48 year old hip replacement vs Resurface any advice?
Discussion
My wife is 48, fit and well, but suffers badly from Osteoarthritis, she has it in her hands and most joints, including her hip. This has gradually been getting worse over the last few years. She also had a small bit of odd bone growth on one hip that was making things worse.
After months of going backwards and forwards to a specialist in London, she had an op to remove the growth and during that they confirmed that the Osteoarthritis was very bad in that hip and that it would need to be replaced at some point.
Fast forward a couple of years and the pain means she struggles to walk any distance and cannot sleep without pain killers.
We were just going to go straight to a replacement, but having done lots of reading, it looks like a re-surface might be a better option, mainly because she might well outlive it or a replacement and it appears to be a better option to only do a single full replacement, which she could do when the re-surface gives up.
Just wondered if anyone else has had this done or has any advice on the pros/cons?
After months of going backwards and forwards to a specialist in London, she had an op to remove the growth and during that they confirmed that the Osteoarthritis was very bad in that hip and that it would need to be replaced at some point.
Fast forward a couple of years and the pain means she struggles to walk any distance and cannot sleep without pain killers.
We were just going to go straight to a replacement, but having done lots of reading, it looks like a re-surface might be a better option, mainly because she might well outlive it or a replacement and it appears to be a better option to only do a single full replacement, which she could do when the re-surface gives up.
Just wondered if anyone else has had this done or has any advice on the pros/cons?
Whilst not exactly the same problem, mine was a simile. I was diagnosed with early onset cataracts at 45. I had my other eye done 6 weeks ago. I could’ve waited to see if affected my quality of life any more but decided it was the better option to not just make allowances. I’m in a job that really doesn’t accept not being able to see properly.
In terms of your wife, I think you’ve answered your own question. Osteoarthritis doesn’t get any better-think about age now, having a resurfacing with the possibility of having to have a full replacement in 20 years? She’ll be 70 then. Notwithstanding anything else, major surgery at that age has far more significant risks than at 48, when actually otherwise fit and healthy?
Remember, it’s not just about fix it, job done. Good exercise etc will help. Is that cause or effect? Who knows.
Don’t want to be political but my Mum (77) now is developing cataracts and as it won’t effect her quality of life until she starts falling over stuff and really causing a problem to herself, op is on the back burner.
I’d go with full hip replacement now. Balancing the benefits/negatives with her age. Other opinions are available.
In terms of your wife, I think you’ve answered your own question. Osteoarthritis doesn’t get any better-think about age now, having a resurfacing with the possibility of having to have a full replacement in 20 years? She’ll be 70 then. Notwithstanding anything else, major surgery at that age has far more significant risks than at 48, when actually otherwise fit and healthy?
Remember, it’s not just about fix it, job done. Good exercise etc will help. Is that cause or effect? Who knows.
Don’t want to be political but my Mum (77) now is developing cataracts and as it won’t effect her quality of life until she starts falling over stuff and really causing a problem to herself, op is on the back burner.
I’d go with full hip replacement now. Balancing the benefits/negatives with her age. Other opinions are available.
Edited by TVR1 on Sunday 27th December 20:57
Difficult one but how long do the hip replacements last? 20 years? If so she will be in a worse situation to have another aged 70. A full hip replacement is a big surgery but redoing it may not be possible or may be less successful. No right or wrong but better to have orthopaedic consultants opinion. For such an important decision I would get at least 2 opinions.
Hip replacements are very successful procedures. Something like 98%+ of patients can’t feel or tell they have a replacement hip in terms of pain or mobility, it’s a life changing operation.
Can’t comment on the efficacy of re-surfacing v THR. Get some good advice on which is most appropriate for an active person aged 48, which is young for this surgery.
Life of a THR is 10 to 20+ years depending on activity level and how well it is fitted. I think aseptic loosening is now the most common failure mode, but tends to take a long time. Revisions are costly and generally have a much shorter life than the original and a second or third revision is sometimes not possible.
Make sure you get a surgeon who specialises in hips and does lots of them, 100+/annum. I once sat in a presentation from a shoulder surgeon who raged about his fellow orthopaedic surgeons who only did 3 or 4 shoulder surgeries a year that later required revision, so the surgeon got paid again.
Please check my numbers (correct them if wrong), they are from memory but shouldn’t be too far out. Hope that helps.
Can’t comment on the efficacy of re-surfacing v THR. Get some good advice on which is most appropriate for an active person aged 48, which is young for this surgery.
Life of a THR is 10 to 20+ years depending on activity level and how well it is fitted. I think aseptic loosening is now the most common failure mode, but tends to take a long time. Revisions are costly and generally have a much shorter life than the original and a second or third revision is sometimes not possible.
Make sure you get a surgeon who specialises in hips and does lots of them, 100+/annum. I once sat in a presentation from a shoulder surgeon who raged about his fellow orthopaedic surgeons who only did 3 or 4 shoulder surgeries a year that later required revision, so the surgeon got paid again.
Please check my numbers (correct them if wrong), they are from memory but shouldn’t be too far out. Hope that helps.
My previous business partner and I were out winter climbing when a long spell through deep snow drifts trashed his hip. This was 10 years ago when he was 50. He had it re-surfaced (twice, I think) and on each occasion it was a bit successful. A couple of years ago he had the hip replaced, aged 58. It took about 12 weeks for full recovery and today we went on a 5 mile walk up into the snow line again - all good.
I can't speak on his behalf obviously, but his hip damage had been largely caused by running up and down hills with Army Bergens on his back. The Munro bashing in deep snow 10 years ago brought things to a head.
I did mechanical engineering at uni and we did some biomechanics stuff as part of that; I seem to recall in the early 90s that hip replacements were estimated to have a life of 15-20 years. My amateur understanding is that they've now got a longer life and if you have one replaced at aged 50 it's not a complete given that you'll have to have another one before your expected end of life (sorry to be cheery!).
Now knees are I think much, much worse from a pain and healing point of view.
Hope that helps.
I can't speak on his behalf obviously, but his hip damage had been largely caused by running up and down hills with Army Bergens on his back. The Munro bashing in deep snow 10 years ago brought things to a head.
I did mechanical engineering at uni and we did some biomechanics stuff as part of that; I seem to recall in the early 90s that hip replacements were estimated to have a life of 15-20 years. My amateur understanding is that they've now got a longer life and if you have one replaced at aged 50 it's not a complete given that you'll have to have another one before your expected end of life (sorry to be cheery!).
Now knees are I think much, much worse from a pain and healing point of view.
Hope that helps.
Had one done in October. Minimally invasive rather than the old long scar with staples. Basically parted the misch longitudinally and the whole thing left me with a three inch scar. No stitches. They just glued it closed.
Was waking with no cane or walker on four weeks. Driving in three.
Amazing operation -worth checking the surgical procedure.
Was waking with no cane or walker on four weeks. Driving in three.
Amazing operation -worth checking the surgical procedure.
RDMcG said:
Had one done in October. Minimally invasive rather than the old long scar with staples. Basically parted the muscle longitudinally and the whole thing left me with a three inch scar. No stitches. They just glued it closed.
Was waking with no cane or walker on four weeks. Driving in three.
Amazing operation -worth checking the surgical procedure.
Was waking with no cane or walker on four weeks. Driving in three.
Amazing operation -worth checking the surgical procedure.
RDMcG said:
Had one done in October. Minimally invasive rather than the old long scar with staples. Basically parted the misch longitudinally and the whole thing left me with a three inch scar. No stitches. They just glued it closed.
Was waking with no cane or walker on four weeks. Driving in three.
Amazing operation -worth checking the surgical procedure.
THR or metal resurfacing?Was waking with no cane or walker on four weeks. Driving in three.
Amazing operation -worth checking the surgical procedure.
I had a metal resurfacing in July, now I'm going like a clipped cat.
OP, is it a metal resurfacing your wife's considering? I was under the impression that women getting them is frowned upon in the UK? If she can indeed have it then it's defo the way to go. THR materials are much better these days and so last a lot longer but resurfacing takes away a lot less bone leaving a lot more to play with if a second op becomes necessary at some point, which it prob won't with a resurfacing anyway.
I'm absolutely not an expert but I did happily get chatting with a hip surgeon on here about a year ago who totally steered me in the right direction. I had an NHS consultation a year and a half ago about my hip but didn't get to see the actual consultant, just his Registrar. The Registrar said no way was I suitable for metal resurfacing as it was only top level athletes that were suitable. How rude I thought lol. Anyway, a while later I got chatting on here with the aforementioned surgeon who told me the Registrar was completely wrong, I was perfect for the op: fit and healthy, early 50s, male, good bone quality, etc.
I do have a long scar to show for it, and there was a horrendous amount of swelling for a fortnight after the op but it all settled down quite quickly. Having watched the op on Youtube I can see why there was so much swelling, they don't mess about. Also because with metal resurfacing they don't take much bone away they have a lot less room to work which is why they are prob rougher than with a THR, leading to more swelling. As I understand it metal resurfacing is more "painful" initially post-op but recovery after that initial period is much better than with THR. Here I am at 5 months absolutely desperate to go skiing to test it out. My hip feels great and I have a new lease of life. Just need my knee replaced now grrrrrr. All of the above is my opinion of course, your wife needs proper surgical advice.
OP, is it a metal resurfacing your wife's considering? I was under the impression that women getting them is frowned upon in the UK? If she can indeed have it then it's defo the way to go. THR materials are much better these days and so last a lot longer but resurfacing takes away a lot less bone leaving a lot more to play with if a second op becomes necessary at some point, which it prob won't with a resurfacing anyway.
I'm absolutely not an expert but I did happily get chatting with a hip surgeon on here about a year ago who totally steered me in the right direction. I had an NHS consultation a year and a half ago about my hip but didn't get to see the actual consultant, just his Registrar. The Registrar said no way was I suitable for metal resurfacing as it was only top level athletes that were suitable. How rude I thought lol. Anyway, a while later I got chatting on here with the aforementioned surgeon who told me the Registrar was completely wrong, I was perfect for the op: fit and healthy, early 50s, male, good bone quality, etc.
I do have a long scar to show for it, and there was a horrendous amount of swelling for a fortnight after the op but it all settled down quite quickly. Having watched the op on Youtube I can see why there was so much swelling, they don't mess about. Also because with metal resurfacing they don't take much bone away they have a lot less room to work which is why they are prob rougher than with a THR, leading to more swelling. As I understand it metal resurfacing is more "painful" initially post-op but recovery after that initial period is much better than with THR. Here I am at 5 months absolutely desperate to go skiing to test it out. My hip feels great and I have a new lease of life. Just need my knee replaced now grrrrrr. All of the above is my opinion of course, your wife needs proper surgical advice.
DaveGrohl said:
I had a metal resurfacing in July, now I'm going like a clipped cat.
OP, is it a metal resurfacing your wife's considering? I was under the impression that women getting them is frowned upon in the UK? If she can indeed have it then it's defo the way to go. THR materials are much better these days and so last a lot longer but resurfacing takes away a lot less bone leaving a lot more to play with if a second op becomes necessary at some point, which it prob won't with a resurfacing anyway.
I'm absolutely not an expert but I did happily get chatting with a hip surgeon on here about a year ago who totally steered me in the right direction. I had an NHS consultation a year and a half ago about my hip but didn't get to see the actual consultant, just his Registrar. The Registrar said no way was I suitable for metal resurfacing as it was only top level athletes that were suitable. How rude I thought lol. Anyway, a while later I got chatting on here with the aforementioned surgeon who told me the Registrar was completely wrong, I was perfect for the op: fit and healthy, early 50s, male, good bone quality, etc.
I do have a long scar to show for it, and there was a horrendous amount of swelling for a fortnight after the op but it all settled down quite quickly. Having watched the op on Youtube I can see why there was so much swelling, they don't mess about. Also because with metal resurfacing they don't take much bone away they have a lot less room to work which is why they are prob rougher than with a THR, leading to more swelling. As I understand it metal resurfacing is more "painful" initially post-op but recovery after that initial period is much better than with THR. Here I am at 5 months absolutely desperate to go skiing to test it out. My hip feels great and I have a new lease of life. Just need my knee replaced now grrrrrr. All of the above is my opinion of course, your wife needs proper surgical advice.
Thanks, for this really useful - Had no idea that MHR was frown upon for women, why is that?OP, is it a metal resurfacing your wife's considering? I was under the impression that women getting them is frowned upon in the UK? If she can indeed have it then it's defo the way to go. THR materials are much better these days and so last a lot longer but resurfacing takes away a lot less bone leaving a lot more to play with if a second op becomes necessary at some point, which it prob won't with a resurfacing anyway.
I'm absolutely not an expert but I did happily get chatting with a hip surgeon on here about a year ago who totally steered me in the right direction. I had an NHS consultation a year and a half ago about my hip but didn't get to see the actual consultant, just his Registrar. The Registrar said no way was I suitable for metal resurfacing as it was only top level athletes that were suitable. How rude I thought lol. Anyway, a while later I got chatting on here with the aforementioned surgeon who told me the Registrar was completely wrong, I was perfect for the op: fit and healthy, early 50s, male, good bone quality, etc.
I do have a long scar to show for it, and there was a horrendous amount of swelling for a fortnight after the op but it all settled down quite quickly. Having watched the op on Youtube I can see why there was so much swelling, they don't mess about. Also because with metal resurfacing they don't take much bone away they have a lot less room to work which is why they are prob rougher than with a THR, leading to more swelling. As I understand it metal resurfacing is more "painful" initially post-op but recovery after that initial period is much better than with THR. Here I am at 5 months absolutely desperate to go skiing to test it out. My hip feels great and I have a new lease of life. Just need my knee replaced now grrrrrr. All of the above is my opinion of course, your wife needs proper surgical advice.
cashmax said:
DaveGrohl said:
I had a metal resurfacing in July, now I'm going like a clipped cat.
OP, is it a metal resurfacing your wife's considering? I was under the impression that women getting them is frowned upon in the UK? If she can indeed have it then it's defo the way to go. THR materials are much better these days and so last a lot longer but resurfacing takes away a lot less bone leaving a lot more to play with if a second op becomes necessary at some point, which it prob won't with a resurfacing anyway.
I'm absolutely not an expert but I did happily get chatting with a hip surgeon on here about a year ago who totally steered me in the right direction. I had an NHS consultation a year and a half ago about my hip but didn't get to see the actual consultant, just his Registrar. The Registrar said no way was I suitable for metal resurfacing as it was only top level athletes that were suitable. How rude I thought lol. Anyway, a while later I got chatting on here with the aforementioned surgeon who told me the Registrar was completely wrong, I was perfect for the op: fit and healthy, early 50s, male, good bone quality, etc.
I do have a long scar to show for it, and there was a horrendous amount of swelling for a fortnight after the op but it all settled down quite quickly. Having watched the op on Youtube I can see why there was so much swelling, they don't mess about. Also because with metal resurfacing they don't take much bone away they have a lot less room to work which is why they are prob rougher than with a THR, leading to more swelling. As I understand it metal resurfacing is more "painful" initially post-op but recovery after that initial period is much better than with THR. Here I am at 5 months absolutely desperate to go skiing to test it out. My hip feels great and I have a new lease of life. Just need my knee replaced now grrrrrr. All of the above is my opinion of course, your wife needs proper surgical advice.
Thanks, for this really useful - Had no idea that MHR was frown upon for women, why is that?OP, is it a metal resurfacing your wife's considering? I was under the impression that women getting them is frowned upon in the UK? If she can indeed have it then it's defo the way to go. THR materials are much better these days and so last a lot longer but resurfacing takes away a lot less bone leaving a lot more to play with if a second op becomes necessary at some point, which it prob won't with a resurfacing anyway.
I'm absolutely not an expert but I did happily get chatting with a hip surgeon on here about a year ago who totally steered me in the right direction. I had an NHS consultation a year and a half ago about my hip but didn't get to see the actual consultant, just his Registrar. The Registrar said no way was I suitable for metal resurfacing as it was only top level athletes that were suitable. How rude I thought lol. Anyway, a while later I got chatting on here with the aforementioned surgeon who told me the Registrar was completely wrong, I was perfect for the op: fit and healthy, early 50s, male, good bone quality, etc.
I do have a long scar to show for it, and there was a horrendous amount of swelling for a fortnight after the op but it all settled down quite quickly. Having watched the op on Youtube I can see why there was so much swelling, they don't mess about. Also because with metal resurfacing they don't take much bone away they have a lot less room to work which is why they are prob rougher than with a THR, leading to more swelling. As I understand it metal resurfacing is more "painful" initially post-op but recovery after that initial period is much better than with THR. Here I am at 5 months absolutely desperate to go skiing to test it out. My hip feels great and I have a new lease of life. Just need my knee replaced now grrrrrr. All of the above is my opinion of course, your wife needs proper surgical advice.
about 3" - no stitches)
cashmax said:
Thanks, for this really useful - Had no idea that MHR was frown upon for women, why is that?
You would be best getting this information from a hip surgeon. Its very complicated and very patient specific. I don't do hips.Resurfacing can be a good option, but it isn't the panacea that it was touted to be 10 years ago. There is also a problem with metal on metal bearings in some Total Hip Replacements (THR)
Absolute proportions of resurfacing vs THR in the UK is down at <1%. In fact it looks like only 66 NEW resurfacings were done in the UK in 2019 See the 17th annual NJR report https://reports.njrcentre.org.uk/ Page 45/46. - 312 page report on joint replacement that is produced every year.
Here's the spread of new hip replacements/resurfacings put in by year
The Americans might be a bit more adventurous, but it doesn't mean successful. They have a reputation in some areas for being foolhardy and ill-judged. There are obviously some outstanding US surgeons just like here, but just because an operation is available and performed doesn't make it a good choice.
Whilst the patient info provided on this thread is useful, the surgeon/implant advice should really come from a specialist hip surgeon
Edited by The_Doc on Tuesday 29th December 10:21
The_Doc said:
cashmax said:
Thanks, for this really useful - Had no idea that MHR was frown upon for women, why is that?
You would be best getting this information from a hip surgeon. Its very complicated and very patient specific. I don't do hips.Resurfacing can be a good option, but it isn't the panacea that it was touted to be 10 years ago. There is also a problem with metal on metal bearings in some Total Hip Replacements (THR)
Absolute proportions of resurfacing vs THR in the UK is down at <1%. In fact it looks like only 66 NEW resurfacings were done in the UK in 2019 See the 17th annual NJR report https://reports.njrcentre.org.uk/ Page 45/46. - 312 page report on joint replacement that is produced every year.
Here's the spread of new hip replacements/resurfacings put in by year
The Americans might be a bit more adventurous, but it doesn't mean successful. They have a reputation in some areas for being foolhardy and ill-judged. There are obviously some outstanding US surgeons just like here, but just because an operation is available and performed doesn't make it a good choice.
Whilst the patient info provided on this thread is useful, the surgeon/implant advice should really come from a specialist hip surgeon
Edited by The_Doc on Tuesday 29th December 10:21
cashmax said:
My wife is 48, fit and well, but suffers badly from Osteoarthritis, she has it in her hands and most joints, including her hip. This has gradually been getting worse over the last few years. She also had a small bit of odd bone growth on one hip that was making things worse.
After months of going backwards and forwards to a specialist in London, she had an op to remove the growth and during that they confirmed that the Osteoarthritis was very bad in that hip and that it would need to be replaced at some point.
Fast forward a couple of years and the pain means she struggles to walk any distance and cannot sleep without pain killers.
We were just going to go straight to a replacement, but having done lots of reading, it looks like a re-surface might be a better option, mainly because she might well outlive it or a replacement and it appears to be a better option to only do a single full replacement, which she could do when the re-surface gives up.
Just wondered if anyone else has had this done or has any advice on the pros/cons?
I PM'd you a few days ago if you're still interested.
After months of going backwards and forwards to a specialist in London, she had an op to remove the growth and during that they confirmed that the Osteoarthritis was very bad in that hip and that it would need to be replaced at some point.
Fast forward a couple of years and the pain means she struggles to walk any distance and cannot sleep without pain killers.
We were just going to go straight to a replacement, but having done lots of reading, it looks like a re-surface might be a better option, mainly because she might well outlive it or a replacement and it appears to be a better option to only do a single full replacement, which she could do when the re-surface gives up.
Just wondered if anyone else has had this done or has any advice on the pros/cons?
I PM'd you a few days ago if you're still interested.
It’s come a long way this hip replacement business.
My Mum (76) is having a hip replaced on Thursday this week and I was amazed she had a CT scan, it would be made bespoke to her somehow, she isn’t having a general just sedation, it was being done by a surgeon using a robot and it’s likely to take just under two hours.
If that’s all true it’s outstanding progress, I just hope she is ok.
Oh and then there the virus to contend with!
My Mum (76) is having a hip replaced on Thursday this week and I was amazed she had a CT scan, it would be made bespoke to her somehow, she isn’t having a general just sedation, it was being done by a surgeon using a robot and it’s likely to take just under two hours.
If that’s all true it’s outstanding progress, I just hope she is ok.
Oh and then there the virus to contend with!
interstellar said:
It’s come a long way this hip replacement business.
My Mum (76) is having a hip replaced on Thursday this week and I was amazed she had a CT scan, it would be made bespoke to her somehow, she isn’t having a general just sedation, it was being done by a surgeon using a robot and it’s likely to take just under two hours.
If that’s all true it’s outstanding progress, I just hope she is ok.
Oh and then there the virus to contend with!
I did not have a robot, but had the whole thing done with just a spinal. Very tidy and very quick.My Mum (76) is having a hip replaced on Thursday this week and I was amazed she had a CT scan, it would be made bespoke to her somehow, she isn’t having a general just sedation, it was being done by a surgeon using a robot and it’s likely to take just under two hours.
If that’s all true it’s outstanding progress, I just hope she is ok.
Oh and then there the virus to contend with!
Gassing Station | Health Matters | Top of Page | What's New | My Stuff