Currently being talked about by the knife man as being something to consider in the next year or two. I’m 37 currently. Anyone got an experience or knowledge?

friend at work had it done must be five years or more ago, had a quick recovery and has had no problems, quite a sporty guy to.
They recon they last 20 years or more now don’t they, how long have you been having problems?

My mum had it done, too young for a replacement. Did the job, as in cured the horrible pain of a worn out hip. She wished she had it done sooner.

Because its a new surgery they told her they really dont know how long it will last. At least until she is in the age bracket for a new hip, maybe much longer.

The op is a major deal and the recovery for her was a little slow and painful.

My Dad had a procedure done called Bristol hip replacement(?). They didnt replace the ball, they applied a metal sleeve over it to renew the surface.
They do quote long recovery periods for this procedure (6 months or so) as they have to cut through some large muscles to get to it. He was back on a turbo trainer as soon as he could get on and off his bike (within a month). This did a lot to hurry his recovery along. I think he was back working within 3 months. It seems that being cyclist did a lot to help his recovery.
Its worth having done sooner rather than later, as in my dads case, he wore the good hip out by compensating for the bad one, and needed that one doing about 18 months later. He had both done either side of his 50th.

They recon they last 20 years or more now don’t they, how long have you been having problems?

10 years I think would be the max I could realistically expect it to last if I use it as a 40 yearold should. Had problems for 5 years well I havent been able to ride a bike for 5 years, had problems a bit longer. Have had arthroscopic ops on both hips already and another is scheduled. If that doesnt work the re surfacing is the next option. But as the surgeon said once that genie is out of the box it cant be put away.

You may find the information in this link useful http://gsss.redpaint.co.uk/docs/033__001__hip__patient_information__hip_resurfacing__1308762622.pdf

In good hands resurfacing can be good but technically difficult and can be disastrous in wrong hands. Metal on metal bearings are also a potential minefield which is not yet fully understood. (in joint replacements that is)

The majority of procedures are successful and yes there will always be a few that fail but that is true of any with any operation init!
And as regards five years live span, well i think you would be very unlucky to find yourself in that situation.
You got to be optimistic about it, how you approach this mentally is key to a good recovery as you probably know already… chin up mate and good luck 😉

OK, I did just say in the other thread that I know nowt about this, but I’m curious… What are the alternatives? And what’s the worst case scenario? Reason I ask is that with mine, the only alternative was a replacement and the worst-case scenario was just that it wouldn’t work, and that they’d have to do a replacement after all. It’s quite grim finding out about worst cases, but also often worthwhile.

Resurfacing is the worst case senario best is that the next round of arthroscpic ops leave me pain free for a while and i can ride my bike.

a_a – if you don’t mind me asking, what’s caused the hip problem? Curious as I suffer myself from arthritis caused by hip dysplasia (I’m 34) and so am likely to have similar things in future and am interested in what’s out there.

Hope it goes well for you!

This web site some info and advice from consultant who specialises in hips and knees particularly in younger patients.

http://www.hipandkneeadvice.com/

I’m currently under his care at the moment through the NHS after being referred from the fracture clinic having broken both my hips already at the tender age of 34. He’s also a cyclist so has a good understanding of that side of things.

mattstreet I have FAI, kind of the opposite of dysplasia if I understand it correctly

http://www.hipfai.com/

Hip resurfacing is not a bad option if you don’t have a problem with cancer and pseudo tumors.

hugor, care to elaborate?

I’ll be looking into something similar one day after being diagnosed with osteonecrosis last year, unless I can stop it from getting worse somehow.

There’s lots of people out there who’ve had THR who carry on cycling, although perhaps not mountain biking..but anyway, that gives me some hope 🙂

Plenty folk out there who’ve had total hip replacements who carry on biking. I know someone who has had both hips done and he rides off road most days.

Look up stuff on alval and metallosis with respect to pseudo tumours.

Look up stuff on alval and metallosis with respect to pseudo tumours.

Exactly! Google and Pubmed are your friends.
Look up Depuy ASR while your at it.
Make up your own mind.

A little bird told me that Lance Pharmstrong had bilateral hip resurfacing when he “retired” the first time. It went so well that he came back to professional racing for a few more years. I suppose his hips might have been damaged by his cancer chemo/radio-therapy.

You really need to see an orthopaedic surgeon who does a lot of this particular operation. If you’re anywhere near Oswestry you could do a lot worse than see someone from the Royal Orthopaedic Hospital. I know some top chaps there.

Finally, you need to read up about the (occasional) dangers of metal-on-metal bearings.

R.E.: De Puy ASR. From what I’ve read there is a particular problem with that hip, possibly to do with the congruity of the bearing surfaces. It has been said that the Birmingham hip doesn’t suffer from the same issues due to some subtle design cunning.

There was a big article in the BMJ earlier in 2011 on this very subject.

Not sure lance had it done but flyod landis had one done whilst on his drugs ban.
Question is how do you know if you surgeon is any good. No data sems to be available.

This is a very difficult topic to explain thoroughly and your surgeon is best placed to advise you. I would expand on what Jet26 said and say the whole field of joint replacement is poorly understood and a complete minefield!

What I would say is:

– As far as artificial joint replacements go hips are pretty much as good as it gets right now (compared to knees for example). So at least you picked the right joint to damage! The inherent stability of the joint and relatively simple motion eases the task of Engineers and Surgeons.

– That said they are still unsophisticated devices and the most successful implant design has changed little since it’s introduction 40 years ago. Newer designs struggle to match the clinical outcome of this original device (mentioned above).

– It is very difficult to gauge the advantages of different devices/ surgeon/ surgical techniques. “Clinical outcome” usually means how many devices had to be revised (done again). This information is published online at the National Joint Registry. There are a huge number of people with painful artificial joints who struggle through the pain to avoid a second major surgery or maybe even have no pain but terribly aligned joint and secondary problems in other areas of the body such as the knee and back- hence revision rates tell very little of the overall picture of success. I would say it is important to realise it is not a quick fix, is not a painless process and there is no guarantee you will be better off afterwards (although the vast majority are).

– Also as mentioned, it is a major surgery with a lot of disruption to the surrounding soft tissues- some surgical approaches are better than others but this is something you have no control over. Equally, you are unlikely to have any say in which brand/ model/ etc implant you get- this is down to surgeon and NHS Trust preference.

– Finally, a little information in the wrong hands is a bad thing as shown in this thread! Do not start worrying yourself too much over metal on metal implants or the Depuy ASR. I have sat through hours of meetings with Surgeons/ Manufacturers/ Researchers and the arguments go round and round for days. I would personally not pay too much attention to the scare stories above or in the media. These are something of a scapegoat for issues extending beyond specific implants. This is a whole can of worms best avoided. For example the Depuy ASR has nothing to do with the bearing surfaces (i.e. between ball and cup) as Gasman Jim suggests but actually the interface between the ball part and the neck part (not one piece as you might think)… arggghh couldn’t help myself getting involved in this!

What I would say is:

1) Be very clear with your surgeon what your problems are, the magnitude of your problems and your expectations following surgery. This helps both you and the surgeons make as good an informed choice as possible about the best way forward for you. An artificial joint is largely a last resort treatment for pain at the moment and not really a treatment for improving joint function. As others have said- get the full picture and make sure you are fully aware of best case, average case and worst case scenarios.

2) The one factor in hip resurfacing to not be ignored is the surgeon. A good surgeon makes a massive difference and unfortunately the experience and approach taken by different surgeons varies greatly (and isn’t something Joe Public can get information about or has any real control over). The best I think you can do is request an experienced hip surgeon dedicated to hip surgeries. I would certainly not want a new hip put in by a guy who does 2 or 3 a year.

Sorry to sound so negative but I couldn’t help trying to clear a few things up. Ultimately, make sure you trust your surgeon. Best of luck!

Thanks for that DanW. Since i posted the thread i have met the surgeon and we decided on another arthroscopic op had that a couple of months ago so fingers crossed, expect the other hip will need that. After the latest op he said it didnt look like a joint that needed replacing yet. However if i’m not able to get back to any sort if activity then thats easy for him to say.

Sorry AA, didn’t see how old the thread is! For some reason it popped up on the first page in the chat forum for me 😕

Good to here that treatment is conservative for the time being. If you aren’t already then get as much much physiotherapy/ rehab advice as possible- surgery only does so much and a decent physio may well do wonders for your pain and activity levels. It is a bit of a lottery as to the help and advice you will get but the trick with the NHS is to be persistent if you feel you could be doing more. All the best!