November 1, 2008

I am an active 48 year old man engaged in a number of sports that require good hips, including bicycling, motocross, kiteboarding (similar to windsurfing) and skiing. I began to experience pain in my left hip approximately 10 years ago. The pain was intermittent in the early years and usually followed vigorous exercise. I was diagnosed with the early stages of osteoarthritis in my hips and was told that I should minimize high-impact sports, lose weight and wait until the pain became intolerable then seek hip replacement surgery. In early 2005 the pain in my left hip became substantially more acute, to the point that I was walking with a limp at all times, and experiencing almost constant pain.

After several visits to orthopedic surgeons based in the U.S., I was encouraged to pursue total hip replacement (“THR”) surgery. Dissatisfied with this advice, I began my own research into alternatives. The internet was an incredibly empowering force in my discovery process, introducing me to a wide range of knowledge on hip conditions and corrective procedures, as well as fellow patients, doctors, and hospitals. Of particular note, the Yahoo Group “Surfacehippies” provided a wealth of information and contacts with hip surgery advocates and patients. Through Surfacehippies, I was introduced to the Birmingham Hip Resurfacing (BHR) procedure. BHR appeared to be a better solution for me, being a relatively young and physically active patient (there are many reasons for this, but for purposes of this letter I will assume the reader knows of the inherent benefits of BHR over traditional hip replacements for younger patients). I visited two doctors in the U.S. who ostensibly provided the BHR procedure, but soon discovered that they had minimal experience with the procedure and/or did not advocate it over THR.

As BHR surgery is a relatively new procedure in the U.S., I was encouraged to seek a doctor outside the U.S. who had substantial experience with the procedure. Through the course of my research, the names of several physicians kept appearing as the worldwide “leaders” in the field, including Dr. deSmets in Belgium and Dr. Bose in India. I initiated contact with Dr. Bose in 2005, and sent him a CD with x-ray images of my hips. He indicated that I was a good candidate for the procedure and should seek to obtain the surgery as soon as the pain became intolerable. I waited two more years and ultimately arranged for my surgery with Dr. Bose in September 2007.

The experience of traveling to India for a major medical procedure was daunting at first for someone coming from the U.S., but I was able to communicate with several of Dr. Bose’ former patients who assured me that I would be well cared for and in good hands. In the end, this proved to be the case as I felt completely comfortable while under the care of Dr. Bose and his dedicated team at the Apollo Hospital Chennai. From the coordination of my travel plans with the International Patient Coordinator Mr. Mohan to the medical care provided by Dr. Bose and his staff, I was completely satisfied with my experience at the hospital and with the outcome of the procedure.

Jun 10, 2005
Wright Medical Closes "Study Group" at JRI Beaule Leaving

Hello everyone. I was scheduled for a resurfacing with Dr. Beaule at JRI next month and was informed today by his office that Wright Medical has "enough study patients" and is not approving any additional study patients during clinical trials of their C+ device. On top of that, the office informed me that Dr. Beaule is leaving the JRI and moving back to Canada at the end of July. I asked what my options are at this point and was told that my only option is THR. Obviously, all of this news is most distressing to me, and most unexpected.

Has anyone else heard about this? If so, what are my options? I made an appointment to meet Dr. Beaule next week to discuss this in person, and will report back to the board thereafter.

Feb 17, 2007
BHR vs THR

Decision not obvoius given latest tech Hi everyone - I'm a long-time lurker and occasional poster, but unfortunately a very real candidate for hip surgery. I have OA and am bone-on-bone in my left hip, partly genetic, partly due to a lifetime of high-impact activities. I'm now 47. I walk with a limp, and have some hip pain 24/7, but I normally can manage without pain killers so things could be worse... Sports are a vital part of my life and I do not want to give them up. In spite of my pain, I am still very active, though my running/squash/basketball/tennis, etc. days are over.

I would like to share with everyone what I have learned lately and would appreciate any advice. I've met with several orthopedic surgeons, including some mentioned often on this site, and have read all the books. So here goes:

BHR: no need to re-state all the benefits that we on this site all know, but here are some potential NEGATIVES:

• unproven track record - only 5-10 yrs of data;
• femoral fractures may be an issue - "jury is out", esp with very active younger patients;
• surgery is more complicated, more invasive and recovery time is greater.
• insurance issues....

THR: in spite of how we like to "diss" this procedure, i'm hearing the following POSITIVE news that is making me think twice:

• new prosthetic devices are providing the same benefits of BHR with a better track record - Johnson&Johnson Gateway ASR XL metal-on-metal large diameter device offers the same biomechanics as the BHR (i. e. similar ball and socket size as nature intended);
• "cementless" prosthetic (part that attaches to femur) is super-solid once bone has grown in; may withstand trauma better than BHR device (say you have a potentially femur-breaking skiing accident post-op, which device offers you a better chance?)
• surgical procedure is less invasive, less tissue damage, quicker, and recovery time is reduced;
• hip may be "stronger" once fully healed than with (unproven) BHR (?).
• no insurance hassles.

Honestly, I really want to believe that there is an obvious choice for someone like me, and that choice is BHR. I just want to do what's best for me, and I find it unsettling that this whole hip surgery business sounds more like a "business" than "about helping people". I don't like the fact that everyone has a different opinion! Why can't there be a consensus? I suppose it's great that we live in an age with all of this evolving technology and lots of choices, but it remains daunting to those of us who need to make a major decision about our bodies SOON!

Thanks for reading,
Peter