Re: life expectation of resurface

[Guest guest]

Also, I heard that if you engage in (moderately) high impact activity, you

actually lengthen the life of the implant because the major cause of failure is

likely to be degeneration of the underlying bone.

High impact exercise will most likely strengthen the bone under the

prosthesis, rather than the other way around.

Barring any major trauma of a twisting or smashing nature on the actual hip

joint, I would therefore expect high impact activity to actually prolong the

life of a resurface.

Cock-eyed optimist/masochist Des Tuck

In a message dated 5/21/2004 12:01:50 PM Pacific Standard Time,

dm_griggzy@... writes:

Your question assumes resurfacing has a limited life expectancy in

which higher impact sports shorten its life even more. That thinking

has been historically associated with traditional THRs, which are

known to wear out, but large head MoM resurfacing is setting much

higher expectations. Both the resurfacing surgical community and its

patient community are hopeful it will be a once-in-a-lifetime

procedure, but there's only a handful of these large head MoM

resurfacing implants over 10 years old. There have been a few

resurfacing revisions, and you need to ask about them, but the bottom

line is until more long-term data is available, any projection can

only be a best guess. Even then, you have to factor in the

relatively recent improvements in both the implants and surgical

techniques and their impact on longevity.

[Guest guest]

I have a BHR. I asked my osteo point blank what the most common failure

mode for athletes is and he replied

=========

...

I know there have been some loosenings of other resurfacing

devices in the US, all I can tell you is that I have done just over 2,000

BHR's myself now and I do not have a single cup or femoral component

loosening. To date therefore loosening just has not featured as a failure

mode but what has featured as a failure mode in the early months after

surgery is bone failure, either by fracturing of the femoral neck or

collapse of poor quality bone in the femoral head.

...

I can't tell you

what the athletes of BHR failure mode is going to be as apart from a few

cases of infection and a few cases of bone failure there haven't been any

other failures.

==========

Here is my understanding...

* high impact sports *may* cause the glue to give way for the femoral

component if glued. Maybe. This was reported in US resurfacings

* uncemented femoral components are more likely to loosen earlier. Maybe.

* wear and tear from low impact walking, cycling, swimming is not an issue,

since the component has a life expectancy of 300 or so years, meaning it is

unlikely you will wear it out.

As for the glue issue, this was the suspected cause of one resurfacing by

Amstutz at the 5 year mark on a women who played hard doubles tennis almost

every day post-op. However, the same sort of glue holds crowns on and this

will last a good 20 years with a lot more wear and tear than the hip. The

major factor in crown longevity is how good the fit of the cap is

initially. If it is nice and tight then the glue doesn't get stressed as

much, so I suspect that this might just possibly carry to hips. Maybe.

As for me, I walk/elliptic train 30 miles a week (so no/low impact) and

swim too. My osteo said that he put no limit on the amount I do of these. I

also do martial arts (getting thrown) and that is exactly where I allow for

any and all high impact. Others are well past me in doing these sorts of

things with no ill effects (e.g. who does judo actively and

has had his BHR for 9 years). I wouldn't do this if I thought there was a

chance I'd shorten the life of the implant, but since I have a knee

problem, I do have to control impact for that (it swells if I run

cross-country, but I can do the elliptical trainer as much as I want with

no problem).

Hope this helps...

Jeff

rBHR Aug. 1, 2001

Mr. McMinn

==================

" One of the advantages of being disorderly is that one is constantly making

exciting discoveries. "

- A. A. Milne

>I have heard that it is " miles " more than how long. In the past I

>have been very active...leading to the need for resurfacing. Does

>anyone know what activities put more wear or is their any rating for

>activities. I would like to carry on doing the following: cycling,

>mountaineering, racket sports, ice hockey, and maybe a few. I can

>see how racket sports/hour may be " mile " intensive. Any feedback

>would be appreciated.

>

>

>

>

>

[Guest guest]

Your question assumes resurfacing has a limited life expectancy in

which higher impact sports shorten its life even more. That thinking

has been historically associated with traditional THRs, which are

known to wear out, but large head MoM resurfacing is setting much

higher expectations. Both the resurfacing surgical community and its

patient community are hopeful it will be a once-in-a-lifetime

procedure, but there's only a handful of these large head MoM

resurfacing implants over 10 years old. There have been a few

resurfacing revisions, and you need to ask about them, but the bottom

line is until more long-term data is available, any projection can

only be a best guess. Even then, you have to factor in the

relatively recent improvements in both the implants and surgical

techniques and their impact on longevity.

Questions about post-resurfacing activity levels are fairly frequent

on this site, as are the answers. You'll find many of us

surfacehippies have resumed our reasonably high pre-op activity

levels, including virtually all the high-impact sports, including the

ones you enjoy. I'm in my 7th year on one resurfacing implant

and 4th month on the other. I've beat on my original C+s with

zero problems, leading me to conclude that if you choose the right

surgeon and are willing to work at rehab, there's an excellent

chance you can resume all your activities to your pre-op level, if

not better. As far as for how long, that's an open question. I,

for one, feel other parts of my body will wear out before my new hips.

Dave

> I have heard that it is " miles " more than how long. In the past I

> have been very active...leading to the need for resurfacing. Does

> anyone know what activities put more wear or is their any rating

for

> activities. I would like to carry on doing the following: cycling,

> mountaineering, racket sports, ice hockey, and maybe a few. I can

> see how racket sports/hour may be " mile " intensive. Any feedback

> would be appreciated.

[Guest guest]

Hi Des,

It is also my understanding and there does seems to be a theme that this is

one of the reasons Resurfacing is being suggested for younger people wanting

to regain high activity levels............

Now to this point I guess that has to be based on the known theory of how

bone health works rather than trials with large numbers............. but

there does seem some truth to the claim that bones responds to impact type

activities. I would also hazzard a guess that people who are fit enough to

indulge in major activites end up with very good muscle support around their

hip joints.........and may even have gone to some lengths to correct any bad

habits that could have contributed to the original problems during

rehab....... Therefore they may not be actually jarring etc the bone section

of the joint as much as might be perceived at first glance...........

The more I learn about all this and how bodies work, the more significant it

seems to be that being fit and keeping fit is the best way to keep any

joints in a body........ and my guess is maintaining strong healthy muscles

around the hip area would have to significantly contribute to the life of

any hip prothesis........ and lack of it may well be more responsible for

the wear/failure rates of a THR than any other factor........... given the

general populations reluctance to partake in meaningful

exercise............... An area just waiting for a few dozen PhD

doctorials...............smile.

Edith LBHR Dr. L Walter Syd Aust 8/02

> Also, I heard that if you engage in (moderately) high impact activity, you

> actually lengthen the life of the implant because the major cause of

failure is

> likely to be degeneration of the underlying bone.

>

> High impact exercise will most likely strengthen the bone under the

> prosthesis, rather than the other way around.

>

> Barring any major trauma of a twisting or smashing nature on the actual

hip

> joint, I would therefore expect high impact activity to actually prolong

the

> life of a resurface.

>

> Cock-eyed optimist/masochist Des Tuck

>

[Guest guest]

Hi Des,

It is also my understanding and there does seems to be a theme that this is

one of the reasons Resurfacing is being suggested for younger people wanting

to regain high activity levels............

Now to this point I guess that has to be based on the known theory of how

bone health works rather than trials with large numbers............. but

there does seem some truth to the claim that bones responds to impact type

activities. I would also hazzard a guess that people who are fit enough to

indulge in major activites end up with very good muscle support around their

hip joints.........and may even have gone to some lengths to correct any bad

habits that could have contributed to the original problems during

rehab....... Therefore they may not be actually jarring etc the bone section

of the joint as much as might be perceived at first glance...........

The more I learn about all this and how bodies work, the more significant it

seems to be that being fit and keeping fit is the best way to keep any

joints in a body........ and my guess is maintaining strong healthy muscles

around the hip area would have to significantly contribute to the life of

any hip prothesis........ and lack of it may well be more responsible for

the wear/failure rates of a THR than any other factor........... given the

general populations reluctance to partake in meaningful

exercise............... An area just waiting for a few dozen PhD

doctorials...............smile.

Edith LBHR Dr. L Walter Syd Aust 8/02

> Also, I heard that if you engage in (moderately) high impact activity, you

> actually lengthen the life of the implant because the major cause of

failure is

> likely to be degeneration of the underlying bone.

>

> High impact exercise will most likely strengthen the bone under the

> prosthesis, rather than the other way around.

>

> Barring any major trauma of a twisting or smashing nature on the actual

hip

> joint, I would therefore expect high impact activity to actually prolong

the

> life of a resurface.

>

> Cock-eyed optimist/masochist Des Tuck

>

[Guest guest]

Hi Des,

It is also my understanding and there does seems to be a theme that this is

one of the reasons Resurfacing is being suggested for younger people wanting

to regain high activity levels............

Now to this point I guess that has to be based on the known theory of how

bone health works rather than trials with large numbers............. but

there does seem some truth to the claim that bones responds to impact type

activities. I would also hazzard a guess that people who are fit enough to

indulge in major activites end up with very good muscle support around their

hip joints.........and may even have gone to some lengths to correct any bad

habits that could have contributed to the original problems during

rehab....... Therefore they may not be actually jarring etc the bone section

of the joint as much as might be perceived at first glance...........

The more I learn about all this and how bodies work, the more significant it

seems to be that being fit and keeping fit is the best way to keep any

joints in a body........ and my guess is maintaining strong healthy muscles

around the hip area would have to significantly contribute to the life of

any hip prothesis........ and lack of it may well be more responsible for

the wear/failure rates of a THR than any other factor........... given the

general populations reluctance to partake in meaningful

exercise............... An area just waiting for a few dozen PhD

doctorials...............smile.

Edith LBHR Dr. L Walter Syd Aust 8/02

> Also, I heard that if you engage in (moderately) high impact activity, you

> actually lengthen the life of the implant because the major cause of

failure is

> likely to be degeneration of the underlying bone.

>

> High impact exercise will most likely strengthen the bone under the

> prosthesis, rather than the other way around.

>

> Barring any major trauma of a twisting or smashing nature on the actual

hip

> joint, I would therefore expect high impact activity to actually prolong

the

> life of a resurface.

>

> Cock-eyed optimist/masochist Des Tuck

>