Re: Resurface or Metal on Metal THR

April 1, 2004

Hi,

A note from another country....... Here in Aust, where there has been no

trials and no insurance hassles, a Resurface is quickly becoming the

preferred option for those younger and with femurs still in good enough

shape to take it. Even then some OS's with more experience will take on

worse case senarios femurs and complete the job successfully. And initially,

like with all new devices, various OS put up the routine arguments against

it but I note they are now going off to be trained to do

Resurfacing........So it has become a standard available hip operation all

over the place.

And here only some doctors have patients stay more than one or 2 nights in

hospital........... 3 people I know who had a Resurface very early in the

piece were up walking a few hours after their operations and able to leave

the hospital quickly. i.e. we don't have the rules about being on crutches

for 6 weeks here in Australia. Only one of those had hassles, then with the

top cup becoming loose and he is a very large gentleman and they didn't let

him walk so quickly after they went in again to fix the cup more securely.

The other 2 are still enjoying their hips 4 years on............

The case always is simply put, less bone removal - so less interference with

natural bone function, better stress loading for maintaining the health of

the femur, few limits to any activities and little or no dislocation risks.

There is no more information on the lasting time of the newer varieties of

THR's than there is on a Resurface............ The risks of failure on a

Resurface appear to be very small and my OS said they appear to be related

to putting the cover on the femur and show up within 12 months. Apparently,

every so often some OS get a tad too enthusiastic with the hammer and cracks

the femur head.......... so pick cool headed OS's for your op....... And as

every man and his dog OS gets to do it in Australia I guess our failure

rates will give a much better idea of what actually happens than 'conducted

trials'.............

Because of a number of complications I was also one who had to wait until

technology caught up with my problems. A resurface BHR has been a gift of

life so I am pretty biased............smile.

Edith LBHR Dr. L Walter Syd Australia 8/02

>

> I was considering a resurfacing for my badly degenerated hip. I am 48

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

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

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

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

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

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

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

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

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

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

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

>

April 1, 2004

Noah

I know alot of others will also reply to you however . . . . . . . I couldn't

let your email go by with out saying something myself. Please continue your

research. Call another OS!

Resurfacing IS being done.

It is less traumatic to the body as compared to a THR in that you do not

loose your femoral head and there is no shaft pressed down through the femoral

canal of your thigh bone.

The entry into the body may be the same however there is less for the body to

recover from.

A standard THR must always be considered in wear & tear for the sheering or

stress placed between the prosthetic and the bone ingrowth in the femoral

component. A more active person will place more stress on the part of th

prosthetic and that is when revision surgery comes in.

Noah . . . . check with other Orthopedic surgeons yourself. Do not stop with

what you have heard until you have heard it from more than one source.

Best

Alyce

LC2K Wm Kennedy 5/23/03

April 2, 2004

Dear Noah,

Writing here to challenge what you just heard from Dr Inglis in practice in

New York. I too, can not pass up reading your posting without offering my two

cents!

I too, live in New York City and have once called the offices of Dr. Inglis

inquiring about his Hip Resurfacing. Fortunately a receptionist answered,

succinctly stating, " Dr. Inglis has filled his quota and is not doing

Resurfacings

at this time, " and was spared a 15 minute sales pitch. Find it very disturbing

that an orthopedic surgeon who has performed both Resurfacing and Total Hip

Replacements, would make a number of statements about Resurfacing which can

seemingly be so easily refuted. Would think that a man, having been extensively

trained in Hip Resurfacing, having performed 28 Resurfacings himself, would

clearly, undoubtedly recognize the remarkable benefits and clear advantages Hip

Resurfacing has over Total Hip Replacement and would highly recommend this

procedure for those who want and would likely most benefit from it. Would hope

Dr.

Inglis is apparently ill informed, as hard as this is to believe, and not

driven by, perhaps, less than virtues motives.

Feel very sad (and troubled) that you have been influenced to the point that

you are now reconsidering a Total Hip Replacement after spending the past 13

years trying to avoid having one. Obviously, many medical personal and

sometimes our very families have tried to persuade us to believe that our

decision to

have a Resurfacing is not intelligently thought out, impractical and even

dangerous. Some have succeeed in their efforts. Not surprised, of the many

wonderful Surfacehippy replies you have received from around the world, each a

gem

in their own right, each being as thoroughly informative as they are genuinely

moving and inspirational. Trust in reading them you may come to feel

differently about the information that has previously come your way.

Think I might have had a Total Hip Replacement now if it was not for kindness

and generosity of this group.... Likely might not have a MOM, either. (Smile)

Very pleased with my BHR! Feels like my own hip more everyday. Hope you

consider your decision to have either a Resurfacing or a Total Hip Replacement

very wisely! My Best...

K. r/BHR De Smet Feb 3rd, 04

Hi Noah,

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

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

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

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

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

resurfacing unless part of an approved study. "

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

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

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

participated in the FDA clinical trials of the Medical

Conserve Plus and Corin Cormet 2000 devices have been

granted " continued access " to the devices.

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

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

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

need this but people only interested in conventional team sports or

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

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

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

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

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

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

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

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

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

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

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

failed THR.

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

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

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

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

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

resurfacing.

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

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

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

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

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

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

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

Good Luck,

Jim V.S.

LBHR, De Smet, 11/25/03

> Hello Surface Hippies