2 US devices have screws. He was able to work me in

on

March 3rd, and I can hardly wait!

I will be paying for this out of pocket because I don't have any time

left

to ditz around with insurance claims anymore. Fortunately, resurfacing

in

Belgium costs about half what it does here. I'll just submit the bill

after

the fact and see if they pay for any of it. Some of Dr. De Smet's

patients

have received partial reimbursement (maybe because it's not an

Investigational Procedure in Europe).

Don't lose any more bone or spend any more time in pain! If Dr.Gross

thinks

you have too much bone damage to be a suitable candidate for

resurfacing,

send those films to Belgium! Dr. De Smet has done over 1200

resurfacings

and has taken on many difficult cases, mine included. You'll find many

positive postings about both of them on this site. Let us know what Dr.

Gross says.

Przygoda

Ten Questions - Anyone Returning to Skiing or

> Running?

>

>

> Thank you to those of you who share your experiences. It has been

> very informative as I am new to researching my recently diagnosed

> condition.

>

> History:

> I recently turned forty, however, I feel much older. I have lived in

> consistent pain for more than four years and often get discouraged

> and depressed as I attempt to do things that are now physically

> impossible or too painful. I am unaccustomed to these limitations.

> I am a former Member of the US Ski Team, US National and NCAA

> champion, member of World Cup Team and World Pro Tour. After

> retirement from skiing and unaware of this condition, I got involved

> in many sports recreationally, including cycling and running several

> marathons, including Boston three times usually between 2:30 and

> 2:40. My athletic career was pretty mediocre as I did not achieve my

> objective of becoming a world or Olympic champion and I was injured

> on several occasions. I had five major reconstructive knee

> operations while I was competing. Thanks to our team doctor who

> consistently and effectively pieced me together I have not had any

> significant reoccurring knee problems. I share this because I am

> interested to know more about those who have returned to any

> significant level of sport. I no longer have crazy ambitions to

> compete at any real athletic level; however, I have two aspiring

> little athletes seven and four who still believe their daddy is

> superman. I am looking at doing something because I owe it to them

> to remain as active as possible and seek the alternatives (the

> ability to get my socks on in the morning may also be an added

> benefit). I continue to ski, play hockey, soccer and teach my kids

> many other sports, however, the pain and repercussions are unbearable.

>

> Diagnosis:

> I recently went to two well-known OS in Boston. They have done THRs

> on some very famous people with a stated high success rate. I was

> diagnosed with late stage bone on bone OA worse in the right hip

> relative to the left. After looking into BHR and resurfacing, I was

> very disappointed to find that they both spoke very negatively about

> resurfacing when it seemed so intuitive to me to consider this

> approach. I am unfamiliar with the medical vernacular, however, in

> summary they both were adamantly opposed to the procedure. They

> viewed it as a " romantic " alternative that has a poor track

> record

> and limited data to make any judgment relative to future success. It

> was referred to as an unsubstantiated short-term alternative to the

> inevitable THR. I was drawn diagrams showing how the thickness of

> the covered joint was physiologically incompatible, limiting range of

> motion and will create impingement and thus a higher incidence of

> dislocation and/or fracture. I was also told about the fallacy of

> bone stock retention and the argument was invalid due to the fact

> that the head of the femur will fracture and the inside piece will

> need to be further reamed in the soon and certain revision to THR. I

> left feeling rejected at the overwhelming lack of enthusiasm for this

> alternative approach. In my estimation, the best of the best in THR

> seemed very myopic and uninterested in my quest for a better life.

> That is when I moved on and found you.

>

> Questions: (sorry for the delay in getting here)

> 1. What can be anticipated in the near term future (two years)

> for alternatives to treat this condition? Is it worth waiting? How

> do you decide?

> 2. Am I jeopardizing being a candidate for this procedure if I

> remain active given my current state?

> 3. Are better materials being considered and when will they be

> available?

> 4. Is anyone able to do this in a minimally invasive approach?

> Is it possible?

> 5. Will I regain some range of motion? Currently it is dismal.

> 6. Is it possible to get back to some level of rigorous activity

> and sport?

> 7. Are there data points to suggest that the results or

> procedures are more effective in Europe compared to the US?

> 8. Are there any studies or is data available relative to the

> effectiveness of this procedure generally? How long will it last?

> 9. Can a joint be resurfaced more that one time?

> 10. How long does recovery take?

>

> Thank you for your time and potential response to my questions.

>

>

>

>

>

>

Link to comment
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Posted
Posted

Dear Aleks - I agree with below – do not wait a minute longer.

My OA came on suddenly - in July 2003 I was told I had mild OA of the

right hip and by 5/03 it was diagnosed as severe. I ignored it for a

while then decided to see what my options were with an OS specializing

in hips. The appt was July 03 and he told me (at the age of 55) he

could schedule me for a THR the next week. He also mentioned I would

never ski again, never run again, never play tennis again and needed to

plan on having it done again in 10 years. He never said anything about

any other options here or in Europe, Australia, India, etc. He just

said if I did not want to have the THR next week to just take

anti-inflammatory medications, continue until I could not walk anymore

then come in and he’d do a THR.

I almost ran out of his office (actually limped is a better term)

spending the next 5 months in denial sure I could beat this with diet,

vitamins, exercise, etc. By December 03 I knew I had to do something.

Between hearing from a friend who had a friend successfully resurfaced

by Dr. De Smet in the Summer 03, finding the Yahoo chat room (with

wonderful people willing to go out of their way to support me) and

reading Dr. De Smet’s web site I knew if anyone could do this surgery on

someone so far gone it would be Dr. De Smet and resurfacing. I was

afraid to waste anymore time looking for local physicians who’d not done

as many, did not specialize in hips only and were probably more

interested in positive outcomes for their clinical trials than in

helping me. I also did not look into Insurance coverage. I got some

good advice from this chat group that it’s better to wait and let your

surgeon communicate with the insurance company after the fact than to

send up red flags and cause a possible denial before hand. Even if I am

not covered I feel I’m ahead – I have a chance at an active life for

less than the price of a car. Going to Belgium was also significantly

cheaper than resurfacing in the US if I end up paying - even with

travel/hotel/food/surgery/hospital etc. going to Belgium ends up being

1/3 to ½ the price of resurfacing in the US.

So two days after I found this site I sent my x-rays to Dr. De Smet. .

Six days later I confirmed surgery six weeks into the future and today

I’ve been home less than a week, already walking and with better

posture than prior to surgery. Good luck with your decision – act now.

I wish I’d done this earlier like the others who’ve posted.

RBHR Dr. De Smet 2/4/04

Re: Ten Questions - Anyone Returning to Skiing

or Running?

Hi Aleks!

Don't wait any longer! Like you, the first OS I consulted 3 years ago

told

me to wait until I couldn't stand the pain anymore, and then we'd do a

THR.

At the time, the pain was just an occasional ache, so I waited another 2

years until I was having significant pain to look into THRs. The more I

learned, the less I liked what I found. When I went to the internet and

started looking for alternatives, I found out about the hip resurfacing

clinical trials. Resurfacing looked like a much more reasonable

procedure,

so I eventually contacted the JRI and was accepted as a patient by Dr.

Amstutz back in June of last year. I wasted 8 months battling for

insurance

coverage because at the time the JHR wasn't coding resurfacing as a THR

the

way virtually all the other surgeons in the clinical trials of the

Conserve

+ and Corin devices have been doing all along. JHR's change in policy

came

too late for me.

I've heard wonderful things about Dr. Gross on this site. In fact, I

had

sent my x-rays to him, too, but with several denials in my file, I was

afraid the insurance company would question a request for coverage from

his

office, too. I've not heard back from him yet, so I don't know if he

thinks

he could still do a resurfacing on me. Fortunately, through this site,

I

had also found Dr.De Smet in Belgium. I FedExed him my x-rays last

week,

and he e-mailed me back within 3 days (over the weekend!). He says that

I

have such significant damage to my right hip by now that I will need a

dysplasia cup with screws, and that my window of opportunity to do this

is

now very short. Dr. Smet uses the BHR device, which has this option. I

don't

think either of the 2 US devices have screws. He was able to work me in

on

March 3rd, and I can hardly wait!

I will be paying for this out of pocket because I don't have any time

left

to ditz around with insurance claims anymore. Fortunately, resurfacing

in

Belgium costs about half what it does here. I'll just submit the bill

after

the fact and see if they pay for any of it. Some of Dr. De Smet's

patients

have received partial reimbursement (maybe because it's not an

Investigational Procedure in Europe).

Don't lose any more bone or spend any more time in pain! If Dr.Gross

thinks

you have too much bone damage to be a suitable candidate for

resurfacing,

send those films to Belgium! Dr. De Smet has done over 1200

resurfacings

and has taken on many difficult cases, mine included. You'll find many

positive postings about both of them on this site. Let us know what Dr.

Gross says.

Przygoda

Ten Questions - Anyone Returning to Skiing or

> Running?

>

>

> Thank you to those of you who share your experiences. It has been

> very informative as I am new to researching my recently diagnosed

> condition.

>

> History:

> I recently turned forty, however, I feel much older. I have lived in

> consistent pain for more than four years and often get discouraged

> and depressed as I attempt to do things that are now physically

> impossible or too painful. I am unaccustomed to these limitations.

> I am a former Member of the US Ski Team, US National and NCAA

> champion, member of World Cup Team and World Pro Tour. After

> retirement from skiing and unaware of this condition, I got involved

> in many sports recreationally, including cycling and running several

> marathons, including Boston three times usually between 2:30 and

> 2:40. My athletic career was pretty mediocre as I did not achieve my

> objective of becoming a world or Olympic champion and I was injured

> on several occasions. I had five major reconstructive knee

> operations while I was competing. Thanks to our team doctor who

> consistently and effectively pieced me together I have not had any

> significant reoccurring knee problems. I share this because I am

> interested to know more about those who have returned to any

> significant level of sport. I no longer have crazy ambitions to

> compete at any real athletic level; however, I have two aspiring

> little athletes seven and four who still believe their daddy is

> superman. I am looking at doing something because I owe it to them

> to remain as active as possible and seek the alternatives (the

> ability to get my socks on in the morning may also be an added

> benefit). I continue to ski, play hockey, soccer and teach my kids

> many other sports, however, the pain and repercussions are unbearable.

>

> Diagnosis:

> I recently went to two well-known OS in Boston. They have done THRs

> on some very famous people with a stated high success rate. I was

> diagnosed with late stage bone on bone OA worse in the right hip

> relative to the left. After looking into BHR and resurfacing, I was

> very disappointed to find that they both spoke very negatively about

> resurfacing when it seemed so intuitive to me to consider this

> approach. I am unfamiliar with the medical vernacular, however, in

> summary they both were adamantly opposed to the procedure. They

> viewed it as a " romantic " alternative that has a poor track

> record

> and limited data to make any judgment relative to future success. It

> was referred to as an unsubstantiated short-term alternative to the

> inevitable THR. I was drawn diagrams showing how the thickness of

> the covered joint was physiologically incompatible, limiting range of

> motion and will create impingement and thus a higher incidence of

> dislocation and/or fracture. I was also told about the fallacy of

> bone stock retention and the argument was invalid due to the fact

> that the head of the femur will fracture and the inside piece will

> need to be further reamed in the soon and certain revision to THR. I

> left feeling rejected at the overwhelming lack of enthusiasm for this

> alternative approach. In my estimation, the best of the best in THR

> seemed very myopic and uninterested in my quest for a better life.

> That is when I moved on and found you.

>

> Questions: (sorry for the delay in getting here)

> 1. What can be anticipated in the near term future (two years)

> for alternatives to treat this condition? Is it worth waiting? How

> do you decide?

> 2. Am I jeopardizing being a candidate for this procedure if I

> remain active given my current state?

> 3. Are better materials being considered and when will they be

> available?

> 4. Is anyone able to do this in a minimally invasive approach?

> Is it possible?

> 5. Will I regain some range of motion? Currently it is dismal.

> 6. Is it possible to get back to some level of rigorous activity

> and sport?

> 7. Are there data points to suggest that the results or

> procedures are more effective in Europe compared to the US?

> 8. Are there any studies or is data available relative to the

> effectiveness of this procedure generally? How long will it last?

> 9. Can a joint be resurfaced more that one time?

> 10. How long does recovery take?

>

> Thank you for your time and potential response to my questions.

>

>

>

>

>

>

Link to comment
Share on other sites
Guest guest

Guest guest

Posted
Posted

Dear Aleks - I agree with below – do not wait a minute longer.

My OA came on suddenly - in July 2003 I was told I had mild OA of the

right hip and by 5/03 it was diagnosed as severe. I ignored it for a

while then decided to see what my options were with an OS specializing

in hips. The appt was July 03 and he told me (at the age of 55) he

could schedule me for a THR the next week. He also mentioned I would

never ski again, never run again, never play tennis again and needed to

plan on having it done again in 10 years. He never said anything about

any other options here or in Europe, Australia, India, etc. He just

said if I did not want to have the THR next week to just take

anti-inflammatory medications, continue until I could not walk anymore

then come in and he’d do a THR.

I almost ran out of his office (actually limped is a better term)

spending the next 5 months in denial sure I could beat this with diet,

vitamins, exercise, etc. By December 03 I knew I had to do something.

Between hearing from a friend who had a friend successfully resurfaced

by Dr. De Smet in the Summer 03, finding the Yahoo chat room (with

wonderful people willing to go out of their way to support me) and

reading Dr. De Smet’s web site I knew if anyone could do this surgery on

someone so far gone it would be Dr. De Smet and resurfacing. I was

afraid to waste anymore time looking for local physicians who’d not done

as many, did not specialize in hips only and were probably more

interested in positive outcomes for their clinical trials than in

helping me. I also did not look into Insurance coverage. I got some

good advice from this chat group that it’s better to wait and let your

surgeon communicate with the insurance company after the fact than to

send up red flags and cause a possible denial before hand. Even if I am

not covered I feel I’m ahead – I have a chance at an active life for

less than the price of a car. Going to Belgium was also significantly

cheaper than resurfacing in the US if I end up paying - even with

travel/hotel/food/surgery/hospital etc. going to Belgium ends up being

1/3 to ½ the price of resurfacing in the US.

So two days after I found this site I sent my x-rays to Dr. De Smet. .

Six days later I confirmed surgery six weeks into the future and today

I’ve been home less than a week, already walking and with better

posture than prior to surgery. Good luck with your decision – act now.

I wish I’d done this earlier like the others who’ve posted.

RBHR Dr. De Smet 2/4/04

Re: Ten Questions - Anyone Returning to Skiing

or Running?

Hi Aleks!

Don't wait any longer! Like you, the first OS I consulted 3 years ago

told

me to wait until I couldn't stand the pain anymore, and then we'd do a

THR.

At the time, the pain was just an occasional ache, so I waited another 2

years until I was having significant pain to look into THRs. The more I

learned, the less I liked what I found. When I went to the internet and

started looking for alternatives, I found out about the hip resurfacing

clinical trials. Resurfacing looked like a much more reasonable

procedure,

so I eventually contacted the JRI and was accepted as a patient by Dr.

Amstutz back in June of last year. I wasted 8 months battling for

insurance

coverage because at the time the JHR wasn't coding resurfacing as a THR

the

way virtually all the other surgeons in the clinical trials of the

Conserve

+ and Corin devices have been doing all along. JHR's change in policy

came

too late for me.

I've heard wonderful things about Dr. Gross on this site. In fact, I

had

sent my x-rays to him, too, but with several denials in my file, I was

afraid the insurance company would question a request for coverage from

his

office, too. I've not heard back from him yet, so I don't know if he

thinks

he could still do a resurfacing on me. Fortunately, through this site,

I

had also found Dr.De Smet in Belgium. I FedExed him my x-rays last

week,

and he e-mailed me back within 3 days (over the weekend!). He says that

I

have such significant damage to my right hip by now that I will need a

dysplasia cup with screws, and that my window of opportunity to do this

is

now very short. Dr. Smet uses the BHR device, which has this option. I

don't

think either of the 2 US devices have screws. He was able to work me in

on

March 3rd, and I can hardly wait!

I will be paying for this out of pocket because I don't have any time

left

to ditz around with insurance claims anymore. Fortunately, resurfacing

in

Belgium costs about half what it does here. I'll just submit the bill

after

the fact and see if they pay for any of it. Some of Dr. De Smet's

patients

have received partial reimbursement (maybe because it's not an

Investigational Procedure in Europe).

Don't lose any more bone or spend any more time in pain! If Dr.Gross

thinks

you have too much bone damage to be a suitable candidate for

resurfacing,

send those films to Belgium! Dr. De Smet has done over 1200

resurfacings

and has taken on many difficult cases, mine included. You'll find many

positive postings about both of them on this site. Let us know what Dr.

Gross says.

Przygoda

Ten Questions - Anyone Returning to Skiing or

> Running?

>

>

> Thank you to those of you who share your experiences. It has been

> very informative as I am new to researching my recently diagnosed

> condition.

>

> History:

> I recently turned forty, however, I feel much older. I have lived in

> consistent pain for more than four years and often get discouraged

> and depressed as I attempt to do things that are now physically

> impossible or too painful. I am unaccustomed to these limitations.

> I am a former Member of the US Ski Team, US National and NCAA

> champion, member of World Cup Team and World Pro Tour. After

> retirement from skiing and unaware of this condition, I got involved

> in many sports recreationally, including cycling and running several

> marathons, including Boston three times usually between 2:30 and

> 2:40. My athletic career was pretty mediocre as I did not achieve my

> objective of becoming a world or Olympic champion and I was injured

> on several occasions. I had five major reconstructive knee

> operations while I was competing. Thanks to our team doctor who

> consistently and effectively pieced me together I have not had any

> significant reoccurring knee problems. I share this because I am

> interested to know more about those who have returned to any

> significant level of sport. I no longer have crazy ambitions to

> compete at any real athletic level; however, I have two aspiring

> little athletes seven and four who still believe their daddy is

> superman. I am looking at doing something because I owe it to them

> to remain as active as possible and seek the alternatives (the

> ability to get my socks on in the morning may also be an added

> benefit). I continue to ski, play hockey, soccer and teach my kids

> many other sports, however, the pain and repercussions are unbearable.

>

> Diagnosis:

> I recently went to two well-known OS in Boston. They have done THRs

> on some very famous people with a stated high success rate. I was

> diagnosed with late stage bone on bone OA worse in the right hip

> relative to the left. After looking into BHR and resurfacing, I was

> very disappointed to find that they both spoke very negatively about

> resurfacing when it seemed so intuitive to me to consider this

> approach. I am unfamiliar with the medical vernacular, however, in

> summary they both were adamantly opposed to the procedure. They

> viewed it as a " romantic " alternative that has a poor track

> record

> and limited data to make any judgment relative to future success. It

> was referred to as an unsubstantiated short-term alternative to the

> inevitable THR. I was drawn diagrams showing how the thickness of

> the covered joint was physiologically incompatible, limiting range of

> motion and will create impingement and thus a higher incidence of

> dislocation and/or fracture. I was also told about the fallacy of

> bone stock retention and the argument was invalid due to the fact

> that the head of the femur will fracture and the inside piece will

> need to be further reamed in the soon and certain revision to THR. I

> left feeling rejected at the overwhelming lack of enthusiasm for this

> alternative approach. In my estimation, the best of the best in THR

> seemed very myopic and uninterested in my quest for a better life.

> That is when I moved on and found you.

>

> Questions: (sorry for the delay in getting here)

> 1. What can be anticipated in the near term future (two years)

> for alternatives to treat this condition? Is it worth waiting? How

> do you decide?

> 2. Am I jeopardizing being a candidate for this procedure if I

> remain active given my current state?

> 3. Are better materials being considered and when will they be

> available?

> 4. Is anyone able to do this in a minimally invasive approach?

> Is it possible?

> 5. Will I regain some range of motion? Currently it is dismal.

> 6. Is it possible to get back to some level of rigorous activity

> and sport?

> 7. Are there data points to suggest that the results or

> procedures are more effective in Europe compared to the US?

> 8. Are there any studies or is data available relative to the

> effectiveness of this procedure generally? How long will it last?

> 9. Can a joint be resurfaced more that one time?

> 10. How long does recovery take?

>

> Thank you for your time and potential response to my questions.

>

>

>

>

>

>

Link to comment
Share on other sites
Guest guest

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Posted
Posted

Hi,

The best way to tackle this is go for a read of the archives..........there

you will find people reporting doing all sorts of activities and tales of

long distance runners etc doing this for a good few years now..........

seems noone told their resurfaced hips about ROM being limited, femur heads

cracking etc........... And you simply wouldn't get your sort of story from

surgeons of any caliber in places like Australia or UK......... they know

from experience now that it isn't a romantic story......... For amusement

you could also ask both surgeons to produce the research papers what proves

their assertions about this current device...............While of course

they will expect you to take at face value that a plastic THR will go the

distance - the newer ones have not been around long either...........

In Australia now we have several choices of resurfacing device made by

various coys............. and my surgeon said he thinks someone will have a

go at making a plastic one before long......... big prothesis coys wouldn't

be doing this if they didn't think there was a future in these

devices.............. most know all about the recall nightmares on prothesis

and wouldn't be wanting to tempt fate going down that lane I would

think.............

The issue of cartledge regrowth has come up here from time to time but given

how much hassle you guys are having just getting a metal resurface into your

country I couldn't see that happening for years.........even if they could

figure out how to get it to grow where it should etc or you were prepared to

take the months off to let it happen etc..............

The ROM you end up appears to be only limited by scar tissue around the

joint - if procedures occured there before, how long you have been hobbling

around for and the state of the joint area now as against how much work you

personally want to put into getting it back. My hip was frozen for 35 years

and I can now move it enough to get by in life.......... in fact yesterday I

was fast cruising along a footpath and leaping up and down from high gutters

landing onto the hip without a blink......... and sure some will do that

with a THR no trouble at all........ so it really always comes down to the

question of how you personally feel about metal down your femur bone and

cutting off the femur head...........

Edith LBHR Dr. L Walter Syd Aust 8/02

> Thank you to those of you who share your experiences. It has been

> very informative as I am new to researching my recently diagnosed

> condition.

>

> History:

> I recently turned forty, however, I feel much older. I have lived in

> consistent pain for more than four years and often get discouraged

> and depressed as I attempt to do things that are now physically

> impossible or too painful. I am unaccustomed to these limitations.

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Posted

Hi,

The best way to tackle this is go for a read of the archives..........there

you will find people reporting doing all sorts of activities and tales of

long distance runners etc doing this for a good few years now..........

seems noone told their resurfaced hips about ROM being limited, femur heads

cracking etc........... And you simply wouldn't get your sort of story from

surgeons of any caliber in places like Australia or UK......... they know

from experience now that it isn't a romantic story......... For amusement

you could also ask both surgeons to produce the research papers what proves

their assertions about this current device...............While of course

they will expect you to take at face value that a plastic THR will go the

distance - the newer ones have not been around long either...........

In Australia now we have several choices of resurfacing device made by

various coys............. and my surgeon said he thinks someone will have a

go at making a plastic one before long......... big prothesis coys wouldn't

be doing this if they didn't think there was a future in these

devices.............. most know all about the recall nightmares on prothesis

and wouldn't be wanting to tempt fate going down that lane I would

think.............

The issue of cartledge regrowth has come up here from time to time but given

how much hassle you guys are having just getting a metal resurface into your

country I couldn't see that happening for years.........even if they could

figure out how to get it to grow where it should etc or you were prepared to

take the months off to let it happen etc..............

The ROM you end up appears to be only limited by scar tissue around the

joint - if procedures occured there before, how long you have been hobbling

around for and the state of the joint area now as against how much work you

personally want to put into getting it back. My hip was frozen for 35 years

and I can now move it enough to get by in life.......... in fact yesterday I

was fast cruising along a footpath and leaping up and down from high gutters

landing onto the hip without a blink......... and sure some will do that

with a THR no trouble at all........ so it really always comes down to the

question of how you personally feel about metal down your femur bone and

cutting off the femur head...........

Edith LBHR Dr. L Walter Syd Aust 8/02

> Thank you to those of you who share your experiences. It has been

> very informative as I am new to researching my recently diagnosed

> condition.

>

> History:

> I recently turned forty, however, I feel much older. I have lived in

> consistent pain for more than four years and often get discouraged

> and depressed as I attempt to do things that are now physically

> impossible or too painful. I am unaccustomed to these limitations.

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Posted
Posted

Hi,

The best way to tackle this is go for a read of the archives..........there

you will find people reporting doing all sorts of activities and tales of

long distance runners etc doing this for a good few years now..........

seems noone told their resurfaced hips about ROM being limited, femur heads

cracking etc........... And you simply wouldn't get your sort of story from

surgeons of any caliber in places like Australia or UK......... they know

from experience now that it isn't a romantic story......... For amusement

you could also ask both surgeons to produce the research papers what proves

their assertions about this current device...............While of course

they will expect you to take at face value that a plastic THR will go the

distance - the newer ones have not been around long either...........

In Australia now we have several choices of resurfacing device made by

various coys............. and my surgeon said he thinks someone will have a

go at making a plastic one before long......... big prothesis coys wouldn't

be doing this if they didn't think there was a future in these

devices.............. most know all about the recall nightmares on prothesis

and wouldn't be wanting to tempt fate going down that lane I would

think.............

The issue of cartledge regrowth has come up here from time to time but given

how much hassle you guys are having just getting a metal resurface into your

country I couldn't see that happening for years.........even if they could

figure out how to get it to grow where it should etc or you were prepared to

take the months off to let it happen etc..............

The ROM you end up appears to be only limited by scar tissue around the

joint - if procedures occured there before, how long you have been hobbling

around for and the state of the joint area now as against how much work you

personally want to put into getting it back. My hip was frozen for 35 years

and I can now move it enough to get by in life.......... in fact yesterday I

was fast cruising along a footpath and leaping up and down from high gutters

landing onto the hip without a blink......... and sure some will do that

with a THR no trouble at all........ so it really always comes down to the

question of how you personally feel about metal down your femur bone and

cutting off the femur head...........

Edith LBHR Dr. L Walter Syd Aust 8/02

> Thank you to those of you who share your experiences. It has been

> very informative as I am new to researching my recently diagnosed

> condition.

>

> History:

> I recently turned forty, however, I feel much older. I have lived in

> consistent pain for more than four years and often get discouraged

> and depressed as I attempt to do things that are now physically

> impossible or too painful. I am unaccustomed to these limitations.

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Aleks:

I have bilateral OA, and live in Boston. It sounds like we went to

the same two " prominent " orthopedic surgeons!! I was diagnosed two

years ago by the President of the Massachusetts Society of

Orthopedic Surgeons. He gave me two options: Wait until the pain is

so bad that you can't walk on it and then do a THR (he still uses

the polyethylene cup device.....I'm only 41!!!!), or see a

specialist friend of his in Boston to see if a pelvic osteotomy was

an option " to take advantage of the remaining acetabular cartilage " .

I am a veterinarian and I know that the latter approach is extremely

invasive and involves a minimum 12-month recovery with short-term

benefit (if any).

The second guy told me " you're left hip looks like hell " and " come

back for a THR when you can't walk anymore " .

Although not a world-class athlete such as yourself, I enjoyed

running, biking and squats up until about 2 years ago. It's really

depressing to go from an active lifestyle to a pattern of avoidance.

Fortunately, I came across this web site and have received excellent

advice. I submitted my X-rays to Dr. Gross in SC and he agreed that

I would be a good candidate for resurfacing. I am currently waiting

for a surgery date in June after the kids are out of school.

As you can see from this site, you are not alone. Good luck with

your decision!!

Jim

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Aleks:

I have bilateral OA, and live in Boston. It sounds like we went to

the same two " prominent " orthopedic surgeons!! I was diagnosed two

years ago by the President of the Massachusetts Society of

Orthopedic Surgeons. He gave me two options: Wait until the pain is

so bad that you can't walk on it and then do a THR (he still uses

the polyethylene cup device.....I'm only 41!!!!), or see a

specialist friend of his in Boston to see if a pelvic osteotomy was

an option " to take advantage of the remaining acetabular cartilage " .

I am a veterinarian and I know that the latter approach is extremely

invasive and involves a minimum 12-month recovery with short-term

benefit (if any).

The second guy told me " you're left hip looks like hell " and " come

back for a THR when you can't walk anymore " .

Although not a world-class athlete such as yourself, I enjoyed

running, biking and squats up until about 2 years ago. It's really

depressing to go from an active lifestyle to a pattern of avoidance.

Fortunately, I came across this web site and have received excellent

advice. I submitted my X-rays to Dr. Gross in SC and he agreed that

I would be a good candidate for resurfacing. I am currently waiting

for a surgery date in June after the kids are out of school.

As you can see from this site, you are not alone. Good luck with

your decision!!

Jim

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ive to the

> inevitable THR. I was drawn diagrams showing how the thickness of

> the covered joint was physiologically incompatible, limiting range of

> motion and will create impingement and thus a higher incidence of

> dislocation and/or fracture.

The incidence of dislocation is somewhere between 10 and 100 times

lower with resurfacing than with a conventional small ball metal on

polyethylene THR. It's hard to give a precise

figure because dislocations are extremely rare with resurfacings so

it's very hard to get a reliable figure for their frequency.

Dislocation rates with large ball MoM THRs is comparable to

resurfacing. The incidence with ceramic THRs is better than with

metal/poly THRs, but I don't think it is quite as good as MoM or

resurfacing.

Range of motion is better with a resurfacing than with a conventional

small-ball metal/poly THR. Resurfacing ROM is basically the same as

with a large ball Metal-on-Metal THR.

The major risk factors for fracture are female gender, small size,

advanced age, and poor bone condition. Even so, the published papers

show a failure rate of about 3% in early cases, with the incidence of

failure decreasing rapidly as surgeons gain experience and as they

improve patient selection. Resurfacing is not for everyone. If you

have poor bone quality, it's probably not for you. As a relatively

young male athlete, I can't imagine that you'd be in this situation as

long as you don't wait too long. However, you need to have your X-rays

evaluated by an OS who actually does resurfacing. Nobody can judge

your bone condition from an internet post.

I was also told about the fallacy of

> bone stock retention and the argument was invalid due to the fact

> that the head of the femur will fracture and the inside piece will

> need to be further reamed in the soon and certain revision to THR.

See above.

> left feeling rejected at the overwhelming lack of enthusiasm for this

> alternative approach. In my estimation, the best of the best in THR

> seemed very myopic and uninterested in my quest for a better life.

> That is when I moved on and found you.

>

> Questions: (sorry for the delay in getting here)

> 1. What can be anticipated in the near term future (two years)

> for alternatives to treat this condition? Is it worth waiting? How

> do you decide?

Biological treatments (cartilage regrowth) are a long way away.

I understand that some of the companies are looking into using hard,

biologically inert coatings (ceramic or diamond) for resurfacing

components, but those won't be available anytime soon. If you allow

your bone quality to degrade too much, you may not have any alternatives.

> 2. Am I jeopardizing being a candidate for this procedure if I

> remain active given my current state?

Possibly. At a certain point, you'll find it nearly impossible to

remain highly active. As someone who is approaching that point with

alarming rapidity, my advice is to expedite the resurfacing process.

> 3. Are better materials being considered and when will they be

> available?

I already commented on coatings above. They're not in the immediate

future. They'll come eventually, but not in your decision timeframe.

In a conversation with Dr. Amstutz today, I was informed of the

existence of a metal on crosslinked poly resurfacing device, which

might be useful in patients (like me) who have compromised renal

function and are thus at more danger of high metal ion levels. I can't

see why anyone with normal kidney function would even consider it.

Only 21 of them have been installed and they require removal of some

acetabular bone because they have a larger external shell than a MoM

resurface. The head size is larger than a typical THR, but smaller

than a MoM resurface (about 40-44mm maximum). Wear is something of a

crap shoot.

In THRs, your options are metal/poly, metal/crosslinked poly, metal on

metal, and ceramic. Ceramic wears the least, but doesn't permit quite

as large a ball as metal on metal (because the shell has to be thicker

to avoid cracking). Metal on metal gives you a large ball (like a

resurface) and very similar wear characteristics, low risk of

dislocation, and excellent ROM. Metal on cross-linked poly is

reltively new. It wears roughly 5 times better than conventional

metal/poly. This may permit somewhat larger ball sizes (giving better

ROM and reduced dislocation risk). Metal/poly is the traditional

alternative. Most folks in this group don't think very highly of it.

Small ball, higher wear rate, higher dislocation risk, higher risk of

osteolysis (leading to aseptic loosening) than the other alternatives.

Stem-type devices in general tend to suffer from stress shielding in

the femur, which may or may not cause loosening of the femoral

component with the passage of time.

> 5. Will I regain some range of motion? Currently it is dismal.

Starrett, the first patient to get a simultaneous bilateral

in the US, went back to performing lead roles as a ballet dancer after

his surgery. He has since retired from performing (understandable

since he's about 50), but he still teaches and can still do the

splits. I'd say that 180 degrees of flexion and abduction constitutes

regaining range of motion. ;-)

> 6. Is it possible to get back to some level of rigorous activity

> and sport?

This group is full of people who have.

As far as elite athletes like yourself are concerned, , a

Masters judo competitor, won the 2001 World Championship in his age

division after being resurfaced. He was still competing on a

world-class level last year (I don't know about this year).

> 7. Are there data points to suggest that the results or

> procedures are more effective in Europe compared to the US?

Not really.

> 8. Are there any studies or is data available relative to the

> effectiveness of this procedure generally? How long will it last?

Wear studies suggest that resurfacings wear 20-100 times less than

conventional metal on polyethylene. So far, the clinical results for

resurfacings are better than for THRs among young, active patients.

There aren't any long-term clinical results yet.

> 9. Can a joint be resurfaced more that one time?

I don't know if anyone's tried. No resurfacing has every " worn out "

as far as I know. Those that have been revised have been due to

loosening of the femoral component, which is usually due to failure

of the underlying bone. This would preclude a subsequent resurfacing

of that joint. These patients are typically revised to a large ball

MoM THR, using the acetabular shell that's already present. We've got

a couple of folks here who've had this done. They can fill you in on

the details. The incidence of this is very low, but it does happen.

> 10. How long does recovery take?

It varies. The usually cited figures are " 2 to 3 times faster than a

THR " . Some people take a longer time due to severe muscle atrophy

or other problems. I can't tell you how long mine took because it

hasn't happened yet. :-(

Steve (progressing at a glacial pace towards a bilateral resurf)

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ive to the

> inevitable THR. I was drawn diagrams showing how the thickness of

> the covered joint was physiologically incompatible, limiting range of

> motion and will create impingement and thus a higher incidence of

> dislocation and/or fracture.

The incidence of dislocation is somewhere between 10 and 100 times

lower with resurfacing than with a conventional small ball metal on

polyethylene THR. It's hard to give a precise

figure because dislocations are extremely rare with resurfacings so

it's very hard to get a reliable figure for their frequency.

Dislocation rates with large ball MoM THRs is comparable to

resurfacing. The incidence with ceramic THRs is better than with

metal/poly THRs, but I don't think it is quite as good as MoM or

resurfacing.

Range of motion is better with a resurfacing than with a conventional

small-ball metal/poly THR. Resurfacing ROM is basically the same as

with a large ball Metal-on-Metal THR.

The major risk factors for fracture are female gender, small size,

advanced age, and poor bone condition. Even so, the published papers

show a failure rate of about 3% in early cases, with the incidence of

failure decreasing rapidly as surgeons gain experience and as they

improve patient selection. Resurfacing is not for everyone. If you

have poor bone quality, it's probably not for you. As a relatively

young male athlete, I can't imagine that you'd be in this situation as

long as you don't wait too long. However, you need to have your X-rays

evaluated by an OS who actually does resurfacing. Nobody can judge

your bone condition from an internet post.

I was also told about the fallacy of

> bone stock retention and the argument was invalid due to the fact

> that the head of the femur will fracture and the inside piece will

> need to be further reamed in the soon and certain revision to THR.

See above.

> left feeling rejected at the overwhelming lack of enthusiasm for this

> alternative approach. In my estimation, the best of the best in THR

> seemed very myopic and uninterested in my quest for a better life.

> That is when I moved on and found you.

>

> Questions: (sorry for the delay in getting here)

> 1. What can be anticipated in the near term future (two years)

> for alternatives to treat this condition? Is it worth waiting? How

> do you decide?

Biological treatments (cartilage regrowth) are a long way away.

I understand that some of the companies are looking into using hard,

biologically inert coatings (ceramic or diamond) for resurfacing

components, but those won't be available anytime soon. If you allow

your bone quality to degrade too much, you may not have any alternatives.

> 2. Am I jeopardizing being a candidate for this procedure if I

> remain active given my current state?

Possibly. At a certain point, you'll find it nearly impossible to

remain highly active. As someone who is approaching that point with

alarming rapidity, my advice is to expedite the resurfacing process.

> 3. Are better materials being considered and when will they be

> available?

I already commented on coatings above. They're not in the immediate

future. They'll come eventually, but not in your decision timeframe.

In a conversation with Dr. Amstutz today, I was informed of the

existence of a metal on crosslinked poly resurfacing device, which

might be useful in patients (like me) who have compromised renal

function and are thus at more danger of high metal ion levels. I can't

see why anyone with normal kidney function would even consider it.

Only 21 of them have been installed and they require removal of some

acetabular bone because they have a larger external shell than a MoM

resurface. The head size is larger than a typical THR, but smaller

than a MoM resurface (about 40-44mm maximum). Wear is something of a

crap shoot.

In THRs, your options are metal/poly, metal/crosslinked poly, metal on

metal, and ceramic. Ceramic wears the least, but doesn't permit quite

as large a ball as metal on metal (because the shell has to be thicker

to avoid cracking). Metal on metal gives you a large ball (like a

resurface) and very similar wear characteristics, low risk of

dislocation, and excellent ROM. Metal on cross-linked poly is

reltively new. It wears roughly 5 times better than conventional

metal/poly. This may permit somewhat larger ball sizes (giving better

ROM and reduced dislocation risk). Metal/poly is the traditional

alternative. Most folks in this group don't think very highly of it.

Small ball, higher wear rate, higher dislocation risk, higher risk of

osteolysis (leading to aseptic loosening) than the other alternatives.

Stem-type devices in general tend to suffer from stress shielding in

the femur, which may or may not cause loosening of the femoral

component with the passage of time.

> 5. Will I regain some range of motion? Currently it is dismal.

Starrett, the first patient to get a simultaneous bilateral

in the US, went back to performing lead roles as a ballet dancer after

his surgery. He has since retired from performing (understandable

since he's about 50), but he still teaches and can still do the

splits. I'd say that 180 degrees of flexion and abduction constitutes

regaining range of motion. ;-)

> 6. Is it possible to get back to some level of rigorous activity

> and sport?

This group is full of people who have.

As far as elite athletes like yourself are concerned, , a

Masters judo competitor, won the 2001 World Championship in his age

division after being resurfaced. He was still competing on a

world-class level last year (I don't know about this year).

> 7. Are there data points to suggest that the results or

> procedures are more effective in Europe compared to the US?

Not really.

> 8. Are there any studies or is data available relative to the

> effectiveness of this procedure generally? How long will it last?

Wear studies suggest that resurfacings wear 20-100 times less than

conventional metal on polyethylene. So far, the clinical results for

resurfacings are better than for THRs among young, active patients.

There aren't any long-term clinical results yet.

> 9. Can a joint be resurfaced more that one time?

I don't know if anyone's tried. No resurfacing has every " worn out "

as far as I know. Those that have been revised have been due to

loosening of the femoral component, which is usually due to failure

of the underlying bone. This would preclude a subsequent resurfacing

of that joint. These patients are typically revised to a large ball

MoM THR, using the acetabular shell that's already present. We've got

a couple of folks here who've had this done. They can fill you in on

the details. The incidence of this is very low, but it does happen.

> 10. How long does recovery take?

It varies. The usually cited figures are " 2 to 3 times faster than a

THR " . Some people take a longer time due to severe muscle atrophy

or other problems. I can't tell you how long mine took because it

hasn't happened yet. :-(

Steve (progressing at a glacial pace towards a bilateral resurf)

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ive to the

> inevitable THR. I was drawn diagrams showing how the thickness of

> the covered joint was physiologically incompatible, limiting range of

> motion and will create impingement and thus a higher incidence of

> dislocation and/or fracture.

The incidence of dislocation is somewhere between 10 and 100 times

lower with resurfacing than with a conventional small ball metal on

polyethylene THR. It's hard to give a precise

figure because dislocations are extremely rare with resurfacings so

it's very hard to get a reliable figure for their frequency.

Dislocation rates with large ball MoM THRs is comparable to

resurfacing. The incidence with ceramic THRs is better than with

metal/poly THRs, but I don't think it is quite as good as MoM or

resurfacing.

Range of motion is better with a resurfacing than with a conventional

small-ball metal/poly THR. Resurfacing ROM is basically the same as

with a large ball Metal-on-Metal THR.

The major risk factors for fracture are female gender, small size,

advanced age, and poor bone condition. Even so, the published papers

show a failure rate of about 3% in early cases, with the incidence of

failure decreasing rapidly as surgeons gain experience and as they

improve patient selection. Resurfacing is not for everyone. If you

have poor bone quality, it's probably not for you. As a relatively

young male athlete, I can't imagine that you'd be in this situation as

long as you don't wait too long. However, you need to have your X-rays

evaluated by an OS who actually does resurfacing. Nobody can judge

your bone condition from an internet post.

I was also told about the fallacy of

> bone stock retention and the argument was invalid due to the fact

> that the head of the femur will fracture and the inside piece will

> need to be further reamed in the soon and certain revision to THR.

See above.

> left feeling rejected at the overwhelming lack of enthusiasm for this

> alternative approach. In my estimation, the best of the best in THR

> seemed very myopic and uninterested in my quest for a better life.

> That is when I moved on and found you.

>

> Questions: (sorry for the delay in getting here)

> 1. What can be anticipated in the near term future (two years)

> for alternatives to treat this condition? Is it worth waiting? How

> do you decide?

Biological treatments (cartilage regrowth) are a long way away.

I understand that some of the companies are looking into using hard,

biologically inert coatings (ceramic or diamond) for resurfacing

components, but those won't be available anytime soon. If you allow

your bone quality to degrade too much, you may not have any alternatives.

> 2. Am I jeopardizing being a candidate for this procedure if I

> remain active given my current state?

Possibly. At a certain point, you'll find it nearly impossible to

remain highly active. As someone who is approaching that point with

alarming rapidity, my advice is to expedite the resurfacing process.

> 3. Are better materials being considered and when will they be

> available?

I already commented on coatings above. They're not in the immediate

future. They'll come eventually, but not in your decision timeframe.

In a conversation with Dr. Amstutz today, I was informed of the

existence of a metal on crosslinked poly resurfacing device, which

might be useful in patients (like me) who have compromised renal

function and are thus at more danger of high metal ion levels. I can't

see why anyone with normal kidney function would even consider it.

Only 21 of them have been installed and they require removal of some

acetabular bone because they have a larger external shell than a MoM

resurface. The head size is larger than a typical THR, but smaller

than a MoM resurface (about 40-44mm maximum). Wear is something of a

crap shoot.

In THRs, your options are metal/poly, metal/crosslinked poly, metal on

metal, and ceramic. Ceramic wears the least, but doesn't permit quite

as large a ball as metal on metal (because the shell has to be thicker

to avoid cracking). Metal on metal gives you a large ball (like a

resurface) and very similar wear characteristics, low risk of

dislocation, and excellent ROM. Metal on cross-linked poly is

reltively new. It wears roughly 5 times better than conventional

metal/poly. This may permit somewhat larger ball sizes (giving better

ROM and reduced dislocation risk). Metal/poly is the traditional

alternative. Most folks in this group don't think very highly of it.

Small ball, higher wear rate, higher dislocation risk, higher risk of

osteolysis (leading to aseptic loosening) than the other alternatives.

Stem-type devices in general tend to suffer from stress shielding in

the femur, which may or may not cause loosening of the femoral

component with the passage of time.

> 5. Will I regain some range of motion? Currently it is dismal.

Starrett, the first patient to get a simultaneous bilateral

in the US, went back to performing lead roles as a ballet dancer after

his surgery. He has since retired from performing (understandable

since he's about 50), but he still teaches and can still do the

splits. I'd say that 180 degrees of flexion and abduction constitutes

regaining range of motion. ;-)

> 6. Is it possible to get back to some level of rigorous activity

> and sport?

This group is full of people who have.

As far as elite athletes like yourself are concerned, , a

Masters judo competitor, won the 2001 World Championship in his age

division after being resurfaced. He was still competing on a

world-class level last year (I don't know about this year).

> 7. Are there data points to suggest that the results or

> procedures are more effective in Europe compared to the US?

Not really.

> 8. Are there any studies or is data available relative to the

> effectiveness of this procedure generally? How long will it last?

Wear studies suggest that resurfacings wear 20-100 times less than

conventional metal on polyethylene. So far, the clinical results for

resurfacings are better than for THRs among young, active patients.

There aren't any long-term clinical results yet.

> 9. Can a joint be resurfaced more that one time?

I don't know if anyone's tried. No resurfacing has every " worn out "

as far as I know. Those that have been revised have been due to

loosening of the femoral component, which is usually due to failure

of the underlying bone. This would preclude a subsequent resurfacing

of that joint. These patients are typically revised to a large ball

MoM THR, using the acetabular shell that's already present. We've got

a couple of folks here who've had this done. They can fill you in on

the details. The incidence of this is very low, but it does happen.

> 10. How long does recovery take?

It varies. The usually cited figures are " 2 to 3 times faster than a

THR " . Some people take a longer time due to severe muscle atrophy

or other problems. I can't tell you how long mine took because it

hasn't happened yet. :-(

Steve (progressing at a glacial pace towards a bilateral resurf)

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