Friday, August 31. 2007
Why I Chose A Hip Resurfacing Instead Of A Total Hip Replacement
By Pat Walter
My hip hurt, my body hurt and I needed a new hip. I had fought hip pain for almost ten years because I just did not want "half my leg bone cut off" to get a new hip replacement. It just did not make sense to me that doctors were still sawing off a big hunk of a femur bone to replace a hip. We sent men to the moon, had nuclear power and every kind of electronic device imaginable, so why are our operations still old-fashioned?
I asked myself that question quite often. One evening while visiting our local tavern, I was telling a gentleman my feelings about total hip replacement. I am not sure how the conversation started, but perhaps I was complaining about my hip pain. To my surprise, he told me that they don't have to saw off part of your femur bone to replace a hip any more. I was shocked. I had been doing some internet searching, but had not found information about hip resurfacing yet.
He explained that he had his hip resurfaced with Dr. Schmalzried in California in 2005. With hip resurfacing, the surgeon reshapes the top of your femur bone to accept a cap that is the same size as your original bone, he explained. The cap has a small stem which is placed into a hole that is drilled in the top of the femur bone. A small amount of cement is used to hold the cap in place until new bone grows under the cap. A matching metal cup is placed in the acetabulum of your hip to provide a bearing surface for the cap on the femur bone. It becomes a perfect metal bearing which replaces your injured or arthritic hip joint.
Hip resurfacing is major surgery just as a total hip replacement is. The basic difference is that the doctor does not saw off a major portion of your femur bone and drill a long hole into it to accept the long stem of a total hip replacement device.
Hip resurfacing is bone conserving. The reason that hip resurfacing is a better choice than total hip replacement for many people is that at some time in the future, you could require a revision. The actual hip devices don't wear out since they are metal, but the bone holding the hip device often deteriorates. The hip device becomes lose and very painful. A revision is then necessary to replace the old hip device. If a person starts with a hip resurfacing and at some point later in life requires a revision, then they have a complete femur bone for the surgeon to work with. If a person starts with a total hip replacement, then the doctor has to break apart the femur bone to remove the long steam of the old total hip device. The femur bone must be wired back together when the new stem is in place. Hip resurfacing allows a much easier revision later in life if it is required.
The second advantage of a hip resurfacing is that the hip device, due to it's large size, allows a person to return to any of their favorite activities without restrictions or possibility of a dislocation. The old fashioned total hip replacement devices used a very small diameter ball as compared to size of your natural femur bone. The small size of the ball would allow a hip to dislocate easily. The size of the hip resurfacing device is matched very closely to the original size of your hip, so any movements you make are much less likely to cause a dislocation. The hip resurfacing device is acting the same way your natural hip use to function.
I was sixty-one and still felt young when I needed a hip replacement. I had always been very active during my life playing tennis, ice skating, bike riding and participating in other sports. I wanted to remain active and did not want to worry about dislocating a hip after a total hip replacement. I had sixteen dogs and often got on the floor to groom and cut nails. I needed to be as active as possible and the only solution for me was hip resurfacing.
I had my hip resurfaced with a Birmingham Hip Resurfacing, BHR, in March 2006 with Dr. De Smet in Belgium. I did not have health insurance and could not afford surgery in the United States. Dr. De Smet is one of the best hip surgeons in the world and had done over 2400 hip resurfacings when I went to him. My surgery and medical costs were $13,500. The complete trip for my husband and I to Belgium, including the medical costs, was about $17,000. I felt this was the best investment I ever made in my whole life, an investment in my own health and well being.
Birmingham Hip Resurfacing, BHR, was not FDA approved in the United States until May 2006. The BHR had been used world wide for over nine years. Younger, active people all over the world were offered hip resurfacing instead of a total hip replacement. Over 90,000 people world wide have hip resurfacings and now I am one of them. Hip resurfacing has allowed me to be as active as possible without worrying about a dislocation. If you have hip pain and need a new hip, be sure to ask your doctor about hip resurfacing. Although the BHR is FDA approved, many doctors are not trained to do the BHR surgery. It is a more difficult surgery than a THR and requires training and experience. There are many sources available to learn about hip resurfacing like the Surface Hippy Website, a Patient to Patient Guide About Hip Resurfacing, the Yahoo Surface Hippy Discussion Group and many doctor and medical equipment websites.
About the Author: Patricia Walter had her hip resurfaced in March 2006. She is the webmaster and owner of several Patient to Patient Websites about Hip Replacement.
Hip Resurfacing News Features Up to Date News about Hip Resurfacing
Hips for You is a Patient to Patient Guide to Total Hip Replacement
Surface Hippy
Article Source: http://EzineArticles.com/?expert=Pat_Walter
http://EzineArticles.com/?Why-I-Chose-A-Hip-Resurfacing-Instead-Of-A-Total-Hip-Replacement&id=710186
Friday, August 31. 2007
Keith McDonald Hip Resurfacing Video - Choosing a Hip Resurfacing - New York Times Video
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Friday, August 31. 2007
Lynn Beyler's Hip Story Video featuring her hip reusrfacing surgery with Dr. De Smet in Belgium.
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Friday, August 31. 2007
Hip Surgery in Belgium Video
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Thursday, August 30. 2007
Data On Doctors To Be Available
RICARDO ALONSO-ZALDIVAR Los Angeles Times August 30, 2007 WASHINGTON Whether it's a hernia repair or heart bypass, doctors who perform a given operation more frequently get better results. The problem for patients has been finding out who those physicians are before picking one.
Now a court ruling appears to open the way for consumer access to such information for the first time, possibly transforming the relationship between doctors and their patients, as well as the business of health care.
In a little-noticed decision last week, a federal judge in Washington ruled in favor of a consumer group that sued the Health and Human Services Department to allow disclosure of doctor-level detail from the vast Medicare claims database. U.S. District Judge Emmet G. Sullivan concluded "a significant public benefit" could be served by releasing the data, and ordered the department to turn it over by Sept. 21.
With information on more than 40 million patients and 700,000 doctors, the Medicare database is far richer than any private insurer's. Although it would not have information on some doctors, such as pediatricians, who don't treat Medicare patients, it is considered the mother lode for data on those who treat adults, because Medicare recipients are a mainstay of most practices.
The database's usefulness has been limited by a decades-old government policy that protects the privacy of doctors, who fear the information could be used to micromanage the practice of medicine. But as the cost of medical care has skyrocketed, employers, insurers and consumer groups have pressured the government to open up Medicare's files on individual doctors.
Those files could reveal far more than how many times a year a surgeon performs a hip replacement operation. The data could also be analyzed to determine how individual doctors make critical decisions on tests and procedures that determine both quality and costs. They would show which doctors fail to order prudent preventive tests that could catch disease early. And they could indicate which ones order duplicative tests or unnecessary hospitalizations...
...Those files could reveal far more than how many times a year a surgeon performs a hip replacement operation. The data could also be analyzed to determine how individual doctors make critical decisions on tests and procedures that determine both quality and costs. They would show which doctors fail to order prudent preventive tests that could catch disease early. And they could indicate which ones order duplicative tests or unnecessary hospitalizations.
"These data will make it possible to develop measures that will be very helpful to consumers," said Robert Krughoff, president of Consumers' Checkbook, the nonprofit group that sued for the information.
"Someone who is thinking they need a knee replacement--or a prostatectomy--will be able to go on our website and see how many of these procedures their physician has done for Medicare patients," added Krughoff.
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Monday, August 27. 2007
You, Too, Can Have A Bionic Body New materials and high-tech procedures are driving a surge in hip, knee and even ankle replacements.
Knee and hip replacements are serious surgeries, but increasingly, they're also a serious business. As the baby boomers' joints wear out, more of them are turning to orthopedic surgeons for the procedures. Docs now perform more than 450,000 knee replacements and 208,000 hip replacements a year, and rising numbers of them are done to boomers willing and able to pay $30,000 and up. By 2031, one study predicts, docs will perform more than 3.5 million knee replacements alone—a 673 percent increase from current numbers. It's as if an entire generation has taken Matthew 18:8 to heart: "If thy hand or thy foot offend thee, cut them off, and cast them from thee." And, apparently, sub in something better and keep going...
...Now, though, orthopedic surgeons can offer much better treatments. Most exciting is a strategy called "resurfacing," which has come to the United States within the last two years after proving successful in England. Well suited to ac-tive, younger patients, it holds back on replacing the entire joint (usually the hip), instead leaving a great deal of bone in place and covering it with a protective surface. "The pain relief is dramatic, even right away," says Moorman. And it doesn't require some types of traditional cement that can eat away at bone tissue, so it may be a more sustainable fix than a full replacement. Several new resurfacing devices are currently awaiting FDA approval...
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Monday, August 27. 2007
Live Video of BHR Surgery by Dr. MacCauly at NY Presbyterian VIEW VIDEO On Thursday, February 8, 2006 at 8 p.m. EST, join NewYork-Presbyterian Hospital orthopedic surgeons Drs. William B. Macaulay and Jeffrey A. Geller for a web cast discussion on total hip resurfacing. The doctors will show highlights from an actual total hip resurfacing surgery, discuss the procedure and its promise as an alternative to total hip replacement, and engage in a live question and answer session with audience members.
Dr. Macaulay trained under Drs. Derek McMinn and Ronan Treacy, the Birmingham, England-based orthopedic surgeons who developed the implant for total hip resurfacing.
Monday, August 27. 2007
All About Hip Resurfacing
Hip resurfacing is all the rage in the orthopedic community these days. In fact, I had four different hospitals pitch me stories on it in the last year, independent of one another. But is it right for everyone with chronic, debilitating hip problems? NYMD News panelist Dr. William Macaulay, attending orthopedic surgeon at New York Presbyterian Hospital/Columbia and director of Columbia's Center for Hip and Knee Replacement, has the answers below and after the break. By William Macaulay, M.D.
You just turned 40 or 50. Your mind tells you you’re younger, but you feel older because you have real hip pain that won’t quit. You limp everyday. You do a little research and come across a new procedure called total hip resurfacing. Then you wonder: Is this the right procedure for me? I hear the same story over and over from my patients. Looking for a solution to their hip pain, they have stumbled upon total hip resurfacing, which was approved for use in the U.S. in May of 2006. While many patients are ideal candidates for resurfacing, often I must inform them that hip resurfacing is not for everyone. Hip resurfacing is not a new concept. Older, less successful versions of hip resurfacing came and went between the 1930s and 1980s, which included materials such as glass, plastic and stainless steel. These implants eventually failed under normal activity requirements. Advances in metallurgy and refinements in surgical technique have brought resurfacing back to the foreground of hip surgery. Today, total hip replacement remains the gold standard, especially for patients over the age of 60 or 65 with severe, debilitating arthritis of the hip. However, for the younger and more active hip arthritis patient, the long-term success of THR remains a concern. Scandinavian hip registries (the U.S. does not yet have one) have shown that active total hip replacement patients under the age of 55 have a 15% to 20% chance of requiring a re-operation within 10 years. As a 40 or 50 year old with severe hip pain, arriving at surgical intervention as your last resort, which option do you choose? As with most things, there are pros and cons to each. The benefit of hip resurfacing is suggested by its name. The top of the thigh bone is preserved by reshaping and capping with metal (Figure 1) instead of replaced, as is the case with traditional hip replacements with a metal spike driven down the inside of the thigh bone ... READ COMPLETE ARTICLE
Monday, August 27. 2007
Hip Surgery With a Future By Barnaby J. Feder Correction Appended Hip replacement, an operation that about 300,000 Americans undergo each year, is one of the great success stories of modern medicine. But woe to those who outlive their artificial hips, which typically cannot be counted on to last more than 20 years or so. Because it is difficult to extract and replace a worn-out or defective artificial hip, doctors routinely advise patients to put off hip replacement as long as possible. For middle-aged or younger people whose hips have been damaged by disease or injury, that typically means a punishing waiting game. Now, though, an alternative to total hip replacement can offer an interim solution to many younger patients. The alternative, called hip resurfacing, usually yields at least as many short-term benefits as a total replacement. It costs about the same and is typically covered by insurance. And though many patients can expect to outlive the treatment’s effectiveness, hip resurfacing has the advantage of preserving enough healthy bone to allow for a future total hip implant. “It’s nice to know that down the road, if necessary, it will be an original total hip — not a revision,” said Keith McDonald, a 54-year-old air traffic controller from Melville, N.Y., whose right hip was resurfaced late last month. This past Tuesday, just 15 days after the operation — and at least a week earlier than doctors would recommend — Mr. McDonald drove his car. “Every day I do more,” he said. Tens of thousands of patients around the world have had hips resurfaced in the past decade. That includes some Americans who went overseas before the Food and Drug Administration started allowing it to be done in this country last May. “The demand from patients and surgeons is tremendous,” said Brian Austin, of Smith & Nephew, the British maker of the F.D.A.-approved resurfacing system. More than 400 surgeons in the United States have now been trained to use Smith & Nephew’s product, which is known as the Birmingham Hip System. Competing devices already sold overseas are expected to begin arriving in this country later this year... ... “You should have pain every day before you even think about it,” said Dr. William B. Macaulay Jr., a Manhattan surgeon who performs hip resurfacing surgeries. “If you are doing it in people with moderate pain who just want to improve their tennis game, that’s crazy.” Experts say that 10 percent to 15 percent of hip-replacement candidates may find hip resurfacing a viable alternative. But unless they are Web-savvy like Mr. McDonald, who learned about it only through his own Internet research, they may not have heard about the procedure... READ COMPLETE ARTICLE
Friday, August 24. 2007
Chris Swingle Staff writer Margaret Swift's hip pain was so bad by age 40 that she gave up softball. She struggled to walk up hills on the golf course. She limped giving tours of Woodcliff Hotel & Spa in Perinton, where she works in marketing. "I'd do one hour of yard work, and I'd come in the house in tears," says Swift, now 43, of Penfield. She eventually needed prescription painkillers to get through the day. Her first orthopedic surgeon diagnosed degenerative bone disease but said that Swift was too young for hip replacement surgery. That's because an artificial hip could wear out after 15 or 20 years; redoing it is more difficult than first-time hip replacement and generally less successful. The surgeon recommended she use a cane as needed, lose weight to help her joints and switch to low-impact exercise such as swimming. "I couldn't believe that was the answer," says Swift.
Eventually she met with Dr. Hubert F. Riegler, one of two Rochester-area surgeons offering a new alternative: hip resurfacing. The procedure, approved last year, is aimed at younger adults — typically women ages 45 to 55 and men ages 50 to 65, or younger. (The guideline is younger for women because they tend to develop osteoporosis; once bones weaken, they're not appropriate for resurfacing.) After those ages, patients get the more conventional full hip replacement. That surgery removes the entire ball at the top of the thigh bone and replaces it with an artificial one. Hip resurfacing is like capping a tooth. The ball is reshaped — not removed — and capped with a metal prosthesis secured by a small stem. This approach conserves more bone, making a full hip replacement easier if needed later. Local orthopedic surgeons who don't offer hip resurfacing give three reasons. The parts are new enough that nobody can be sure how long they will last. It's a more demanding surgery than hip replacement (requiring up to twice the time, a longer incision and moving and cutting through more muscles and tendons). And there's some concern about metal ions produced when the metal parts rub together. The ions are absorbed into the bloodstream and eliminated by the kidneys, so resurfacing isn't recommended for women who may become pregnant or people with weak kidney function... ...Riegler, chief of orthopedics at Highland Hospital, has done about 28 resurfacings in the past two years. He maintains that about one-third of the full hip replacements don't turn out well in young, active people because they're more likely to wear out or loosen the artificial joint during their lifetime. Resurfacing allows a greater range of motion, and the joint is less likely to dislocate, so its results so far are better for people pursuing recreational sports... ...The U.S. Food and Drug Administration approved Smith & Nephew's Birmingham metal hip resurfacing system in May 2006. Last month, the FDA approved a competitor, the Cormet 2000 hip resurfacing device from the British firm Corin Group, to be distributed in the United States this fall. Of nearly 300,000 Americans who get hip replacements per year, 10 percent to 15 percent may be appropriate for resurfacing.
Resurfacing and total hip replacement are covered equally by health insurance, says Excellus BlueCross BlueShield. The costs for both differ by hospital, ranging from $12,300 to $22,000 in western New York, a spokesman says... READ COMPLETE ARTICLE
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