Daniel Fox Bilateral Hip Resurfacing Dr. Barrack 2009/2010

The first time I noticed any hip pain was in 2004 when I was jogging and had a very sharp pain in my left groin area which only occurred when my left knee was raised to its highest point which didn’t occur on every run and typically when running hard uphill. The pain subsided and would only reoccur periodically during subsequent runs (I would run about 2-3 times per week) so I put off seeing an orthopedic specialist. About 6 months later while on a long walk with my family I experienced a new pain in my left groin area – very different from my running pain. This was more like a dull ache and honestly didn’t necessarily relate the two symptoms. About 6 months later I began to notice a clicking in my hip when I would move my left leg laterally (typically while shifting my position in bed).

At this point I set my first appointment with an orthopedic surgeon. After looking at an x-ray, he referred me to a specialist in St. Louis, Dr. John Clohisy (Wash U Physicians at BJC). Dr. Clohisy specializes in preserving hips in younger active patients. I was diagnosed with torn cartilage and bone spurs that had developed in my hip due to a natural occurring impingement due to the shape of my femoral head. His goal was to trim the cartilage, remove bone spurs and finally debride (shave down) a portion of the femoral head so as to diminish or eliminate the impingement and provide more life to my hip until which time I would need a hip replacement. I awoke post Op to a nurse who informed me that the doctor was unable to complete the surgery due to certain conditions but that I would be non-weight bearing for 8 weeks and would be going home that evening. Needless to say I was very surprised and disappointed but during surgery Dr. Clohisy noticed that I had very little cartilage and knew that I would require a replacement shortly and rather than doing the debridement, elected to drill some micro size holes in the surface of my femoral head which was intended to create scar tissue which would act like cartilage and hopefully lengthen the life of my joint until which time I would need the replacement. After the initial non-weight bearing period I was happy with the results because I was able to move my left leg laterally with little pain, though I still had limited motion. At this point I had heard about resurfacing but at the time it was not approved in the US. Doctor Clohisy told me that his associate, Dr. Barrack was training to perform the surgery when it would be approved by the FDA later that year. Eventually (mid 2006) I had my first appointment with Dr. Barrack who though I would make an excellent candidate for resurfacing and scheduled the surgery for later that year. About two months later, however, I had second thoughts and cancelled the surgery having heard that one should wait until the pain becomes almost unbearable. My hip pain was not typical in that it didn’t hurt all the time but primarily related to the motion of my hip. I could not go up or down a ladder, climb over a short fence, get down on my knees, etc, without exceptional pain. However, I could walk miles without much pain – I was a golfer and could walk and carry a bag 18 holes without much pain. Reaching down to get a ball out of the cup was another issue – practically impossible.

During the summer of 2008, I had an opportunity to visit with Dr. Berry at Mayo Clinic in Rochester, MN who had recently completed a total hip replacement for a relative. I wanted a second opinion regarding my situation and whether a replacement or resurfacing was the best solution for me. He asked me how often I woke up in the morning and told myself I needed a new hip. At that point, it was only 2-3 days a week since I could walk normally with little pain. He also told me that both a replacement and resurfacing would a good solution and it was really up to me to make that decision which I really appreciated. By Spring 2009 I had practically no motion in my left hip and constant pain and decided it was time for the resurfacing. I scheduled the surgery with Barrack for September 15, 2009. Surgery went very well and I was on cane by the first days of week three though I had quite a bit of thigh pain which subsided at about week four The Dr. Barrack mentioned that the fit was “tight” but that all went well and the placement and angles went as he had hoped. By week five I felt well enough to walk (with cane) in a 5K charity walk with my wife. I was off the cane after 6 weeks and played my first round of golf week 8. I agreed to participate in a study that tracks the metal ions in my blood.

During the final weeks just prior to my first resurfacing surgery I noticed much more pain in my right hip which was most likely to me favoring it over the bad hip while having a very active summer on the golf course. I had hoped that it would get better once the left hip was healed but later in the year admitted that it needed to be replaced as well and scheduled that surgery for Feb 9, 2010. I have read of others that put off the second hip but frankly for me there was no benefit to doing the first if the condition of the remaining hip prevented me from doing all the things that I wanted to do. That surgery was equally successful, or more so in that I was able to transfer to a cane by end of week one and Dr. Barrack mentioned that the surgery went even smoother than the first – not sure what exactly that means but I presume more room to work and get the placement perfect. For the first time in about 5 years I have virtually no pain in my hips and can stand for hours with no pain. I think the biggest challenge in front of me is not so much the strengthening but getting back my flexibility that I haven’t had for 6+ years due to the impingement in my hips.

I hope this information is helpful and would highly recommend Dr. Barrack for those considering a hip resurfacing.