Replacement or Resurfacing?

Posted , 6 users are following.

Hi! New to the board but hoping for some advice on ‘next steps’ as I was recently told I have arthritis in my right hip and it’s basically bone-on-bone at this point. I’m 46 and played basketball for most of my life and was running a couple of miles every other day as recently as three years ago. That’s when I started having severe right knee pain and when it buckled on me while playing basketball with my kids I had it checked out and they found nothing (I was not having hip pain- all knee and upper leg). . I just kept telling myself it would go away even though it was painful to even put on my shoes and socks the knee would stiffen after standing or sitting for any length of time. It wasn’t until a few months ago when I went for PT on my knee that I was told I have almost no mobility in my right hip and, long story short, I saw two docs who both told me I would need to do something fairly soon and they recommended I stop running (which I did anyway a couple of years ago and I’ve gained 20 pounds- I know I need to do something like cycling or swimming but I think I’m still in denial). The second doc mentioned that I might be a “poster child” for hip resurfacing. I sent my x-rays and info to a surgeon who specializes in resurfacing and now waiting to see if I am even a candidate. Anyone familiar with or had this procedure performed? My general physician told me to wait as long as I can before having surgery but that just seems odd that I would want to get to that point before doing anything. It’s obviously only going to get worse since the cartilage is essentially gone. Thanks for any help you can offer!! 

0 likes, 10 replies

10 Replies

  • Posted

    Hi Unc, had RTHR 25months ago, like you I thought it was all to do with knee. I had a torn cartilage removed a couple of years before. Pain in thigh and groin. Although overweight I used to keep fit going to gym, gradually couldn't do certain machines and movements. Surgeon could not believe how stiff my hip was and that I was walking around unaided. I couldn't have had a resurface as top of joint was flat where it had worn away against the socket. I was 56 time I had op. Doc said it will last a lifetime. From what I have heard resurfacing can help but you will still need a replacement but it can also cause more pain. My cousin had THR at 50 and doing ok 6 yrs on. Hips are more successful than knees. As I have said to others I dancedfor over three hours at a party recently. Run around with my grandson, although he understands I cannot do everything his only 4 so full of energy. Hope you find some answers.

    • Posted

      Thanks so much for this information! Glad you are able to spend quality time with your grandson without pain. I’m hoping to do the same with my three boys one day soon. Take care. 
  • Posted

    Unc:

    I had my shoulder resurfaced over 3 years ago and that worked out very well. When I found that osteoarthritis had become more pervasive I learned that I needed total hip arthroscopy. Naturally the first thing I looked at was a hip resurfacing since it had worked so well for my shoulder.

    The more research I did and feedback from OPs , I determined that the hip resurfacing was not a good solution. Firstly, it won't last nearly as long as the thr. Second, that will require going in a second time within a relatively short period (you are 46 so say ,10 years or less) and doing a complete replacement. Just do the replacement. I've had direct anterior procedures done to both of my hips (most recently 3 weeks ago with my right) now with spectacular success. I will be able to get back to working out, legs included, as well as bike touring.

    Make sure you get an experienced orthopedic hip surgeon who specializes in the anterior approach. Both of my surgeries were out patient events: in at 7 am home by 3:30 the same day. Pain has been a non issue.

    As far as playing basketball, I'm not sure on that one whether it be resurfacing or total replacement. Running may also be a no no because of the pounding both sports bring to your joints.

    Anyway, you will ask yourself why didn't I do this earlier... it is remarkable especially with all the tech and experience there is with hip replacement. My shoulder was quite a bit more difficult than either of my hips.

    Hope this helps,

    Take care,

    • Posted

      Thanks, Erin! I have heard so many different things about the hip resurfacing. A part of me is holding on to the hope that I can have the resurfacing and still squeeze out a few more years of activities that i’ve missed but the logical side of me- which is even more validated after reading these posts- says the THR is the better way to go. Thanks again for responding! 
  • Posted

    In a word do not delay, get you hip replacement surgery arranged now as your hip can only go one way.....bad! Also the longer you wait the more you are likely to have a compromised recovery.

    Look for a surgeon with a REALLY good record above anything else. Do not be seduced by promises of small incisions and less restrictions and quick recovery because I really do believe they are a bit of a red herring!

    How can I say such stuff I hear many say under their breath! OK my surgery was done by a competent well experienced man using the posterior approach twenty years ago.

    I was walking with just one stick on the day I left hospital. Back to work doing office stuff in about a week and driving a manual car in three weeks. No pain after leaving hospital and walking uneven country tracks.

    Within a couple of months I had forgotten about the new hip...I just got on with a very physically demanding life. Lots of building work climbing ladders, roofing work the whole jolly lot and sheep farming on a hillside that was very steep.

    That hip lasted me twenty tough years and only needed to be revised because the plot cup wore out. The recent revision was carries out using the posterior approach using a slightly larger ball and matching cup by a surgeon with a great reputation trained by my original surgeon who had now retired.

    If you have any questions please ask or if you would like to give me a ring just message me. That goes for anyone here of course.

    All the best. Richard

    • Posted

      This is SO helpful- thank you! The two doctors I went to see last month did not get into the anterior and posterior procedures so this is all new to me. I’m inspired by your story and can only hope I can have the same results down the road. I might reach out to you as I come closer to making a decision. This is just overwhelming now- not what I expected at 46 after being active for so long. But I found it interesting that the second doc told me the average age of his patients is 28, which he says is a direct reflection of the extreme physical activities people start prticipating in at younger ages. He also said something about me having an “athletic hip” (never heard that before), which apparently serves you well at a younger age but then wears down much quicker. Maybe that was just his way of trying to give me a compliment before telling me I need a new hip!! 😜

  • Posted

    Richard is on Target. Get the best surgeon and don’t dwell on the Approach. The posterior gives the surgeon the best view. My Surgeon was 73 and he only does posterior, but he has over 40 years experience. A few more initial restrictions but after 6 weeks recovery about the same seems to me more bad experiences with Anterior. Quite proud of my 9” scar
    • Posted

      Thank you, Steve. I’m learning a lot on  this forum. Lots to consider for sure! 
  • Posted

    Unc

    I have done lots of research on hip replacement prior to choosing which would be best for me and one that would be least invasive.

    I decided that cutting musculature, higher incidence of nerve damage and all types of post op restrictions was not the least invasive nor quickest recovery approach for thr. The anterior approach procedure required specialized equipment and a skilled surgeon who focuses solely on this procedure. Most of surgeons do the posterior or lateral approach because it is an easier procedure for the surgeon. Not do for the patient. Surgeons have tried to master the anterior approach and give up to stay with posterior or lateral. The surgeon has to know what they are doing. My surgeon, Dr Thomas Ellis (Columbus, Oh), is well respected and very experienced in this procedure.

    I also have been reading these blogs for months and conclude that other complications are responsible for less than favorable outcomes from the anterior approach.

    Obviously, there have been some great outcomes using the posterior approach for this surgery as Richard and Steve attest. However the thought of someone cutting through my glutes maximus is painful just thinking about it especially when there is another way.

    Anyway, my 2 cents...

    Take care ,

    • Posted

      I’m exploring options now and I two doctors have been mentioned as “experts” in this area, particularly with people in my age range. One is Dr. Gross, who is a resurfacing spwcialist in Columbia, SC. The other is Dr. Parvizi in Philadelphia who apparently is a leader in some other “outside the box” approaches. I’m in NC so Duke or Columbia would be more convenient but I also want to make sure I choose the right surgeon. Thank you so much for taking the time to respond! 

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