Dr Chow experiences?

Yes, it's a Birmingham MOM device.  The device is holding up great, and I was racing at a Pro1-2 level on the bike with this hip till I was 54.  A very severe crash ended my career cycling.  During the crash, I fractured my femur, and they had to put in a metal bracket to hold it together while it healed.  I just had that removed 4 weeks ago, and that is when they noticed the negative effects of the MOM device on the tissue around my hip and have recommended I have it removed pretty soon to avoid anymore tissue and joint damage.

Dear vbirddogs

There has been a big issue with MOM resulting in a legal action against manufacturers, patients have had to have their prosthesis replaced all due to the issues you have mentioned.

This is a rotten situation and I feel for you having to go through a difficult revision. Hopefully they can leave the stem in position and just swap the head and the cup. It does rather highlight the fact that new is not necessarily better!

Cheers Richard

My anterior approach was great. Broke my right hip in a fall on 10/17. Surgery on 10/19. Out of hospital on 10/20. On exercise bike 2 hours after release from hospital. I’m over 13 weeks now and running again. No recovery problems at all. 

Thanks for the reply.  Dr. Chow did get back to me and said he was very familiar with the BHR device and that doing the SuperPath approach would not be a problem for a revision.  That I was glad to hear.  But, just want to follow through and see if others have had experience with him.

Thanks again.

Dear Martin

I certainly do not want to cause any concern or distress to anyone who is about to go down the Superpath route, after all it is a very important personal decision. I do think though that we need to look at the evidence that we have.

As numbers go I can only think of two recent Superpath hips here that have gone off well but am aware of at least two where the recipients wish they had never gone down that route.

One of the major selling points of Superpath as I understand it is speed of recovery and no need to dislocate the hip joint. But I do have to ask if that is the reality of the situation. Perhaps Gerri and Gary can update us on how fast the recovery has been for them and how fully they are recovered now.

Martin you make the point of no dislocation which I can see as an advantage as there is less stretching and distorting and or cutting of muscles and tissues such as has to take place with the constricted anterior approach.

However with the SP method the head of the femur still has to be cut off the femur and dislocated from where it is attached to the pelvis otherwise how is the new cup and cage going to be fitted to the pelvis?. Seems to me like a case of six of one and half a dozen of the other <BG>

With the posterior approach, given the longer incision, potentially there should be less of an issue with stretching when compared to the anterior approach, though muscles do have to be cut and the hip joint dislocated before the head of the femur is cut off.

Going on the evidence we have heard on this forum with the posterior approach there is minimal risk of suffering from the nerve damage that many suffer from the anterior approach. An internet search will also support this.

It is good that different approaches are being tried as that is the way progress can be made, but I do think there needs to be caution exercised over claims based on a small sample.

Finally I will finish by saying that twenty one years ago at age fifty-five I had a perfectly bog standard total hip replacement done by an experienced surgeon working in a rural hospital in Wales using the posterior approach using a prosthesis of the same design and materials as used nowadays.

Following the surgery as many here know I made a very fast pain free recovery which is unlikely to be bettered by the most successful SuperPath recovery. I gave that THR a hell of a hard time over those years until the poly wore out early last year The revision last year used the same design components as my original but just sized a few mm larger. I made an excellent recovery with no complications at age sixty-six. I rest my case.

Cheers, Richard

I had the bog standard posterior approach because I felt I would prefer to allow the surgeon easy manipulation, I may have had a larger scar but less chances of nerve damage which does seem to be a problem with the anterior approach. I had also heard bad things about the Super Path which had put me off.  The main things that are really important in a THR is your age, your fitness and your weight. Then the competence of your surgeon and the after op team regarding physiotherapy etc. I came home and did not need to use a stick or any other support indoors, although I did have a stick outdoors. I showered immediately and had no restrictions, although I was careful. Irrespective of what type of surgery you have this is a major operation and you will need to heal. This means you will get tired and will need to eat lots of protein to help the healing. 

Dear Richard

You seem intent on continuing your little one man crusade against the Superpath method yes I know you had successful surgery all those years ago via the traditional posterior method ,oh sorry ,you did have a revision so perhaps not all that successful after all . You really do try to speak with such authority particularly on the subject of approaches to hip replacement that I am guessing you have read many papers from academic sources to come to your conclusions, are you medically trained and qualified ? I think it is about time you started keeping some of your opinions to yourself. I am booked for Superpath in 11 days and certainly do not want to keep hearing the drivel that you keep spouting on about , now please keep your comments to subjects you totally understand and have experience of.

Regards Martin

Hi, Martin, I don't think this is a place to criticize others' viewpoints. I for one have appreciated many of Richard's comments over the past months. Not that he needs me to defend him, but I am also one who has been critical of "newer," though not necessarily all that new, approaches. I had anterior surgery, and it was absolutely horrible. I would never have it again, and I am skeptical about superpath for some of the same reasons. I believe that most of the comments on this forum are based on personal experience, perhaps with some word of mouth thrown in, such as my comment of a day or so ago on this thread where I mentioned knowing people who thought superpath was great, although I might not choose it myself. I think readers here are adults who can make decisions for themselves, in consultation with their surgeons. No one is insisting that one way is better than another for everyone, just that we should all make careful consideration of the options. If you don't like the comments, stop reading. All that being said, I wish you best of luck with your surgery and a speedy recovery!

PS: I AM medically trained, and I DO read the journal articles. I only wish I had read many more of them before taking my surgeon's word for the anterior approach as "best."

Hi firstly thank you for your good wishes for my up coming surgery and recovery. It is a stress full time waiting for surgery especially when you have had 2 cancellations . This leads me on to comments about Superpath . Any surgical procedure for any condition has inherent risks downsides and the potential for complications. I am fully aware of this fact and am under no illusions that things could go wrong the fact that Superpath is a more sophisticated and modern approach to this surgery does not mean it is perfect the same could be said about the anterior approach which sadly you found out does not always work as it should however there are countless people who have had extremely successful anterior surgery including simultaneous bilateral procedures. Now it is not my job to pontificate on the rights and wrongs the good and the bad of hip replacement surgery certainly if I had had a bad experience or a good one then it is fair to share that however to have a procedure critised to the extent that has been happening here with Superpath is wrong especially from some who appears not to understand other procedures when suggesting that the stem could be left in for a resurfacing revision procedure.Comments should be based on personal experience and fact not opinion where there is no experience. Yes I too am medically trained not in orthopaedics and actively read and study in my field and consult patients daily. Regards

Dear Martin

Well, well. Yes you are perfectly correct in that my THR needed to be revised, but to suggest that because it needed to be revised casts doubt on it's success seems very odd given the excellent service it has given me. 

As you will know the poly cup, which is what a large number of hip prosthesis rely on as the bearing surface for the ball wears but the twenty years of a very physical life that my new hip has supported me would surely be considered to be a pretty good life!   If you disagree I wonder how many years you are expecting your SuperPath hip to last you.

No Martin I am not medically trained as I have made clear here and elsewhere on this site from time to time, but that does stop me from being able to read the many in depth papers out there and to form opinions.   I have had to do a lot of research not only for my hip revision but also for my ankle which is a far more complicated and critical surgery than a hip is.

I am not waging a crusade against the SuperPath method or indeed any particular procedure or approach, but when people say that this or that technique or procedure is the best way to go I think it is helpful to be cautious and to look a bit deeper and to ask as many questions as possible.

This is especially so when medical techniques are being promoted on a commercial web sites using marketing language that sometimes appears to be chosen to raise fears and or blur facts.  I'm also very concerned if I read that people have experienced problems and have felt let down and even abandoned by their surgeon as it raises the alarm bells for me and no doubt others.

In the case of the anterior approach to hip replacement surgery this has been promoted as being the answer to hip replacement surgery, but we are now hearing that there are some issues with this approach and that it is not all that it was cracked up to be.  

Metal on metal was not so long ago considered to be the way forward for hip joints but as we have seen it has been shown that claims have been greatly over optimistic.   In all failure situations of course it is the patient who suffers by having to endure perhaps years of pain and lack of mobility.  Then having to face coping with having their prosthesis removed and a replacement put back in, and dealing with the daunting task of yet another recovery period and the fear of the uncertainty and all that this involves, and of course the really unlucky ones never are able to enjoy the pain free freedom they went forward with the surgery to enjoy.

So Martin to wrap this reply up, I think it is in all our interests to embrace new ideas and techniques but with some caution and to recognise those methods and materials that have been proved successful over many years in the hands of a large number of surgeons.

Regards, Richard

 

I agree with your last paragraph but for most people this is a once in a lifetime event the professionals spend their lifetime doing what they do .I hold that it is dangerous to pass opinions that may influence other patients as lay people by all means pass on our experiences but leave opinions and decision making to the professionals. As a side note the Superpath procedure is now being used at the Royal orthopaedic hospital in Birmingham via the NHS and you might do well to read the NICE view on this type of procedure . Climb down from your soapbox for everyone's sake please.

And on a final note I have had patients loose their sight because they thought they knew better and refused professional advice.

Good Morning Richard and Martin, 

?I just want to chime in here with my own opinion.  I believe this sight is for people who want more information regarding THR and different procedures from people who have experienced the actual procedures. I know that is what I came on the sight for. I don't think its fair to say that only 2 people had good Superpath experiences and 2 did not, as there are tons of people who are NOT on this website sharing their experiences. I can appreciate what Martin is saying Richard. I know you are just trying to be helpful for people here, but perhaps opinions should be of your own experiences and not go so far as to claim one procedure or implant is better than another.  As we can all agree, every BODY, every situation is very different.  It is up to the individual to see what their best option is, find the best surgeon they are comfortable with and go with it. None of us, unless we are Orthopedic Surgeons, doing these surgeries, can comment on types of surgery or implants used. Let's all agree that we can learn from each of our experiences without  getting into medical opinions, which is not our place to do. Hopefully the experiences we share here will lead everyone who is making a decision on what kind of surgery to have, to ultimately make the best decisions for themselves. 

Dear Gerri

Thanks for your posting however I do need to correct something.   I did not say that only 2 people had good Superpath experiences, what I actually wrote was this and I paste.  "I can only think of two recent Superpath hips here that have gone off well."  I was thinking of you and Gary and hopefully Martin will join you soon.

Others on this discussion site may very well have had SP hip replacements with excellent outcomes but I do not recall reading about them over the many months I have been reading the many discussions.   It would be good to hear the actual personal experiences of others here who have had this approach so that we can all be better informed and ask questions.

For the record and to clear up any misunderstandings I have never said that the Superpath approach was bad in any way nor have I run it down.   What I have said is that "some" of the marketing language used to promote SP appears to be chosen to raise fears and or blur facts and that all the claims made may not be born out in practice.   I have always said that there was a lot to be said for the tried and tested posterior approach and have always given my reasons were for saying this.

All the best, Richard