Re: Resurfacing v. THR with Ceramic on Ceramic

[Guest guest]

At your age, I would make every effort to research (to convince yourself)

resurfacing without being worried about a THR surgery schedule deadline.

If you are interested in maintaining an active lifestyle doing sports,

resurfacing is the only way to go.

In July 2002, I had double simultaneous ( " bilateral " ) resurfacing with Dr.

DeSmet in Belgium. I was a fairly fit 50 year old at the time. I have now been

restored to the active competitive tournament tennis player that I once was.

DeSmet also restored a world class triathlon " Ironman " competitor (same age- Dr.

Drew Dixon). Dixon finished 2nd in the Madison Ironman and qualified for his

age to the World Championships in Hawaii 8 months after surgery!

Resurfacing as been around for 10-12 years and all reports indicate that the

failure rate is much lower than THR and that active athletes are also lasting.

All you have to do is tune in to " surfacehippy " and you rarely hear a story

of failure or serious complication. If you tune into the THR site " Totally Hip "

you will see far more reports of problems and far less stories of active

participants in running/jumping sports like tennis.

You should be able to be a candidate for resurfacing unless you are an

extreme case or have very advanced AVN. Even then, surgeons like DeSmet have

been

able to do remarkable things with difficult cases (i.e., Ritchie). So make sure

you get a second opinion if a US surgeon says that you are too far gone to

have the resurfacing surgery.

If resurfacing should fail, you can always have the CC THR or the large ball

THR which is also more compatible for impact sports.

I am extremely happy that I did not go the THR route because I know that I

wouldn't be able to run as quickly and fast and as agile if I didn't have the

resurfacing. Some of my local tennis friends who had THR, cannot do anything

close to what I can do- and I and they wish they would have had resurfacing.

Best of luck to you on your decision.

Saeed

Madison, WI

[Guest guest]

At your age, I would make every effort to research (to convince yourself)

resurfacing without being worried about a THR surgery schedule deadline.

If you are interested in maintaining an active lifestyle doing sports,

resurfacing is the only way to go.

In July 2002, I had double simultaneous ( " bilateral " ) resurfacing with Dr.

DeSmet in Belgium. I was a fairly fit 50 year old at the time. I have now been

restored to the active competitive tournament tennis player that I once was.

DeSmet also restored a world class triathlon " Ironman " competitor (same age- Dr.

Drew Dixon). Dixon finished 2nd in the Madison Ironman and qualified for his

age to the World Championships in Hawaii 8 months after surgery!

Resurfacing as been around for 10-12 years and all reports indicate that the

failure rate is much lower than THR and that active athletes are also lasting.

All you have to do is tune in to " surfacehippy " and you rarely hear a story

of failure or serious complication. If you tune into the THR site " Totally Hip "

you will see far more reports of problems and far less stories of active

participants in running/jumping sports like tennis.

You should be able to be a candidate for resurfacing unless you are an

extreme case or have very advanced AVN. Even then, surgeons like DeSmet have

been

able to do remarkable things with difficult cases (i.e., Ritchie). So make sure

you get a second opinion if a US surgeon says that you are too far gone to

have the resurfacing surgery.

If resurfacing should fail, you can always have the CC THR or the large ball

THR which is also more compatible for impact sports.

I am extremely happy that I did not go the THR route because I know that I

wouldn't be able to run as quickly and fast and as agile if I didn't have the

resurfacing. Some of my local tennis friends who had THR, cannot do anything

close to what I can do- and I and they wish they would have had resurfacing.

Best of luck to you on your decision.

Saeed

Madison, WI

[Guest guest]

Brilliant answers all around. Unless anyone has issues, I think this Q&A

should be posted for all newbies, and we all should save it to pass on to anyone

we come in contact who should know about the miracle that is resurfacing.

Maureen

Rhip, Dr. s, 10.31.02

[Guest guest]

Brilliant answers all around. Unless anyone has issues, I think this Q&A

should be posted for all newbies, and we all should save it to pass on to anyone

we come in contact who should know about the miracle that is resurfacing.

Maureen

Rhip, Dr. s, 10.31.02

[Guest guest]

> I am 33 year old male and currently scheduled for 2 THRs, 9 days

> apart. I have only recently come across all this information on

> Resurfacing and obviously am now questioning my THRs. Any insight

> on the following questions would be appreciated. In the meantime I

> am also contacting Dr. Gross' office.

> 1) What determines if Resurfacing is an option?

Basically, whether or not you still have enough intact bone left on

the head of the femur to attach the femoral component.

> 2) How much more active can one be with a Resurfacing v. a THR with

> C/C (ex. Ice Hockey, Baseball are not recommended with a THR)?

Well, the risk of dislocation is lower for a resurface than for C/C

THR. C/C is a very big improvement over the traditional metal/poly

THR. According to the most experienced resurfacing surgeons, the only

contraindicated activities for resurfacing are skydiving and bungee

jumping (although there's at least one skydiver in this group). We

have martial artists, surfers, climbers, triathletes, runners, skiers,

skaters, and maybe even a hockey player or two here. I'm sure we have

some baseball players as well.

> 3) What is the projected (estimated) life of a Resurface v. C/C for

> an active adult?

There isn't enough clinical data to say for sure. Both Metal-on-metal

resurfacing and C/C THRs use very hard, wear-resistant substances for

the bearing surfaces. It's pretty unlikely that either would " wear

out " . They're both polyethylene-free, which means that you don't have

to worry about polyethylene debris causing bone loss dur to

inflammation (osteolysis), which is *the* major cause of loosening and

failure in traditional metal-on-poly THRs. So, your major concern

would be other failure modes. C/C THRs, like all stemmed devices,

suffer from a problem known as " stress shielding " . Basically, they

don't transfer forces to the femur in the same way as a natural joint.

In a natural joint, mechanical stress causes compressive forces on the

head and top part of the femur, to which the body responds by building

up the bone density in these areas. In a step-type device, these

stresses are transferred down the stem and into the center of the bone

further down the shaft. This means that bone density is lost in the

upper part of the femur, which may or may not contribute to loosening

of the device. Early ceramic devices had problems with cracking of the

acetabular component. Manufacturers have successfully dealt with this

by making the acetabular component thicker, which seems to have pretty

much eliminated the problem. Unfortunately, this means that they can't

make the ball of the femoral component as large as that found on

metal-on-metal resurfacng. This means that the risk of dislocation is

somewhat higher with C/C than with resurfacing. It's still

considerably better than a metal/poly THR. Range of motion really

depends on the difference in diameter between the ball and the shaft

it's attached to. This is about the same between C/C and MoM

resurfacing, so it's probably not an issue.

Resurfacing failures are typically due to problems that occur during

the surgery and present themselves over the first few months

thereafter. The most common of these involve things that compromise

the quality of the femoral head: damaging the blood supply, causing

avascular necrosis, or fracturing the head or neck of the femur during

surgery. These events are unlikely (and less and less likely with

increasing surgeon experience). Poor initial bone quality

(osteoporosis) can cause problems, too.

Infection is a danger with any implant. Some people think that it's

less likely with resurfacing, since the femoral canal isn't violated

the way it is with stem-type devices, but there's no conclusive

evidence about this one way or the other.

C/C devices do not release metal ions into the body. There's no

evidence of the minute quantities of metals released by MoM hip

devices causing any health problems, but long-term studies are still

in progress.

> 4) If the Resurface fails, is a C/C THR still an option?

Yes. This is, to my way of thinking, the major advantage of

resurfacing. Since it preserves bone, it also preserves options down

the road. Basically, if a resurface fails, it's almost always due to

loosening of the femoral component. At this point, there are a lot of

options available:

1) One can convert the resurfacing to a large ball, MoM THR, retaining

the acetabular component. Basically, this involves doing half of a

THR. All of the resurfacing manufacturers make MoM THRs which use

the same acetabular components so that these conversions are as

easy as possible.

2) One can just go ahead and do a full THR with some other technology

(C/C, metal/poly, whatever). This is more involved that option (1),

because they'll have to replace the acetabular component, but

it's still possible.

In either of these cases, the THR will be a " primary " rather than

" revision " THR, which means that there's less bone loss and a higher

chance of success (every time a THR is revised, more of the femur has

to be removed).

>

> Time is of the essence for me since I am scheduled for the first THR

> a week from tomorrow. I somehow need to gather enough information

> to at least make a decision to go through with next week or not.

You came to the right place. Personally, I'd delay the THR until a

resurfacing surgeon had a chance to look at my X-rays. Check the

" active joints " web site (www.activejoints.com) for the most complete

information on " alternative: hip replacement technologies. This site

is maintained by , the moderator of this group, and is an

invaluable resource for any active person needing a hip replacement.

>

> Thanks for your thoughts.

You're most welcome!

Steve (bilateral C+ 4/20/04, Amstutz)

[Guest guest]

> I am 33 year old male and currently scheduled for 2 THRs, 9 days

> apart. I have only recently come across all this information on

> Resurfacing and obviously am now questioning my THRs. Any insight

> on the following questions would be appreciated. In the meantime I

> am also contacting Dr. Gross' office.

> 1) What determines if Resurfacing is an option?

Basically, whether or not you still have enough intact bone left on

the head of the femur to attach the femoral component.

> 2) How much more active can one be with a Resurfacing v. a THR with

> C/C (ex. Ice Hockey, Baseball are not recommended with a THR)?

Well, the risk of dislocation is lower for a resurface than for C/C

THR. C/C is a very big improvement over the traditional metal/poly

THR. According to the most experienced resurfacing surgeons, the only

contraindicated activities for resurfacing are skydiving and bungee

jumping (although there's at least one skydiver in this group). We

have martial artists, surfers, climbers, triathletes, runners, skiers,

skaters, and maybe even a hockey player or two here. I'm sure we have

some baseball players as well.

> 3) What is the projected (estimated) life of a Resurface v. C/C for

> an active adult?

There isn't enough clinical data to say for sure. Both Metal-on-metal

resurfacing and C/C THRs use very hard, wear-resistant substances for

the bearing surfaces. It's pretty unlikely that either would " wear

out " . They're both polyethylene-free, which means that you don't have

to worry about polyethylene debris causing bone loss dur to

inflammation (osteolysis), which is *the* major cause of loosening and

failure in traditional metal-on-poly THRs. So, your major concern

would be other failure modes. C/C THRs, like all stemmed devices,

suffer from a problem known as " stress shielding " . Basically, they

don't transfer forces to the femur in the same way as a natural joint.

In a natural joint, mechanical stress causes compressive forces on the

head and top part of the femur, to which the body responds by building

up the bone density in these areas. In a step-type device, these

stresses are transferred down the stem and into the center of the bone

further down the shaft. This means that bone density is lost in the

upper part of the femur, which may or may not contribute to loosening

of the device. Early ceramic devices had problems with cracking of the

acetabular component. Manufacturers have successfully dealt with this

by making the acetabular component thicker, which seems to have pretty

much eliminated the problem. Unfortunately, this means that they can't

make the ball of the femoral component as large as that found on

metal-on-metal resurfacng. This means that the risk of dislocation is

somewhat higher with C/C than with resurfacing. It's still

considerably better than a metal/poly THR. Range of motion really

depends on the difference in diameter between the ball and the shaft

it's attached to. This is about the same between C/C and MoM

resurfacing, so it's probably not an issue.

Resurfacing failures are typically due to problems that occur during

the surgery and present themselves over the first few months

thereafter. The most common of these involve things that compromise

the quality of the femoral head: damaging the blood supply, causing

avascular necrosis, or fracturing the head or neck of the femur during

surgery. These events are unlikely (and less and less likely with

increasing surgeon experience). Poor initial bone quality

(osteoporosis) can cause problems, too.

Infection is a danger with any implant. Some people think that it's

less likely with resurfacing, since the femoral canal isn't violated

the way it is with stem-type devices, but there's no conclusive

evidence about this one way or the other.

C/C devices do not release metal ions into the body. There's no

evidence of the minute quantities of metals released by MoM hip

devices causing any health problems, but long-term studies are still

in progress.

> 4) If the Resurface fails, is a C/C THR still an option?

Yes. This is, to my way of thinking, the major advantage of

resurfacing. Since it preserves bone, it also preserves options down

the road. Basically, if a resurface fails, it's almost always due to

loosening of the femoral component. At this point, there are a lot of

options available:

1) One can convert the resurfacing to a large ball, MoM THR, retaining

the acetabular component. Basically, this involves doing half of a

THR. All of the resurfacing manufacturers make MoM THRs which use

the same acetabular components so that these conversions are as

easy as possible.

2) One can just go ahead and do a full THR with some other technology

(C/C, metal/poly, whatever). This is more involved that option (1),

because they'll have to replace the acetabular component, but

it's still possible.

In either of these cases, the THR will be a " primary " rather than

" revision " THR, which means that there's less bone loss and a higher

chance of success (every time a THR is revised, more of the femur has

to be removed).

>

> Time is of the essence for me since I am scheduled for the first THR

> a week from tomorrow. I somehow need to gather enough information

> to at least make a decision to go through with next week or not.

You came to the right place. Personally, I'd delay the THR until a

resurfacing surgeon had a chance to look at my X-rays. Check the

" active joints " web site (www.activejoints.com) for the most complete

information on " alternative: hip replacement technologies. This site

is maintained by , the moderator of this group, and is an

invaluable resource for any active person needing a hip replacement.

>

> Thanks for your thoughts.

You're most welcome!

Steve (bilateral C+ 4/20/04, Amstutz)

[Guest guest]

I forgot to mention the other big advantage of resurfacing over

stem-type devices: recovery is typically *much* (like 2-3 times

faster). Let me give you an example that's near and dear to my own

personal heart, namely me. I had a bilateral resurfacing (both hips in

one surgery) in Los Angeles two weeks ago today (4/20/04). By 5 days

after surgery (4/25/04), I was able to fly home to Colorado. I live

alone, and I've managed to take pretty good care of myself. I'm on

crutches, but I'm managing around the (single story) house and am

taking short (2-3 block) walks around the neighborhood. I anticipate

being off crutches in a few weeks (probably late this month or early

June). What's your prognosis for day 14 after having both your hips

replaced 9 days apart (i.e., 5 days after the second hip). I suspect

you'll still be in the hospital, right?

Think about it.

Steve (bilateral C+ 4/20/04 Amstutz)

[Guest guest]

I forgot to mention the other big advantage of resurfacing over

stem-type devices: recovery is typically *much* (like 2-3 times

faster). Let me give you an example that's near and dear to my own

personal heart, namely me. I had a bilateral resurfacing (both hips in

one surgery) in Los Angeles two weeks ago today (4/20/04). By 5 days

after surgery (4/25/04), I was able to fly home to Colorado. I live

alone, and I've managed to take pretty good care of myself. I'm on

crutches, but I'm managing around the (single story) house and am

taking short (2-3 block) walks around the neighborhood. I anticipate

being off crutches in a few weeks (probably late this month or early

June). What's your prognosis for day 14 after having both your hips

replaced 9 days apart (i.e., 5 days after the second hip). I suspect

you'll still be in the hospital, right?

Think about it.

Steve (bilateral C+ 4/20/04 Amstutz)

[Guest guest]

I agree (about the answers) and thank everybody for your replies to

date as well as any continued thoughts.

I have already spoken to Dr. Gross's office and sent my x-rays to be

received by them in the morning. I would like to hear from anybody

who has experience with Dr. Gross as well.

BTW, I have no objection to this thread being posted for somebody

like myself to benefit from in the future.

> Brilliant answers all around. Unless anyone has issues, I think

this Q&A

> should be posted for all newbies, and we all should save it to

pass on to anyone

> we come in contact who should know about the miracle that is

resurfacing.

>

> Maureen

> Rhip, Dr. s, 10.31.02

>

>

>

[Guest guest]

I was in the same boat as you about a month ago. I had a THR

scheduled for May 14 All systems go until I happened on this

site.

Afterwards I spent every free minute I had reading past posts

and

researching resurfacing. I then called my OS's office and

told them

I was cancelling. I've since sent digital x-rays to a couple

of docs

who are doing this procedure in the US, and all have told me I

would

be a good candidate. Take your time and check out all of

your

options. Worse comes to worse you can always reschedule your

THR, but once you've had it, you can't reverse it. Good

luck!---

Harriet

[Guest guest]

I was in the same boat as you about a month ago. I had a THR

scheduled for May 14 All systems go until I happened on this

site.

Afterwards I spent every free minute I had reading past posts

and

researching resurfacing. I then called my OS's office and

told them

I was cancelling. I've since sent digital x-rays to a couple

of docs

who are doing this procedure in the US, and all have told me I

would

be a good candidate. Take your time and check out all of

your

options. Worse comes to worse you can always reschedule your

THR, but once you've had it, you can't reverse it. Good

luck!---

Harriet

[Guest guest]

I was in the same boat as you about a month ago. I had a THR

scheduled for May 14 All systems go until I happened on this

site.

Afterwards I spent every free minute I had reading past posts

and

researching resurfacing. I then called my OS's office and

told them

I was cancelling. I've since sent digital x-rays to a couple

of docs

who are doing this procedure in the US, and all have told me I

would

be a good candidate. Take your time and check out all of

your

options. Worse comes to worse you can always reschedule your

THR, but once you've had it, you can't reverse it. Good

luck!---

Harriet

[Guest guest]

As you mentioned ice hockey - I know of a person who had a resurface

who has gone back to playing ice hockey.

Ed

> I am 33 year old male and currently scheduled for 2 THRs, 9 days

> apart. I have only recently come across all this information on

> Resurfacing and obviously am now questioning my THRs. Any insight

> on the following questions would be appreciated. In the meantime I

> am also contacting Dr. Gross' office.

> 1) What determines if Resurfacing is an option?

> 2) How much more active can one be with a Resurfacing v. a THR with

> C/C (ex. Ice Hockey, Baseball are not recommended with a THR)?

> 3) What is the projected (estimated) life of a Resurface v. C/C for

> an active adult?

> 4) If the Resurface fails, is a C/C THR still an option?

>

> Time is of the essence for me since I am scheduled for the first

THR

> a week from tomorrow. I somehow need to gather enough information

> to at least make a decision to go through with next week or not.

>

> Thanks for your thoughts.

[Guest guest]

> I forgot to mention the other big advantage of resurfacing over

> stem-type devices: recovery is typically *much* (like 2-3 times

> faster). Let me give you an example that's near and dear to my own

> personal heart, namely me. I had a bilateral resurfacing (both hips

in

> one surgery) in Los Angeles two weeks ago today (4/20/04). By 5 days

> after surgery (4/25/04), I was able to fly home to Colorado. I live

> alone, and I've managed to take pretty good care of myself. I'm on

> crutches, but I'm managing around the (single story) house and am

> taking short (2-3 block) walks around the neighborhood. I anticipate

> being off crutches in a few weeks (probably late this month or early

> June). What's your prognosis for day 14 after having both your hips

> replaced 9 days apart (i.e., 5 days after the second hip). I suspect

> you'll still be in the hospital, right?

>

> Think about it.

>

> Steve (bilateral C+ 4/20/04 Amstutz)

Great post Steve! I've been keeping up with this web site and am so

glad to hear that you're doing so well with your bilateral! Susie

[Guest guest]

If your OS hasn't mentioned resurfacing at your young age, I would seriously

look at changing OS'S Dr De Smet said at one point that it was 'cruel' to do a

THR on someone as young as you . He's the OS in Belgium who has done 1000+

resurfs, and did mine when I was rejected here in Canada as being too far gone.

Eight months later I am doing great with my resurfaced hip. Resurfacing

has these advantages: give you far more range of motion, so it is pretty much

impossible to dislocate the hip, unlike a THR; recovery time is very quick; if

it fails in a few years, you can then get a THR; THRs don't last much more than

12-15 years in an active person, and can only be redone successfully once or

twice at most - then what? A wheelchair? The type of material used in

resurfacing now is very durable - metal is used, whereas the failures in the

early 80's were made of a type of plastic and didn't last. The metal ones have

been in use since approx 1993, so longterm data is not available, but if our

expert OS, Dr De Smet is anyone to go by, he said he figured they'd last about

500 years....so I figure that's about long enough for me...:-)

As someone else wisely has advised you, stall off on the THRs until you can

determine whether or not you are a good candidate for reurfs. Primarily you

have to have good bone stock (i.e., good density). I sent my xrays to Dr De

Smet and he got back to me within two hours of receiving them to give me the

okay - so get your xrays to an OS who does resurfs (preferably someone who has

done lots of them). There have been innumerable people on this site who

initially got an OS who didn't favour resurfs (usually someone who didn't know

how to do them) and then found an OS who does them, and went ahead succcessfully

to have the surgery. Carry on searching and good luck. Let us know what

happens.

Sharry

Resurfacing v. THR with Ceramic on Ceramic

I am 33 year old male and currently scheduled for 2 THRs, 9 days

apart. I have only recently come across all this information on

Resurfacing and obviously am now questioning my THRs. Any insight

on the following questions would be appreciated. In the meantime I

am also contacting Dr. Gross' office.

1) What determines if Resurfacing is an option?

2) How much more active can one be with a Resurfacing v. a THR with

C/C (ex. Ice Hockey, Baseball are not recommended with a THR)?

3) What is the projected (estimated) life of a Resurface v. C/C for

an active adult?

4) If the Resurface fails, is a C/C THR still an option?

Time is of the essence for me since I am scheduled for the first THR

a week from tomorrow. I somehow need to gather enough information

to at least make a decision to go through with next week or not.

Thanks for your thoughts.

[Guest guest]

I recently sent information to Dr. Gross' office and received a personal

call within a few days of him getting my x-rays.

I sent my actual x-ray films to Dr. Gross, along with a digital ct-scan.

They ask that you send them Fedex because there is a tracking number. I

sent mine UPS due to no Fedex in my area. When Dr. Gross called (a week

ago), he said he could do the surgery the first week of June, so it isn't a

long wait.

My opinion...get a second opinion before making such a big decision. Do

whatever you need to do to delay your surgery until you can get the facts -

fake being sick if you have to. Dr. Gross will give you a candid response

regarding your situation, and his assistant, Lee Web, is fantistic. I just

received an email from her today, after submitting a question via email

yesterday. You should spend time going through the wealth of emails on this

forum, also.

Again, once you get the x-rays sent out, you should have an answer within a

day or two of them receiving them. Based on your schedule, you may want to

overnight them. However, be sure to notify Lee Web, via email, before doing

so.

Best of Luck.

Resurfacing v. THR with Ceramic on Ceramic

I am 33 year old male and currently scheduled for 2 THRs, 9 days

apart. I have only recently come across all this information on

Resurfacing and obviously am now questioning my THRs. Any insight

on the following questions would be appreciated. In the meantime I

am also contacting Dr. Gross' office.

1) What determines if Resurfacing is an option?

2) How much more active can one be with a Resurfacing v. a THR with

C/C (ex. Ice Hockey, Baseball are not recommended with a THR)?

3) What is the projected (estimated) life of a Resurface v. C/C for

an active adult?

4) If the Resurface fails, is a C/C THR still an option?

Time is of the essence for me since I am scheduled for the first THR

a week from tomorrow. I somehow need to gather enough information

to at least make a decision to go through with next week or not.

Thanks for your thoughts.

[Guest guest]

I recently sent information to Dr. Gross' office and received a personal

call within a few days of him getting my x-rays.

I sent my actual x-ray films to Dr. Gross, along with a digital ct-scan.

They ask that you send them Fedex because there is a tracking number. I

sent mine UPS due to no Fedex in my area. When Dr. Gross called (a week

ago), he said he could do the surgery the first week of June, so it isn't a

long wait.

My opinion...get a second opinion before making such a big decision. Do

whatever you need to do to delay your surgery until you can get the facts -

fake being sick if you have to. Dr. Gross will give you a candid response

regarding your situation, and his assistant, Lee Web, is fantistic. I just

received an email from her today, after submitting a question via email

yesterday. You should spend time going through the wealth of emails on this

forum, also.

Again, once you get the x-rays sent out, you should have an answer within a

day or two of them receiving them. Based on your schedule, you may want to

overnight them. However, be sure to notify Lee Web, via email, before doing

so.

Best of Luck.

Resurfacing v. THR with Ceramic on Ceramic

I am 33 year old male and currently scheduled for 2 THRs, 9 days

apart. I have only recently come across all this information on

Resurfacing and obviously am now questioning my THRs. Any insight

on the following questions would be appreciated. In the meantime I

am also contacting Dr. Gross' office.

1) What determines if Resurfacing is an option?

2) How much more active can one be with a Resurfacing v. a THR with

C/C (ex. Ice Hockey, Baseball are not recommended with a THR)?

3) What is the projected (estimated) life of a Resurface v. C/C for

an active adult?

4) If the Resurface fails, is a C/C THR still an option?

Time is of the essence for me since I am scheduled for the first THR

a week from tomorrow. I somehow need to gather enough information

to at least make a decision to go through with next week or not.

Thanks for your thoughts.

[Guest guest]

These are questions that I am sure Dr. Gross or Lee Webb will answer

for you and their responses would be definitive.

> 1) What determines if Resurfacing is an option?

The condition of the bone which the surgeon can usually evaluate by

studying images (primarily x-rays). In some cases they can't tell for

certain until they perform the surgery and can actually see the bone.

> 2) How much more active can one be with a Resurfacing v. a THR with

> C/C (ex. Ice Hockey, Baseball are not recommended with a THR)?

Odds are you will have a larger femoral head with a resurf than you

would have with a C-on-C THR (due to the relative strengths of the

materials). In most cases, resultant range of motion is proportional

to the size of the femoral head. So, you will likely have better

range of motion. Most doctors will probably recommend you avoid

sports where the hip could be injured by impact.

> 3) What is the projected (estimated) life of a Resurface v. C/C for

> an active adult?

There isn't enough data yet. Both C-on-C and M-o-M should last a very

long time. I think the theoretical wear predictions are more

favorable for ceramic. Both C-on-C and M-o-M are showing orders of

magnitude less wear than the devices with polyethylene.

> 4) If the Resurface fails, is a C/C THR still an option?

Wow, good question. I was told if my M-o-M resurf fails a M-o-M THR

was the fallback option. In a resurf, two of the failure modes are

AVN causing the femur to not be strong enough to support the femoral

cap and fracture of the femur (I am told the odds are about 1% for

each) - in either of those cases, only the femoral component would

need to be replaced. I never thought about what it would take to

replace the acetabular component. A good question for the Doctor!

> Time is of the essence for me since I am scheduled for the first THR

> a week from tomorrow. I somehow need to gather enough information

> to at least make a decision to go through with next week or not.

Leave a message for Lee Webb (Dr. Gross's nurse) and ask if she can

call back tonight (she's normally in surgery with Dr. Gross on

Mondays, Wednesdays and Thursdays). She's great about getting back to

people and she can probably answer your questions.

RC2K Dr. Gross 3/24/04

[Guest guest]

I had my resurf done March 24th by Dr. Gross. I would be happy to

answer any questions - I posted a chronology of my first 5 weeks just

last week if you want to look for it in the archives.

I was down in Columbia yesterday for my 6 week follow-up and Dr. Gross

says everything looks good and he is very pleased with my progress.

Dr. Gross has a first class operation (excuse the pun) and I am a very

happy patient/customer!

If you have specific questions or concers, shoot me a message and I

will be happy to respond!

RC2K Dr. Gross 3/24/04

> > Brilliant answers all around. Unless anyone has issues, I think

> this Q&A

> > should be posted for all newbies, and we all should save it to

> pass on to anyone

> > we come in contact who should know about the miracle that is

> resurfacing.

> >

> > Maureen

> > Rhip, Dr. s, 10.31.02

> >

> >

> >