Still searching

[Guest guest]

After consultation with two surgeons so far, one who does resurfacing

and the other who does not, three drawbacks where mentioned

concerning m-o-m resurfacing. (1)metal ions, (2)poor positioning of

drilled hole in the femor head for the cap stem, & (3)the possibility

of deteriorating bone under the cap due to lose of blood supply. I am

a 64 year old short distance extriathlete who is in good health and a

good candidate for resurfacing. I have presently eliminated running

but otherwise continue to cross train. So surgery is not in my

immediate futrue. Any helpful comments would be most appreciated,

especially from anyone with similar activities.

I would like to thank Maureen in N.Y. for her generous input so far.

Jim (extriguy)

[Guest guest]

Hi Jim

Just a few comments........... the metal ions has been done to death.

I have not heard the story of poor positioning of the drilled hole etc. and

it hasn't been cited for causing significant number of failures to date here

or by my OS........... When I saw him in Jan this year he stated that

failures to date in Australia are showing up as mostly related to cracks

made when putting on the femur head part.......... i.e. heavy handed use of

the hammer......... and remember we are just doing them on anyone and

everyone here with no trials etc.so getting a cross section range.

And this problem with cracks is the major cause of the deteriorating bone

under the cap. As I understand it bone deteriorates if a crack cuts the

supply of blood or if for some reason blood supply just stops as in case of

AVN - which can just occur in people. There are people who previously had

AVN who have had the dead bone cut out and a Resurface done with 100%

success, suggesting that this is a very individual thing........ I suspect

one would be hard pressed to get a current and widely accepted scientific

explanation of just why those individuals had dodgy blood supply to parts of

their bones but they do..........or why any of us just develop it.

Later in life osteoporosis starts playing a role as its occurance raises the

stakes on getting later cracks, especially in the femur neck area. This

again cuts blood supply and the bone dies. Which is why so many older folk

end up with hip replacements. And speculation would have it that if we, who

have one, later need revision this will be the most likely cause. The

osteoporosis issue still has many holes in understanding of the process but

one thing is known, bones put under normal operating pressure stay healthier

longer under whatever osteoporosis genetic history one has.............. The

design of the Resurface does enable that stress to be there on the femur

and head area and is more helpful than a THR in that way - one reason

getting put forward for it to be done on younger patients where preserving

femur integrity is potentially important long term.

It is the issue of current osteoporosis status that gets to play a role in

why Resurfacing gets to be less favoured to be done the older one gets when

facing the need for a hip replacement. i.e. the bone density obviously is

implicated in potential cracking capacities of the bone. Therefore it is

seen as more sane to put in a cemented THR than to do a Resurface and have

the femur neck crack in a year or 2 requiring yet another operation to a

body with a more fragile system - operations are traumas that one needs a

fairly fit and healthy body to pull out of...........this starts getting

more difficult the older one gets.

Which probably all leads to the position my OS stated........... We put in a

Resurface if the patient's bone stock and situation says they support it and

a THR in everyone else............ If that is starting to be a standard

response after 4-5 years experience in Australia by general operating OS

groups practicing in big cities, I suspect it will be how the future

actually looks regardless of what any practicing OS in US says now.

Edith LBHR Dr. L Walter Syd Aust 8/02

> After consultation with two surgeons so far, one who does resurfacing

> and the other who does not, three drawbacks where mentioned

> concerning m-o-m resurfacing. (1)metal ions, (2)poor positioning of

> drilled hole in the femor head for the cap stem, & (3)the possibility

> of deteriorating bone under the cap due to lose of blood supply. I am

> a 64 year old short distance extriathlete who is in good health and a

> good candidate for resurfacing. I have presently eliminated running

> but otherwise continue to cross train. So surgery is not in my

> immediate futrue. Any helpful comments would be most appreciated,

> especially from anyone with similar activities.

>

> I would like to thank Maureen in N.Y. for her generous input so far.

>

> Jim (extriguy)