Live in Thailand and the only prosthesis used here is the Hintegra....

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I am scheduled to have this done real soon...23rd of Nov, this year! Hintegra is the only available prosthesis here. Are there folks with positive results using this? I will inquire about osteolysis prior to the surgery. It will be done at Chiangmai University, teaching hospital with Govt insurance. I've other choice. Anyone have a good experience with this one? Thanks in advance. Thom

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  • Posted

    Dear Thom

    The Hintegra has a strong following but regardless of the prosthesis used the critical factor in any ankle replacement surgery is the experience and ability of the surgeon.

    The Hintegra was as I'm sure you know designed by Professor Hintermann in Switzerland and his reputation in installing this device is right at the top. I hope the surgeon who will be carrying out your surgery will have the necessary experience.

    Everything to do with a total ankle replacement is critical especially alignment.

    Osteolysis is going to be more likely if the prosthesis is not well positioned for the simple reason that it will be at greater risk of generating wear debris and it is thought that the greater the amount of wear debris produced the less the body is able to cope and osteolysis is the result.

    Osteolysis in my case started to be noticed at about nine months post op and was not obvious and it slowly increased then seemed to stabilize. But between year three three and four it suddenly got much worse and that is why I'm soon to gave a very difficult revision with a very uncertain outcome. It is something that you need to constantly be aware of and remind your surgeon about.

    It is interesting that most surgeons appear not to mention the possibility of osteolysis when discussing this surgery. Is it that they are not aware of it or just don't want to frighten their patients? There is no excuse for not knowing as there are a number of research papers on the subject available.

    Good luck with the surgery and your recovery.

    Cheers Richard

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  • Posted

    Richard,

    Thank you for that input....not sure how many of these implants this particular surgeon has done, but he is the best in the area according to many. I will email him about the osteolysis issue and my concern about that. I have noticed that Hintegra has an option for sensitive patients, but not sure if that is even an option here. It appears to be gold in color, unlike the SS grey of the original. I will update as I find out more. Again, thanks so much for your reply. Thom

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    • Posted

      Dear Thom

      You are welcome, glad to be able to help.

      The danger of osteolysis comes after the joint has been in use for some time, in my case it was about nine months.

      In my case it seems that there was evidence of a cyst or cysts in the surgery site at the time of surgery but I do not think there was any mention in the surgeons notes if he cleaned them out at the time of the surgery.

      If they were not dealt with then to my mind this inattention was inexcusable as it may have been responsible for my later problems.

      It was only because I moved to a different part of the UK and needed to obtain my hospital records that I found out about the cysts.

      All the best, Richard

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  • Posted

    Well I've pretty much been glued to my computer researching everything I can find about 1) the surgeon that's supposed to perform the procedure, 2) osteolysis, 3) Hintegra, and 4) reviews/comments from those having/had this done.

    From what I've gleaned from forums here in Thailand, lots of OS will refer the really intricate, difficult surgeries to the fellow that's going to do mine. He is a foot only, specialist. I'm trying to find out just how many of these he has done, and that's not real easy to do, so far. His credentials are as follows: Instructor at the Department of Orthopedic Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand. 2005 – present  Consultant, Orthopedic Trauma Division Department of Orthopedic Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand. 2005 –present

    I guess the osteolysis is one of those....ya pays yer money and takes yer chances sort of thing. I originally had bone spurs removed (1996?) from what is giving me problems now. Not sure how this would/will play into it.

    Most of what is available on Hintegra are follow-ups published by the designers themselves (not too much by independents).

    And from what I've read on this site  concerning post op results is about 50/50 and leaves me wondering if I should just do an arthrodesis instead. Hmmmmm......

    I guess I have a couple of weeks to make up my mind....will keep reading and keeping score. Thanks to all for inputting on this. Thom

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    • Posted

      Dear Thom

      A failed TAR is a disaster as revisions are extremely difficult so if you are not totally confident of your surgeons ability to give you a successful FAR you are safer having a fusion IMO.

      Cheers Richard

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    • Posted

      Thank you Richard on this input. So far....I guess I do have confidence in this surgeon. But then again....ye never knows....I still haven't found out, just how many of these he's done....I'm thinking not that many, being in an economy that is basically supporting farmers. Thailand is not like the western world, at all, in any way. Don't get me wrong...there is money here....in some places...a lot of it. But not in my pockets....ha-ha-ha....or....5-5-5. Thom

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    • Posted

      Dear Tom

      Your confidence should be based on the number of successful TARs however nice and confidence instilling he is when you meet him.

      Please be very, very careful.

      All the best

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