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Vicky's 2nd Hip
Resurfacing vs. THR By Mark Bloomfield PDF Print E-mail

The first point I want to make is I have done hundreds or thousands of total hip replacements (THR) on all sorts of people at all sorts of ages and activity levels. Some of this experience pre-dates hip resurfacing, but I still often do THR as well. There were many very happy THR patients, but quite a few with a host of problems. My patients and colleagues' patients referred to me for a second, third or more opinion! Dislocation [sometimes occurring so often further
surgery was required], infection, leg length differences and completely inexplicable pain. Another frequent problem was limping or muscle weakness as a result of using the direct lateral or Hardinge approach to the hip in an effort to avoid the higher dislocation rate associated with the posterior approach - which more rarely has muscle weakness or limp associated with it.

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NCP-Neck Capsule Preservation-Approach in Hip Resurfacing, What is it? PDF Print E-mail

Dr. Su:
The NCP approach, at least the way that we mean it, is a different way to incise the capsule in order to gain access to the hip joint. Usually with THR, the capsule is detached from the femoral neck and flipped back. It is usually preserved and repaired in order to avoid dislocation.

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Heterotopic Bone Growth PDF Print E-mail
What causes it?

Mainly traumatic surgery. No protection of soft tissues and too much pulling and stretching on the muscles. (BAD SURGERY) A NON posterior approach Lengthening of the leg.

Only in the minority patients are predicted to have it (bad luck).

Koen De Smet
 
Groin Pain PDF Print E-mail
Vicky,

Yes, psoas tendinitis is an important reason for groin pain in resurfacing surgery .

This is peculiar to resurfacing as the cup for resurfacing is a very large profile ie half a sphere. Nearly all THR cups are only portions ( arc) of a hemisphere.
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Gluteus Maximus Tendon PDF Print E-mail

Thanks to Vince DePalma for bringing up the subject of the gluteus maximus tendon.
Gluteus Maximus Tendon

Message #136595

Hello, I am new to this group. I am a 54 year old male with osteoarthiris in both hips, a former quarter miler at Bucknell University who can barely walk now. I have been very impressed by conversations I have had with Dr. James Pritchett in Seattle. Dr. Pritchett agrees with Dr. DeSmet in not reconnecting the gluteus maximum tendon (due to risk of impinging the sciatic nerve). By contrast, Dr. Vijay Bose strongly advocates that the gluteus maximus tendon be stitched back at the end of the surgery. In his email this morning he said the risk to the sciatic nerve is only during surgery. On the other hand, Dr. Tom Gross does not take down the gluteus maximus tendon all the way, only a small portion and says it will heal on its own, therefore there is no need for suture. I watched Dr. Bose perform the surgery on Youtube and was impressed with his extreme care taken to preserve the whole bursa and femoral capsule. Nevetheless, I remain confused on gluteus max tendon issue. Having said this, my decison on a doctor might ultimaley be more influenced by which one is in the CIGNA network. Any feedback or encouragement on the subject would be appreciated. Best regards, Vince This e-mail address is being protected from spam bots, you need JavaScript enabled to view it

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