Guest guest Posted June 8, 2004 Report Share Posted June 8, 2004 Hi, When I first started with all this the arguments were only limited to a Resurface or THR....... But I picked up that once Resurfacing gathered pace the argument would then center on which Resurface prothesis........ and you are pushing the front of that argument along.........smile. I suspect you would have to lay out why you personally see a difference in the attachment process for any of us to have much idea what this debate could be about............. and why it may matter.......... I have a BHR........... I think they were the only ones available in Australia at the time...........now I think Corin is moving in on the patch and I personally know someone with 2 varieties............ I guess as time goes on there will be more and more choices and thus things to argue about will arise.......... At the time of my op I was just extremely thankful that some OS somewhere would be clever enough to do a take down on fused hip of 35 years and give me something that seems to have worked so far.......... After 35 years and a body in a big mess I may well have accepted just about anything........... though I never did like the idea of a THR and with the added situation of past osteomylitis, no OS ever did either..........smile. I suspect many patients are in similiar positions after years of pain and misery............and in US they have the added bonus of reluctant insurance coys.......... Thus many of us are far from finer points at this stage. It is good to see surgeons doing web pages............. at least it helps disseminate info........... My only comment on yours was perhaps some more info on benefits of a Resurface could perhaps be included........ This would help some of us who get regularly involved in arguments about why we feel it is beneficial. Edith LBHR Dr. L Walter Syd Aust 8/02 > Real eyeopener scrolling old messages: waiting times in Canada > unbelievable. Makes NHS look like pvt. medicine! > My wait on NHS currently 13 weeks max. for consultation and surgery > within 6 months of that- but only just hanging on to these times! > Do you all realise that there may be very significant differences > between prostheses in terms of metallurgy and fixation? This may > affect the longevity of your resurfacing? > > Feel all should stick to either the BHR from MMT or (grudgingly) the > Cormet from Corin. Personally would not touch the rest no matter > what anyone says! Let someone else be the guinea pig. In essence, > stick with the only 2 designs that have a halfway decent track > record. > How's that for controversy! > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 8, 2004 Report Share Posted June 8, 2004 You won't be making many friends with the 30% of us Surfacehippies who have a C+. Are you at all familiar with the study results of Dr. Amstutz at the JRI? Candace, another very happy guinea pig C+ Vail 12/02 > > > > Feel all should stick to either the BHR from MMT > or (grudgingly) the > > Cormet from Corin. Personally would not touch the > rest no matter > > what anyone says! Let someone else be the guinea > pig. In essence, > > stick with the only 2 designs that have a halfway > decent track > > record. > > How's that for controversy! > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 8, 2004 Report Share Posted June 8, 2004 At 10:54 PM 6/7/2004 +0000, you wrote: >Feel all should stick to either the BHR from MMT or (grudgingly) the >Cormet from Corin. Personally would not touch the rest no matter >what anyone says! Let someone else be the guinea pig. In essence, >stick with the only 2 designs that have a halfway decent track >record. Guinea pig here.... Resurfacing has come SO FAR in the last three years, it feels like another world. When I was researching, I had a choice of the Conserve Plus or standard THR. The name of some unknown doc in Belgium was just starting to be mentioned, and a few were traveling to England (which I could not afford and family would not have supported). Would I choose differently if I were just now looking? I honestly don't know. I feel that I found the best surgeon, and have been thrilled with the results thus far. I keep up with what is going on with resurfacing in general, and particularly the upcoming FDA approval, but have no regrets for the decision I made. I would be happy with any of the devices, but I think in my case, surgeon skill (and especially willingness to tackle a difficult situation) was paramount. I'd bet most of the other surgeons would have turned me down for resurfacing, so it then really WOULD have been a moot point. Try putting yourself in the patient position (again, especially where we were three years ago), and have some compassion! Candace is right (or should that be wright?)--you'll not be making friends with such blatant inflammatory statements, especially with nothing to back them up. Cindy C+ 5/25/01 and 6/28/01 PROUD guinea pig > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 8, 2004 Report Share Posted June 8, 2004 Hi doc. Welcome. I'm in my 7th year on one C+ (L) and the 4th month on the other ®. I was one of the first 50 to get a C+ in the US and my 1998 operation was piped to a group of visiting European OSs, so I was truly a guinea pig. Prior to my recent resurfacing, Dr. Amstutz showed me several shiny tools he developed since my first resurfacing to facilitate the operation. They look like a combination of mechanic and woodworker's tools. Post-op he used my x-rays to point out advances in the technical side of the surgery between my two resurfacings. He also used an x-ray of a BHR to compare the two devices and discussed the merits of each. (Dr. Amstutz actually performed resurfacings in the 1960s but concluded the devices at that time did not have the technology to be successful long-term.) The C+ and the BHR have also undergone technical improvements between my surgeries – the C+ has an incredibly high fit tolerance between the two components. This 57 year old guinea pig is very active and has no restrictions - running, skydiving, high- level tennis, cycling, mountain biking, weight training, skiing, hockey, blading, karate, at, or above, my pre-op levels. The technical advances in tools and newer surgical techniques have improved my recovery time in my second resurfacing and allowed more seriously degenerated hips to qualify for resurfacing. My strong personal belief is that the surgeon's skill, technical innovation, and most importantly of all, experience are significantly more important to a good end result than the device. It's the track record of the doc, doc. Dave C+ Amstutz, 3.24.1998, 2.12.2004 > Real eyeopener scrolling old messages: waiting times in Canada > unbelievable. Makes NHS look like pvt. medicine! > My wait on NHS currently 13 weeks max. for consultation and surgery > within 6 months of that- but only just hanging on to these times! > Do you all realise that there may be very significant differences > between prostheses in terms of metallurgy and fixation? This may > affect the longevity of your resurfacing? > > Feel all should stick to either the BHR from MMT or (grudgingly) the > Cormet from Corin. Personally would not touch the rest no matter > what anyone says! Let someone else be the guinea pig. In essence, > stick with the only 2 designs that have a halfway decent track > record. > How's that for controversy! Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 8, 2004 Report Share Posted June 8, 2004 Hi doc. Welcome. I'm in my 7th year on one C+ (L) and the 4th month on the other ®. I was one of the first 50 to get a C+ in the US and my 1998 operation was piped to a group of visiting European OSs, so I was truly a guinea pig. Prior to my recent resurfacing, Dr. Amstutz showed me several shiny tools he developed since my first resurfacing to facilitate the operation. They look like a combination of mechanic and woodworker's tools. Post-op he used my x-rays to point out advances in the technical side of the surgery between my two resurfacings. He also used an x-ray of a BHR to compare the two devices and discussed the merits of each. (Dr. Amstutz actually performed resurfacings in the 1960s but concluded the devices at that time did not have the technology to be successful long-term.) The C+ and the BHR have also undergone technical improvements between my surgeries – the C+ has an incredibly high fit tolerance between the two components. This 57 year old guinea pig is very active and has no restrictions - running, skydiving, high- level tennis, cycling, mountain biking, weight training, skiing, hockey, blading, karate, at, or above, my pre-op levels. The technical advances in tools and newer surgical techniques have improved my recovery time in my second resurfacing and allowed more seriously degenerated hips to qualify for resurfacing. My strong personal belief is that the surgeon's skill, technical innovation, and most importantly of all, experience are significantly more important to a good end result than the device. It's the track record of the doc, doc. Dave C+ Amstutz, 3.24.1998, 2.12.2004 > Real eyeopener scrolling old messages: waiting times in Canada > unbelievable. Makes NHS look like pvt. medicine! > My wait on NHS currently 13 weeks max. for consultation and surgery > within 6 months of that- but only just hanging on to these times! > Do you all realise that there may be very significant differences > between prostheses in terms of metallurgy and fixation? This may > affect the longevity of your resurfacing? > > Feel all should stick to either the BHR from MMT or (grudgingly) the > Cormet from Corin. Personally would not touch the rest no matter > what anyone says! Let someone else be the guinea pig. In essence, > stick with the only 2 designs that have a halfway decent track > record. > How's that for controversy! Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 8, 2004 Report Share Posted June 8, 2004 Susie, With all of the positive comments about resurfacing and the lack of negative reports on this website, (along with the written data that is available) I find it hard to believe that your internist husband has not come around to believing that resurfacing isn't the best option for someone your age. Has he actually been following the posts here? Has he looked at any of the studies? Does he think that results in places other than the US since 1991 (although better results since 1997 with changes in the device) are not real? That the neanderthal thinking of OS's, only comfortable with a " one size fits all " approach to a very complex issue, is somehow justified because it is held by the COMPLACENT majority? Is he skeptical of all technological advancements in medicine? If not, what does it take for him to believe in something? Does he realize what your restrictions will be if you have a THR? What if you have to have more than a secondary THR? Is anyone going to guarantee that? What would he think if it was his hip and lifestyle on the line? After researching resurfacing and THR thoroughly for my insurance appeal I am convinced that my decision was a good one for someone of my age (48 at the time of surgery) and desired active lifestyle. This is a good decision for right now and for many years to come. I'm sure glad that my open minded, forward thinking spouse supported my decision. Good luck, Fred Dr. Gross, C2K 1/21/04 > > Real eyeopener scrolling old messages: waiting times in Canada > > unbelievable. Makes NHS look like pvt. medicine! > > My wait on NHS currently 13 weeks max. for consultation and surgery > > within 6 months of that- but only just hanging on to these times! > > Do you all realise that there may be very significant differences > > between prostheses in terms of metallurgy and fixation? This may > > affect the longevity of your resurfacing? > > > > Feel all should stick to either the BHR from MMT or (grudgingly) > the > > Cormet from Corin. Personally would not touch the rest no matter > > what anyone says! Let someone else be the guinea pig. In essence, > > stick with the only 2 designs that have a halfway decent track > > record. > > How's that for controversy! Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 8, 2004 Report Share Posted June 8, 2004 Hey Fred! Thanks for your post. Over the weekend while driving to our log cabin on the river far away I had a very unpleasant conversation with my husband about resurfacing during which I wanted to drive the car off a bridge so as not to deal with it any more! I have e-mailed him many, many scientific articles, I have been following a person with protrusio who is now 3 weeks post op re-surf (in Germany) and I check out this web site and others every day. I've about had it, Fred. He's never been interested in checking out this web site nor has he bothered to look at my hip x-rays in the Orthopedists office on the next floor in his medical building! Now I will say that he has asked a few local OS's about resurfacing but they are ALL opposed to it. Lately,(since yesterday and the unpleasant conversation) he communicated with the and Nephew rep here in Memphis and forwarded me the names of surgeons abroad thought to be expertly skilled in resurfacing....one name was Desmet! Of course I had been telling him that for months now! I've always been a very strong, independent woman (it's a good thing, huh?) and I will go this alone if I have to. Thank you ..and everyone else, for listening to my whining. Susie in Memphis > > > Real eyeopener scrolling old messages: waiting times in Canada > > > unbelievable. Makes NHS look like pvt. medicine! > > > My wait on NHS currently 13 weeks max. for consultation and > surgery > > > within 6 months of that- but only just hanging on to these times! > > > Do you all realise that there may be very significant > differences > > > between prostheses in terms of metallurgy and fixation? This may > > > affect the longevity of your resurfacing? > > > > > > Feel all should stick to either the BHR from MMT or (grudgingly) > > the > > > Cormet from Corin. Personally would not touch the rest no matter > > > what anyone says! Let someone else be the guinea pig. In > essence, > > > stick with the only 2 designs that have a halfway decent track > > > record. > > > How's that for controversy! Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 8, 2004 Report Share Posted June 8, 2004 Hey Fred! Thanks for your post. Over the weekend while driving to our log cabin on the river far away I had a very unpleasant conversation with my husband about resurfacing during which I wanted to drive the car off a bridge so as not to deal with it any more! I have e-mailed him many, many scientific articles, I have been following a person with protrusio who is now 3 weeks post op re-surf (in Germany) and I check out this web site and others every day. I've about had it, Fred. He's never been interested in checking out this web site nor has he bothered to look at my hip x-rays in the Orthopedists office on the next floor in his medical building! Now I will say that he has asked a few local OS's about resurfacing but they are ALL opposed to it. Lately,(since yesterday and the unpleasant conversation) he communicated with the and Nephew rep here in Memphis and forwarded me the names of surgeons abroad thought to be expertly skilled in resurfacing....one name was Desmet! Of course I had been telling him that for months now! I've always been a very strong, independent woman (it's a good thing, huh?) and I will go this alone if I have to. Thank you ..and everyone else, for listening to my whining. Susie in Memphis > > > Real eyeopener scrolling old messages: waiting times in Canada > > > unbelievable. Makes NHS look like pvt. medicine! > > > My wait on NHS currently 13 weeks max. for consultation and > surgery > > > within 6 months of that- but only just hanging on to these times! > > > Do you all realise that there may be very significant > differences > > > between prostheses in terms of metallurgy and fixation? This may > > > affect the longevity of your resurfacing? > > > > > > Feel all should stick to either the BHR from MMT or (grudgingly) > > the > > > Cormet from Corin. Personally would not touch the rest no matter > > > what anyone says! Let someone else be the guinea pig. In > essence, > > > stick with the only 2 designs that have a halfway decent track > > > record. > > > How's that for controversy! Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 8, 2004 Report Share Posted June 8, 2004 > > > > Real eyeopener scrolling old messages: waiting times in Canada > > > > unbelievable. Makes NHS look like pvt. medicine! > > > > My wait on NHS currently 13 weeks max. for consultation and > > surgery > > > > within 6 months of that- but only just hanging on to these > times! > > > > Do you all realise that there may be very significant > > differences > > > > between prostheses in terms of metallurgy and fixation? This > may > > > > affect the longevity of your resurfacing? > > > > > > > > Feel all should stick to either the BHR from MMT or > (grudgingly) > > > the > > > > Cormet from Corin. Personally would not touch the rest no > matter > > > > what anyone says! Let someone else be the guinea pig. In > > essence, > > > > stick with the only 2 designs that have a halfway decent track > > > > record. > > > > How's that for controversy! Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 8, 2004 Report Share Posted June 8, 2004 None of you C+ guinea pigs are as happy as my actual guinea pig named Cindy (sorry, Cindy!) ) But you're pretty dang happy I know! Couldn't resist - sorry guys! ) ) In surfacehippy , Candace Castle wrote: > > You won't be making many friends with the 30% of us > Surfacehippies who have a C+. Are you at all familiar > with the study results of Dr. Amstutz at the JRI? > > Candace, another very happy guinea pig C+ Vail 12/02 > > > > > > > Feel all should stick to either the BHR from MMT > > or (grudgingly) the > > > Cormet from Corin. Personally would not touch the > > rest no matter > > > what anyone says! Let someone else be the guinea > > pig. In essence, > > > stick with the only 2 designs that have a halfway > > decent track > > > record. > > > How's that for controversy! Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 9, 2004 Report Share Posted June 9, 2004 > W > If C+ beyond questioning why are so many going to Belgium? Because insurance companies in the US, as a rule, do not cover resurfacing and DeSmet charges several thousand dollars less for the surgery than anyone in the US. Steve (bilat C+ 4/20/04, Amstutz) Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 9, 2004 Report Share Posted June 9, 2004 Good Doctor, Since you're looking for discussion... With the lone exception of Dr. De Smet, we surfacehippies understand and accept that each OS exclusively implants a single device with which they are experienced and comfortable. You like the BHR – that's great. You base it on evidence – even better. No issue there. But you can also understand why hackles are raised when a Volvo mechanic puts down a Mercedes or Mini when they have never worked on them and have no first hand experience. Owners of those models have may have excellent first hand experience that shouldn't be discounted. In addition to rubbing Mercedes and Mini owners the wrong way, that mechanic looses credibility in the eyes of many. Dave C+ Amstutz, 2.24.98, 3.12.04 > Well got my knuckles rapped by some! Probably deservedly. > Sorry if offended anyone but joined group to have stimulating > discussion rather than just make friends. > > Cannot compete with the gravitas of some surgeons or their websites. > Does not mean they are always right. Can say I was a pioneer in my > region and stuck to my guns re hip resurfacing. My unit now does > more BHR's than any other in UK outside Birmingham (3 colleagues > followed my lead). We do both private patients and NHS so we cannot > be accused of simply wanting to get rich quick! > > Agree the prosthesis is only part of the story and surgeon > experience, skill and committment just as important. Pity that US > patients and surgeons do not have easy access to BHR or Cormet 2000. > If C+ beyond questioning why are so many going to Belgium? My point > is that hip resurfacing as a concept is " experimental " and > controversial enough so why introduce another variable by using a > prosthesis that did not come from Birmingham stable ? Worry because > every week a rep comes to see me with a new design of hip > resurfacing that offers some or other " improvement " . Birmingham > group results are the best evidence we have so far. Accept it is > difficult for US patients to travel for surgery and C+ maybe only > viable option. Hopefully it will also stand test of time. As I have > not designed my own hip resurfacing device(and probably never will) > my choice is unbiased. Designers will naturally feel their device is > the best including Mr McMinn! > > When I chose a car for myself it had to be the new Mini . I > knew there would be all the teething problems of a new model and > there were a few hassles. Other owners gripe too. But I had the > first one at work and I still love its cheeky image. When I choose a > new car for my wife and kids, I will look to manufacturers like > Mercedes or Volvo. They are too precious to me to take any chances > with fashion. So there is a place for innovation and experimentation > but there is also sense in tradition and history. Depends on your > philosophy.............................. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 9, 2004 Report Share Posted June 9, 2004 Good Doctor, Since you're looking for discussion... With the lone exception of Dr. De Smet, we surfacehippies understand and accept that each OS exclusively implants a single device with which they are experienced and comfortable. You like the BHR – that's great. You base it on evidence – even better. No issue there. But you can also understand why hackles are raised when a Volvo mechanic puts down a Mercedes or Mini when they have never worked on them and have no first hand experience. Owners of those models have may have excellent first hand experience that shouldn't be discounted. In addition to rubbing Mercedes and Mini owners the wrong way, that mechanic looses credibility in the eyes of many. Dave C+ Amstutz, 2.24.98, 3.12.04 > Well got my knuckles rapped by some! Probably deservedly. > Sorry if offended anyone but joined group to have stimulating > discussion rather than just make friends. > > Cannot compete with the gravitas of some surgeons or their websites. > Does not mean they are always right. Can say I was a pioneer in my > region and stuck to my guns re hip resurfacing. My unit now does > more BHR's than any other in UK outside Birmingham (3 colleagues > followed my lead). We do both private patients and NHS so we cannot > be accused of simply wanting to get rich quick! > > Agree the prosthesis is only part of the story and surgeon > experience, skill and committment just as important. Pity that US > patients and surgeons do not have easy access to BHR or Cormet 2000. > If C+ beyond questioning why are so many going to Belgium? My point > is that hip resurfacing as a concept is " experimental " and > controversial enough so why introduce another variable by using a > prosthesis that did not come from Birmingham stable ? Worry because > every week a rep comes to see me with a new design of hip > resurfacing that offers some or other " improvement " . Birmingham > group results are the best evidence we have so far. Accept it is > difficult for US patients to travel for surgery and C+ maybe only > viable option. Hopefully it will also stand test of time. As I have > not designed my own hip resurfacing device(and probably never will) > my choice is unbiased. Designers will naturally feel their device is > the best including Mr McMinn! > > When I chose a car for myself it had to be the new Mini . I > knew there would be all the teething problems of a new model and > there were a few hassles. Other owners gripe too. But I had the > first one at work and I still love its cheeky image. When I choose a > new car for my wife and kids, I will look to manufacturers like > Mercedes or Volvo. They are too precious to me to take any chances > with fashion. So there is a place for innovation and experimentation > but there is also sense in tradition and history. Depends on your > philosophy.............................. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 9, 2004 Report Share Posted June 9, 2004 Good point Steve! I am sure when all Insurance Companies in US start paying for resurfacing more c+'s will be used and less will travel to Belgium and pay out of pocket. Face it, I'm not trying to keep up with the next store and drive a Volvo I just need a car to get to work. -- In surfacehippy , " sog1927 " wrote: > > > W > > If C+ beyond questioning why are so many going to Belgium? > > Because insurance companies in the US, as a rule, do not cover > resurfacing and DeSmet charges several thousand dollars less for the > surgery than anyone in the US. > > Steve (bilat C+ 4/20/04, Amstutz) Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 9, 2004 Report Share Posted June 9, 2004 Good point Steve! I am sure when all Insurance Companies in US start paying for resurfacing more c+'s will be used and less will travel to Belgium and pay out of pocket. Face it, I'm not trying to keep up with the next store and drive a Volvo I just need a car to get to work. -- In surfacehippy , " sog1927 " wrote: > > > W > > If C+ beyond questioning why are so many going to Belgium? > > Because insurance companies in the US, as a rule, do not cover > resurfacing and DeSmet charges several thousand dollars less for the > surgery than anyone in the US. > > Steve (bilat C+ 4/20/04, Amstutz) Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 9, 2004 Report Share Posted June 9, 2004 > Good point Steve! To be fair, I should add the following: 1) The BHR is available in a wider range of sizes and has a dysplasia cup for those with severe dysplasia who cannot use the or Cormet devices 2) DeSmet has a real knack for successfully resurfacing patients whom other surgeons have been reluctant or unwilling to resurface due to the progression of their hip problems 3) McMinn, Treacy, and DeSmet all have more experience with the resurfacing technique than anyone in the US (although there a number of very experienced US resurfacers). ly, if I had been unable to make arrangements with my insurance company for partial coverage of the surgery at JRI, I probably would've gone to Belgium myself. I corresponded a fair amount with DeSmet and would have had no qualms whatsoever about entrusting my hips to him. Anyway, no disrespect was intended to Mr. Bloomfield. He uses a device that he knows and trusts based on his experience with it. In fairness, however, one should point out the Cormet 2000 has only been in use since 1997 (according to the Corin site) and therefore doesn't have as long a clinical track record as the Conserve Plus (which was first implanted in November 1996, according to Amstutz's paper). Steve (bilat C+ guinea pig 4/20/04, Amstutz) Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 9, 2004 Report Share Posted June 9, 2004 > Good point Steve! To be fair, I should add the following: 1) The BHR is available in a wider range of sizes and has a dysplasia cup for those with severe dysplasia who cannot use the or Cormet devices 2) DeSmet has a real knack for successfully resurfacing patients whom other surgeons have been reluctant or unwilling to resurface due to the progression of their hip problems 3) McMinn, Treacy, and DeSmet all have more experience with the resurfacing technique than anyone in the US (although there a number of very experienced US resurfacers). ly, if I had been unable to make arrangements with my insurance company for partial coverage of the surgery at JRI, I probably would've gone to Belgium myself. I corresponded a fair amount with DeSmet and would have had no qualms whatsoever about entrusting my hips to him. Anyway, no disrespect was intended to Mr. Bloomfield. He uses a device that he knows and trusts based on his experience with it. In fairness, however, one should point out the Cormet 2000 has only been in use since 1997 (according to the Corin site) and therefore doesn't have as long a clinical track record as the Conserve Plus (which was first implanted in November 1996, according to Amstutz's paper). Steve (bilat C+ guinea pig 4/20/04, Amstutz) Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 9, 2004 Report Share Posted June 9, 2004 Mr. Bloomfield: You're certainly not reluctant to state your opinion in a forthright manner! And…I think you're meeting your goal of stimulation and provocation. A couple points in rejoinder: (1) To distill from your comments: " Pity that US patients and surgeons do not have easy access to BHR or Cormet 2000 " … " hip resurfacing as a concept is " experimental " and controversial enough so why introduce another variable by using a prosthesis that did not come from Birmingham stable? " … " Hopefully it [C+] will also stand test of time. " I'm going to be paying a visit to JRI 6/22, a first step that could lead to adding the C+ option to my original equipment. It might be inferred from your comments that the C+ is inferior in some manner to the BHR or Cormet 2000 components. Is there any scientific comparative basis available for this conclusion to which you could direct me? I'd be grateful. (2) I enjoyed your effective Mini vs. Mercedes analogy, but I would have to amend it for it to fit my circumstance better. My family, as for you, are precious to me, such that I could not / would not choose the Mini *for myself* if I thought a Mercedes, Volvo, or Edsel provided greater long-term reliability. I'd rather be wheelchair-bound and stable than have a few gazelle-like moments before substantial and dire decline. I'd love to hear your comments on how one may best discriminate between " innovation and experimentation " on the one side and " tradition and history " on the other, as pertains to the field of hip resurfacing and prostheses in particular, as an aspect of choosing the right surgical course. - Bob > Well got my knuckles rapped by some! Probably deservedly. > Sorry if offended anyone but joined group to have stimulating > discussion rather than just make friends. > > Cannot compete with the gravitas of some surgeons or their websites. > Does not mean they are always right. Can say I was a pioneer in my > region and stuck to my guns re hip resurfacing. My unit now does > more BHR's than any other in UK outside Birmingham (3 colleagues > followed my lead). We do both private patients and NHS so we cannot > be accused of simply wanting to get rich quick! > > Agree the prosthesis is only part of the story and surgeon > experience, skill and committment just as important. Pity that US > patients and surgeons do not have easy access to BHR or Cormet 2000. > If C+ beyond questioning why are so many going to Belgium? My point > is that hip resurfacing as a concept is " experimental " and > controversial enough so why introduce another variable by using a > prosthesis that did not come from Birmingham stable ? Worry because > every week a rep comes to see me with a new design of hip > resurfacing that offers some or other " improvement " . Birmingham > group results are the best evidence we have so far. Accept it is > difficult for US patients to travel for surgery and C+ maybe only > viable option. Hopefully it will also stand test of time. As I have > not designed my own hip resurfacing device(and probably never will) > my choice is unbiased. Designers will naturally feel their device is > the best including Mr McMinn! > > When I chose a car for myself it had to be the new Mini . I > knew there would be all the teething problems of a new model and > there were a few hassles. Other owners gripe too. But I had the > first one at work and I still love its cheeky image. When I choose a > new car for my wife and kids, I will look to manufacturers like > Mercedes or Volvo. They are too precious to me to take any chances > with fashion. So there is a place for innovation and experimentation > but there is also sense in tradition and history. Depends on your > philosophy.............................. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 9, 2004 Report Share Posted June 9, 2004 Mr. Bloomfield: You're certainly not reluctant to state your opinion in a forthright manner! And…I think you're meeting your goal of stimulation and provocation. A couple points in rejoinder: (1) To distill from your comments: " Pity that US patients and surgeons do not have easy access to BHR or Cormet 2000 " … " hip resurfacing as a concept is " experimental " and controversial enough so why introduce another variable by using a prosthesis that did not come from Birmingham stable? " … " Hopefully it [C+] will also stand test of time. " I'm going to be paying a visit to JRI 6/22, a first step that could lead to adding the C+ option to my original equipment. It might be inferred from your comments that the C+ is inferior in some manner to the BHR or Cormet 2000 components. Is there any scientific comparative basis available for this conclusion to which you could direct me? I'd be grateful. (2) I enjoyed your effective Mini vs. Mercedes analogy, but I would have to amend it for it to fit my circumstance better. My family, as for you, are precious to me, such that I could not / would not choose the Mini *for myself* if I thought a Mercedes, Volvo, or Edsel provided greater long-term reliability. I'd rather be wheelchair-bound and stable than have a few gazelle-like moments before substantial and dire decline. I'd love to hear your comments on how one may best discriminate between " innovation and experimentation " on the one side and " tradition and history " on the other, as pertains to the field of hip resurfacing and prostheses in particular, as an aspect of choosing the right surgical course. - Bob > Well got my knuckles rapped by some! Probably deservedly. > Sorry if offended anyone but joined group to have stimulating > discussion rather than just make friends. > > Cannot compete with the gravitas of some surgeons or their websites. > Does not mean they are always right. Can say I was a pioneer in my > region and stuck to my guns re hip resurfacing. My unit now does > more BHR's than any other in UK outside Birmingham (3 colleagues > followed my lead). We do both private patients and NHS so we cannot > be accused of simply wanting to get rich quick! > > Agree the prosthesis is only part of the story and surgeon > experience, skill and committment just as important. Pity that US > patients and surgeons do not have easy access to BHR or Cormet 2000. > If C+ beyond questioning why are so many going to Belgium? My point > is that hip resurfacing as a concept is " experimental " and > controversial enough so why introduce another variable by using a > prosthesis that did not come from Birmingham stable ? Worry because > every week a rep comes to see me with a new design of hip > resurfacing that offers some or other " improvement " . Birmingham > group results are the best evidence we have so far. Accept it is > difficult for US patients to travel for surgery and C+ maybe only > viable option. Hopefully it will also stand test of time. As I have > not designed my own hip resurfacing device(and probably never will) > my choice is unbiased. Designers will naturally feel their device is > the best including Mr McMinn! > > When I chose a car for myself it had to be the new Mini . I > knew there would be all the teething problems of a new model and > there were a few hassles. Other owners gripe too. But I had the > first one at work and I still love its cheeky image. When I choose a > new car for my wife and kids, I will look to manufacturers like > Mercedes or Volvo. They are too precious to me to take any chances > with fashion. So there is a place for innovation and experimentation > but there is also sense in tradition and history. Depends on your > philosophy.............................. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 9, 2004 Report Share Posted June 9, 2004 Dr. Bloomfield, If you would sir, please disclosed the published literature you suggest exists regarding the superior clinical results of the BHR. I searched extensively before my own resurface and found very little pulished literature on resurfacings in general. And most that I did encounter bore the name of Dr. Harlan Amsutz and his work with the C+. I am just a humble home builder, not a Doctor as you are, and so I am sure your research material is superior to mine. Perhaps we can all learn from your experiences? I look forward to reading the supporting material for your contention. Thank you, C+ 4-15-04 > Well got my knuckles rapped by some! Probably deservedly. > Sorry if offended anyone but joined group to have stimulating > discussion rather than just make friends. > > Cannot compete with the gravitas of some surgeons or their websites. > Does not mean they are always right. Can say I was a pioneer in my > region and stuck to my guns re hip resurfacing. My unit now does > more BHR's than any other in UK outside Birmingham (3 colleagues > followed my lead). We do both private patients and NHS so we cannot > be accused of simply wanting to get rich quick! > > Agree the prosthesis is only part of the story and surgeon > experience, skill and committment just as important. Pity that US > patients and surgeons do not have easy access to BHR or Cormet 2000. > If C+ beyond questioning why are so many going to Belgium? My point > is that hip resurfacing as a concept is " experimental " and > controversial enough so why introduce another variable by using a > prosthesis that did not come from Birmingham stable ? Worry because > every week a rep comes to see me with a new design of hip > resurfacing that offers some or other " improvement " . Birmingham > group results are the best evidence we have so far. Accept it is > difficult for US patients to travel for surgery and C+ maybe only > viable option. Hopefully it will also stand test of time. As I have > not designed my own hip resurfacing device(and probably never will) > my choice is unbiased. Designers will naturally feel their device is > the best including Mr McMinn! > > When I chose a car for myself it had to be the new Mini . I > knew there would be all the teething problems of a new model and > there were a few hassles. Other owners gripe too. But I had the > first one at work and I still love its cheeky image. When I choose a > new car for my wife and kids, I will look to manufacturers like > Mercedes or Volvo. They are too precious to me to take any chances > with fashion. So there is a place for innovation and experimentation > but there is also sense in tradition and history. Depends on your > philosophy.............................. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 9, 2004 Report Share Posted June 9, 2004 Dr. Bloomfield, If you would sir, please disclosed the published literature you suggest exists regarding the superior clinical results of the BHR. I searched extensively before my own resurface and found very little pulished literature on resurfacings in general. And most that I did encounter bore the name of Dr. Harlan Amsutz and his work with the C+. I am just a humble home builder, not a Doctor as you are, and so I am sure your research material is superior to mine. Perhaps we can all learn from your experiences? I look forward to reading the supporting material for your contention. Thank you, C+ 4-15-04 > Well got my knuckles rapped by some! Probably deservedly. > Sorry if offended anyone but joined group to have stimulating > discussion rather than just make friends. > > Cannot compete with the gravitas of some surgeons or their websites. > Does not mean they are always right. Can say I was a pioneer in my > region and stuck to my guns re hip resurfacing. My unit now does > more BHR's than any other in UK outside Birmingham (3 colleagues > followed my lead). We do both private patients and NHS so we cannot > be accused of simply wanting to get rich quick! > > Agree the prosthesis is only part of the story and surgeon > experience, skill and committment just as important. Pity that US > patients and surgeons do not have easy access to BHR or Cormet 2000. > If C+ beyond questioning why are so many going to Belgium? My point > is that hip resurfacing as a concept is " experimental " and > controversial enough so why introduce another variable by using a > prosthesis that did not come from Birmingham stable ? Worry because > every week a rep comes to see me with a new design of hip > resurfacing that offers some or other " improvement " . Birmingham > group results are the best evidence we have so far. Accept it is > difficult for US patients to travel for surgery and C+ maybe only > viable option. Hopefully it will also stand test of time. As I have > not designed my own hip resurfacing device(and probably never will) > my choice is unbiased. Designers will naturally feel their device is > the best including Mr McMinn! > > When I chose a car for myself it had to be the new Mini . I > knew there would be all the teething problems of a new model and > there were a few hassles. Other owners gripe too. But I had the > first one at work and I still love its cheeky image. When I choose a > new car for my wife and kids, I will look to manufacturers like > Mercedes or Volvo. They are too precious to me to take any chances > with fashion. So there is a place for innovation and experimentation > but there is also sense in tradition and history. Depends on your > philosophy.............................. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 9, 2004 Report Share Posted June 9, 2004 As well, in my e-mail correspondences with The great Dr. DeSmet during my research phase, he had nothing but positive things to say about the C+. Chris > > > W > > > If C+ beyond questioning why are so many going to Belgium? > > > > Because insurance companies in the US, as a rule, do not cover > > resurfacing and DeSmet charges several thousand dollars less for the > > surgery than anyone in the US. > > > > Steve (bilat C+ 4/20/04, Amstutz) Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 9, 2004 Report Share Posted June 9, 2004 Thanks Steve, you read my mind and typed it out! ) In surfacehippy , " sog1927 " wrote: > > > W > > If C+ beyond questioning why are so many going to Belgium? > > Because insurance companies in the US, as a rule, do not cover > resurfacing and DeSmet charges several thousand dollars less for the > surgery than anyone in the US. > > Steve (bilat C+ 4/20/04, Amstutz) Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 10, 2004 Report Share Posted June 10, 2004 Hi, I suspect we too would be happy to have discussion which is why some asked to hear the differences as you see them........... Personally I am very happy that some surgeons, obviously such as yourself, stick to their guns and do innovative surgery.......... and I know from my own surgeon's comments that that doesn't make life easy and sometimes means you cannot easily live just where you want too in some cases............ i.e. the attitude of your collegues can sometimes get somewhat unbearable and make life too lonely.......... I live in an area of Australia where finding any specialist medical professional who does anything basically well across a range of fields, let alone innovative, is extremely difficult and anyone with half a brain and some basic idea of what's best for them gets on a plane and heads south............ which is what I had to do..........But to get to that point one has to know that one needs to run counter to the old story that we are told to 'respect' doctors opinions and 'doctor knows best'............ i.e. patients as consumers are still well behind the 8 ball about realising not all doctors know what is available, or do their job well etc......... Even with the hip area, especially on the Totallyhip list, there is this constant theme of find a doctor with a good reputation and do as he advises you............. of course ignoring the fact that he may not have a clue what he is talking about when he says Resurfacing doesn't work.............i.e. even reputation doesn't guarantee anything.......... And you mention these reps who come .............. It is a side of medicine that seems to be still fairly hidden and not that well accounted for and discussed......... My sister is a GP and she talks of the endless reps who come peddling drugs of various descriptions for various ailments........... and every so often medical consumers get wind of the great incentives offered to doctors for pushing products........... and the weird distortions promotions can have on the whole scene............ i.e. Celebrex hit Australia like a tidal wave.......... there were few houses in Australia that didn't have a packet of the stuff within months and the National Pharmacutical budget instantly had a huge bill for it............. all obviously because the coy making it decided to pull out all stops..............With time came the problems and obviously the coy will need another 'best seller' to maintain coy profits for shareholders............ All in all I would hope that the people in your immediate area appreciate what they have because there are a good few places in the world where it simply isn't freely available...........and even the purchase price of those said cars makes them out of the question...........smile. Edith LBHR Dr. L Walter Syd Aust 8/02 > Well got my knuckles rapped by some! Probably deservedly. > Sorry if offended anyone but joined group to have stimulating > discussion rather than just make friends. > > Cannot compete with the gravitas of some surgeons or their websites. > Does not mean they are always right. Can say I was a pioneer in my > region and stuck to my guns re hip resurfacing. My unit now does > more BHR's than any other in UK outside Birmingham (3 colleagues > followed my lead). We do both private patients and NHS so we cannot > be accused of simply wanting to get rich quick! > > Agree the prosthesis is only part of the story and surgeon > experience, skill and committment just as important. Pity that US > patients and surgeons do not have easy access to BHR or Cormet 2000. > If C+ beyond questioning why are so many going to Belgium? My point > is that hip resurfacing as a concept is " experimental " and > controversial enough so why introduce another variable by using a > prosthesis that did not come from Birmingham stable ? Worry because > every week a rep comes to see me with a new design of hip > resurfacing that offers some or other " improvement " . Birmingham > group results are the best evidence we have so far. Accept it is > difficult for US patients to travel for surgery and C+ maybe only > viable option. Hopefully it will also stand test of time. As I have > not designed my own hip resurfacing device(and probably never will) > my choice is unbiased. Designers will naturally feel their device is > the best including Mr McMinn! > > When I chose a car for myself it had to be the new Mini . I > knew there would be all the teething problems of a new model and > there were a few hassles. Other owners gripe too. But I had the > first one at work and I still love its cheeky image. When I choose a > new car for my wife and kids, I will look to manufacturers like > Mercedes or Volvo. They are too precious to me to take any chances > with fashion. So there is a place for innovation and experimentation > but there is also sense in tradition and history. Depends on your > philosophy.............................. > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 10, 2004 Report Share Posted June 10, 2004 Mr McMinn's and Mr Treacy's experience with MOM hip resurfacing dates back to 1991. Prior to that, Mr McMinn had observed good long term survival of a long stemmed MOM THR from the 70's and 80's (Ring hip). Ring moved away from MOM to polyethylene, and interviewed during his retirement, he regretted this deeply. McMinn realised that if you were lucky enough to get the MOM bearing just right, the wear rates and frictional torque were low which translated into implant longevity. He then decided to combine this observation with hip resurfacing, a concept which had been tried by Wagner, Freeman, Amstutz, and others including Charnley. Earlier designs of hip resurfacing had used ceramic or metal on polyethylene or some other soft material eg teflon. All these early designs were gradually abandoned as failures rates were too high. McMinn realised that to work well, MOM hip resurfacing needed a good choice of metals and accurate machining. He used the expertise still around from the days of the Ring MOM hip in making the first examples of his resurfacing. Since then, the Birmingham group have learnt a great deal about metallurgy and tribology: see the MMT site at http://midmedtec.co.uk/tribology.htm. Tim Band, who works at MMT and whom I have heard speak on several occasions, is one of the world's foremost experts on MOM tribology and therefore the potential differences between prostheses. Accept he may be biased but if you hear him speak and analyse the available literature in this very technical field you come away feeling that he knows why the current BHR is designed the way it is and that you can have great confidence that it is at the leading edge. The papers that lead me to support BHR and worry about Conserve are published in Journal of Bone and Joint Surgey in March, 2004.One in the American volume, the other in the British volume. http://www.ejbjs.org/cgi/content/abstract/86/1/28 (by Amstutz) and http://www.jbjs.org.uk/ (see March 2004) By McMinn. On the face of it there does seem to be a difference in results. The $18 000 question is why. > > Well got my knuckles rapped by some! Probably deservedly. > > Sorry if offended anyone but joined group to have stimulating > > discussion rather than just make friends. > > > > Cannot compete with the gravitas of some surgeons or their > websites. > > Does not mean they are always right. Can say I was a pioneer in my > > region and stuck to my guns re hip resurfacing. My unit now does > > more BHR's than any other in UK outside Birmingham (3 colleagues > > followed my lead). We do both private patients and NHS so we cannot > > be accused of simply wanting to get rich quick! > > > > Agree the prosthesis is only part of the story and surgeon > > experience, skill and committment just as important. Pity that US > > patients and surgeons do not have easy access to BHR or Cormet > 2000. > > If C+ beyond questioning why are so many going to Belgium? My > point > > is that hip resurfacing as a concept is " experimental " and > > controversial enough so why introduce another variable by using a > > prosthesis that did not come from Birmingham stable ? Worry because > > every week a rep comes to see me with a new design of hip > > resurfacing that offers some or other " improvement " . Birmingham > > group results are the best evidence we have so far. Accept it is > > difficult for US patients to travel for surgery and C+ maybe only > > viable option. Hopefully it will also stand test of time. As I have > > not designed my own hip resurfacing device(and probably never will) > > my choice is unbiased. Designers will naturally feel their device > is > > the best including Mr McMinn! > > > > When I chose a car for myself it had to be the new Mini . I > > knew there would be all the teething problems of a new model and > > there were a few hassles. Other owners gripe too. But I had the > > first one at work and I still love its cheeky image. When I choose > a > > new car for my wife and kids, I will look to manufacturers like > > Mercedes or Volvo. They are too precious to me to take any chances > > with fashion. So there is a place for innovation and > experimentation > > but there is also sense in tradition and history. Depends on your > > philosophy.............................. Quote Link to comment Share on other sites More sharing options...
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