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29 Apr 10 - 07:46 AM (#2896576) Subject: BS: resurfacing versus hip replacement From: VirginiaTam I was seen by a Orthotist yesterday because my RA nurse seem to think I had fallen arches and that was what was causing my hips to seize up about 4 to 5 minutes into a walk. The orthotist found my arches are fine (only a miniscule flattening and lean inwards on my left foot). She suggested that the reason my hips are seizing up is due to osteoarthritis not due to fallen arches or to rheumatoid arthritis. I was first referred to rheumatology in 2005 for hip pain. Xrays have never been taken. I have had 3 or 4 steroid injections in hips. I may not have any more. So the orthotist put in my notes that I should have xray of hips to determine if I have osteoarthritis. What happens from there I am not certain. My next RA appointment is in July. I have done some research and discovered that hip replacement is offered only after age 65 when the joint is so damaged as to prevent normal mobility and normal life. I am 52 so I am not entitled to replacement (or normal life, I guess). But I found out that new procedure resurfacing is being offered to younger patients. I certainly would like to go walking again. So does anyone know someone who knows someone who has had this done? Any information most appreciated. |
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29 Apr 10 - 08:13 AM (#2896599) Subject: RE: BS: resurfacing versus hip replacement From: The Fooles Troupe As a slight, but relevant aside, I was diagnosed as a young kid with 'flat feet' and wore expensive orthopaedic boots for years. A GP who had specialised in that area, looked at me, and said 'nope - extra mobile joints in the feet - perfectly normal - throw those boots away!" Now my hips play up... :-) Good luck with your search for a life more enjoyable. Hang in there. |
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29 Apr 10 - 08:45 AM (#2896615) Subject: RE: BS: resurfacing versus hip replacement From: Newport Boy Virginia, I don't know where you are, but any age rules about hip surgery are strictly for guidance here in UK. I had a full replacement just over 4 years ago, age 70, but a friend of mine had 2 of the first resurfacings aged about 40. Both have now reached the end of their life, and he had a full replacement of one hip just over a year ago, and is waiting for the other. He probably wore the replacements as fast as anyone would - he continues with karate even now. There is a reluctance to carry out replacements at too young an age, but the old 65+ rule was based on an expected life of the replacement of 15 years max. My surgeon now expects 20 to 25 years from the metal/metal joint I have. My neighbour had a replacement last year, age 58. Resurfacing isn't automatically an option - it depends on the surface of the bone being in good condition, but that's more likely in a younger patient, such as you! It is now quite common to carry out a resurfacing at 50+, with a replacement when it wears out at about 65+. For more information than you could ever need, have a look at Evert Smith's site He carried out my surgery (and also that on 5 of my friends). Phil |
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29 Apr 10 - 08:47 AM (#2896618) Subject: RE: BS: resurfacing versus hip replacement From: John MacKenzie The average life of a hip replacement is reckoned to be 15 years. However, many people have had perfectly good artificial hips for many more years than the. It's just a matter of luck, and, I guess, body weight too. This is why they don't want to give you a full hip replcement too soon,as a revision of an old hip replacement is quite tricky. I looked at resurfacing, and was told I was too old, while I was, like you, declared to be too young for a full replacement. I have now had both hips done, and my life is much better as a result. I am 67, and was 63 when the first one was done, and 64 at the second time of asking. From what I have read of resurfacing, it is the best way to go, but it's not easily available on the NHS. |
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29 Apr 10 - 08:52 AM (#2896622) Subject: RE: BS: resurfacing versus hip replacement From: John MacKenzie Sorry, Newport Boy and I have sort of coincided. |
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29 Apr 10 - 09:09 AM (#2896627) Subject: RE: BS: resurfacing versus hip replacement From: Newport Boy OK, John - at least we were in general agreement. I would also agree that revision (2nd replacement) is tricky. A guy was in with me for a revision (after 21 years). The op was expected to take 2-3 hours, but actually took nearly 5 hours. Phil |
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29 Apr 10 - 10:00 AM (#2896659) Subject: RE: BS: resurfacing versus hip replacement From: Noreen Hi Tam, Stewart had one hip done with the Birmingham Hip Resurfacing technique (lots of info if you google it- wikipedia is good). He had his done about 7 years ago, so he'd have been 54. This was all on the NHS, and as suggested by his consultant. As far as I gathered, with this resurfacing they stick a sheet of titanium over the damaged area, so it is far less destructive than taking the bone away, so recovery is better. He's been very happy with it. Good luck with whatever you have done. |
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29 Apr 10 - 10:01 AM (#2896660) Subject: RE: BS: resurfacing versus hip replacement From: artbrooks Herself the occupational therapist says she really has no opinion on the procedures herself (because she's not an orthopedic surgeon, she says), but there really isn't much difference from a post-op rehab perspective. |
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29 Apr 10 - 10:09 AM (#2896664) Subject: RE: BS: resurfacing versus hip replacement From: VirginiaTam Thanks Newport Boy and John I have had trouble with the right hip subluxing since I was age 14. It would suddenly lock while in sitting position and would take hours to days to pop back into place. That stopped at about age 30 and in my mid 40s started the seizing up when walking. Going down hill and down stairs is particularly difficult even when not seizing up. I am in the UK. I keep feeling like I am being fobbed by the rheumatology consultant and nurse to first orthotics, then to physiotherapist who started out by saying he couldn't do much to help me and then kept not showing up for my appointments. I was told I could not have another therapist as I had been assigned to his case load. The receptionist's excuse "he is having some family problems at the moment." After he 4th or 5th time I refused appointment and asked to be discharged. Then I was referred to GP for pain who referred me to pain clinic only because I asked him too. I waited 4 months to be seen and they referred me to acupuncture clinic. Another 6 months I was offered appointments which kept changing. My last appointment I had to cancel on the day as I had flu and they discharged me because it was less than 24 hour notice. Now I have been referred to orthotics again. I don't hold out much hope that I will be offered either treatment. I am kind of resigned to the fact that I may need to get a mobility scooter. The problem is I live in 1st floor flat with no place to store it and no chance to move to a more accommodating place. Sux being me... don't it? |
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29 Apr 10 - 10:18 AM (#2896671) Subject: RE: BS: resurfacing versus hip replacement From: Noreen The obvious thing would seem to be to xray your hips to see if there is damage. Ask your GP whether you have been referred for xrays, and if not, get her/him to do it. If GP is not sympathetic, find another one! |
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29 Apr 10 - 10:53 AM (#2896687) Subject: RE: BS: resurfacing versus hip replacement From: VirginiaTam Yep Noreen. The way the orthotist presented it to me, it is that she has put it in my notes and will be picked up by my RA nurse at next appointment in July. My GP (indeed the whole surgery) is not sympathetic. Won't go into why I think this. Suffice to say I only go to GP as last resort when I am extremely ill with fever or pain I can't handle. I have been known to wait until the surgery is closed so I can call out of hours clinic, just to avoid the GP. Art - that recovery time is the worrying thing. Don't think I can afford to be off work for that amount of time. Also don't know how I would get back upstairs into flat after said procedure. |
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29 Apr 10 - 11:33 AM (#2896719) Subject: RE: BS: resurfacing versus hip replacement From: Newport Boy I'd second Noreen - find another GP, ask for an X-ray and an Oxford hip score (you can find that on the web). Complete the latter with responses for your bad days. Don't worry too much about recovery time or getting to your flat. They won't discharge you until you can go up and down stairs - usually the 2nd or 3rd day. With care, you can then do almost all the essential household tasks (postpone the difficult ones). You will need assistance about every other day for the first 6 weeks to change your compression stockings. Reasonable targets are walking locally by 3 weeks, driving 8 weeks. I went on a walking holiday in Spain at 10 weeks (unusually early). A female friend has just had a replacement. She lives alone, and has been independent from 3 weeks - apart from the damned stockings. But first - get an X-ray and the Oxford hip score. Phil |
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29 Apr 10 - 01:20 PM (#2896759) Subject: RE: BS: resurfacing versus hip replacement From: Richard Bridge A client of mine who has a number of surgeons in his family and who is therefore able to get a good view of where to go recently had a hip replacement at Springfield hospital Chelmsford. He had left it too long to have a resurfacing. It has turned out well and he is very pleased. I gather that there may be a pathway to NHS treatment there under the "Book and Choose" system. http://www.ramsayhealth.co.uk/hospitals/private_hospitals/springfield_hospital.aspx |
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30 Apr 10 - 03:56 AM (#2897135) Subject: RE: BS: resurfacing versus hip replacement From: VirginiaTam I been reading about it and it doesn't look good. First found where procedure is not recommended for women as they are more likely to get fracture later with resurfacing than with THP. They still don't know why. I suspect not enough exercise to keep bone density strong. Not recommended for people who are overweight as the resurfacing material and bone it is connected to is not up to the challenge of added weight. That's 2 strikes agin me. Read somewhere else that it is not recommended for sufferers of inflammatory bone disease but the NICE guidance says it is, provided the patient is eligible (meets all the other NICE requirements, such as stage of disease, age and general health of patient, etc.). What's up with that? I am most worried about recovery. Getting in and out of bed, dressing, bathroom stuff is a huge worry. In the last year, 2 men at work had THP just after they turned 65. They had to wait until that age to get them. Both were off work for 6 weeks with reduced duties for a further 4 to 6 weeks. Both still limp (though they claim the pain is just about nil). One still uses his cane and it has been 5 months since his was done. Thing is both of my hips are very bad with pain and locking up when I walk. They won't do both at the same time and that would mean twice the recovery for 2 separate surgeries. RB - Don't know about the Choose and Book system. When I tried it on GP's advice for the Pain Clinic, I had to return to GP for referral number. However,it was new system then and so maybe he didn't know he should give me a referral number. Also I looked at Springfield (very close to us and very nice and clean from what I am told) but it looks like they only do THP and not resurfacing. Hope I don't have to go far afield for the procedure if that is what is required. Another worry is that uncomfortable car journey home after surgery. As a sort of aside and this is why I let it go so long - My ex (a sports therapist) said I had probably lost all the synovial fluid in the bursa surrounding the joints and that was what caused the sensation of tightening joints and the pain. No doctor has said this to me. They just saw RA markers in my bloods and decided it must be RA. True I have stiffness in wrists and hands and pain in feet. But I am gonna be so pissed off if it turns out that I could have had some other treatment to keep my hips working and pain free. I would not have put on all this weight in the last 5 years. |
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30 Apr 10 - 06:47 PM (#2897610) Subject: RE: BS: resurfacing versus hip replacement From: Don(Wyziwyg)T My father had a replacement at 58, which the surgeon said would last twelve to fifteen years. His second replacement to the same hip took place at age eighty three, so twenty five is possible, even for a man who played thirty six holes, four times a week till his eightieth year, when the hip was starting to hurt. If you have osteoarthritis Tam, it's worth asking your Doc to prescribe Arthrotec. Thet don't like to because it is expensive, but it does give a great deal of relief. My wife has osteoarthritis in spine, hips,and knees, and she swears by it. I have it in both hands, but playing guitar takes care of it quite well. Don T |
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30 Apr 10 - 07:29 PM (#2897642) Subject: RE: BS: resurfacing versus hip replacement From: DougR Sorry about your hip problem Virginia. My (now deceased) wife had full hip surgery when she was in her early to mid sixties and it really changed her life for the better. Of course we live in America and we don't have to get permission from our government for our health treatment. It won't be long, though, before that happens here too though. DougR |
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01 May 10 - 01:05 AM (#2897839) Subject: RE: BS: resurfacing versus hip replacement From: LadyJean My mom had 3 hip replacements, here in the U.S. She was 67, when she had the first 2, and 71, when she had one of the replacements replaced. There are 2 kinds of replacements done in the U.S., or at least there were in the 80s. The old fashioned kind, designed for old people, the replacement hips are cemented on to the bone. The new style, no cement is used, and the bone is supposed to grow into the replacement. Obviously not a good idea for a woman over 60. If you have to have the surgery, have it in the winter. Mom had her second hip replacement in July, and I damn near commited matricide before it was over. February is a great month to spend in bed. July is not. Mom was not a pleasant person. Of course afterwards, Mom was back to her garden club, and doing city tours, and traveling, and her book club, and well you get the idea. |
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01 May 10 - 07:28 AM (#2897941) Subject: RE: BS: resurfacing versus hip replacement From: Noreen Things have changed a great deal in this field since the 80s- as hip replacements weren't commonly available until the 1970s, and even then there were major risks. Now it is offered far more routinely, so make sure you read up-to-date literature, Tam. Recovery these days is also far quicker, patients are usually back on their feet within a day. This avoids problems with immobilisation, DVT etc. You do seem to be seeing all the possible negatives of the situation. While it is good to be realistic and well-informed before going into a procedure, if you think you are going to have problems, they may be more likely to happen... Chin up! |