Total Hip Replacement/Hip Resurfacing

Gd - Excuse me for being tardy in response to your question but I wanted to touch base with my O/S on the resurfacing issue. We did discuss it intially but I couldn't recall the reasons for not doing it. His view of resurfacing from a surgical standpoint is that a larger incision is used and more soft tissue is disturbed to facilitate reaming of the femoral head and the acetablum. The femoral head component is cemented in place and cemented components have a greater incidence of becoming loose. In large boned patients, such as myself, the size of the femoral implant can, but not always, be larger than the orginal femoral head and that a corresponding acetabular implant would necessitate more bone to be removed for the pelvis to accomodate it. Resurfacing has been performed for a relatively short time compared to THR. There dosen't seem to be sufficient clinical evaluation data on resurfacing such as revision rates, longevity and the release of metal ions from metal on metal wear. There is also some speculation that with a resurfacing the weakest point of the joint is at the femoral neck and may be prone to fracture. The most important consideration for anyone thinking of THR, resurfacing or any medical procedure for that matter, is the skill of the practitioner. I am 5 weeks post op today. I have returned to work on light duties for 4 hours per day and am back to driving a standard shift. I have been in the pool every day starting last Friday. Last nights W/O consisted of: 15 X 50 metres pull on 60 seconds ( average 42 sec. with very careful open turns ) 5 X 50 flutter kick 10 sec rest ( no board ) 200 scull with pull bouy 4 X 25 fly on 40 sec. 4 X 25 back on 40 sec. 4 X 25 free on 30 sec. I also tried about 15 seconds of water polo "egg beater" without discomfort. Post W/O therapy consisted of a beer, ice pack and quad stretch with heat.

Gd - Excuse me for being tardy in response to your question but I wanted to touch base with my O/S on the resurfacing issue. We did discuss it intially but I couldn't recall the reasons for not doing it. His view of resurfacing from a surgical standpoint is that a larger incision is used and more soft tissue is disturbed to facilitate reaming of the femoral head and the acetablum. The femoral head component is cemented in place and cemented components have a greater incidence of becoming loose. In large boned patients, such as myself, the size of the femoral implant can, but not always, be larger than the orginal femoral head and that a corresponding acetabular implant would necessitate more bone to be removed for the pelvis to accomodate it. Resurfacing has been performed for a relatively short time compared to THR. There dosen't seem to be sufficient clinical evaluation data on resurfacing such as revision rates, longevity and the release of metal ions from metal on metal wear. There is also some speculation that with a resurfacing the weakest point of the joint is at the femoral neck and may be prone to fracture. The most important consideration for anyone thinking of THR, resurfacing or any medical procedure for that matter, is the skill of the practitioner. I am 5 weeks post op today. I have returned to work on light duties for 4 hours per day and am back to driving a standard shift. I have been in the pool every day starting last Friday. Last nights W/O consisted of: 15 X 50 metres pull on 60 seconds ( average 42 sec. with very careful open turns ) 5 X 50 flutter kick 10 sec rest ( no board ) 200 scull with pull bouy 4 X 25 fly on 40 sec. 4 X 25 back on 40 sec. 4 X 25 free on 30 sec. I also tried about 15 seconds of water polo "egg beater" without discomfort. Post W/O therapy consisted of a beer, ice pack and quad stretch with heat.