Ervaringen

Marianne C’s ervaring met twee BMHR prothesen

Mijn problemen begonnen midden 1990 met pijn rechts in de lies die naar het dijbeen trokken als ik actief was, bijvoorbeeld bij veel lopen of veel werk in de tuin. Sindsdien heb ik een hoop consulten met doktoren gehad om meer te weten te komen over de oorzaak van mijn probleem. Pas veel later in 2008 kwam ik erachter dat ik osteo-artrose had. Jammer genoeg was er geen goede dialoog met de dokter die de diagnose had gesteld, hij zei: “Het is te vroeg om een mes in jou te zette”.
In 2012 werden er nieuwe röntgenfoto’s genomen en die nieuwe diagnose van de Zweedse orthopeed luidde: “Het is veel te vroeg voor een operatie”. Ik werd geadviseerd om meer pijnstillers te gebruiken.
Ik realiseerde me dat ik wat research moest verrichten om deze argumenten te weerleggen. Toen ik via Internet begon te zoeken vond ik informatie over hip resurfacing. Nadat ik met Ron contact in contact kwam vond ik met zijn hulp een aantal buitenlandse chirurgen willig genoeg om mijn röntgenfoto’s van 2012 te beoordelen. Zij concludeerden unaniem dat ik al een paar jaar eerder geopereerd had moeten worden en toen begon alles voor mij duidelijk te worden! De methode die de Zweedse orthopeden voorschrijven houdt in dat de dijbeenhals wordt afgezaagd en de combinatie van de prothese, materialen en maten die zij daarbij gebruiken staan geen grotere belastingen toe. Om die reden willen ze heupoperaties zoveeel mogelijk uitstellen. Bij hip resurfacing daarentegen blijft de dijbeenhals tot de hoogst mogelijke graad ongemoeid gelaten en zijn de gruikte materialen ook slijtvaster. Om zoveel mogelijk onbeschadigd bot te behouden moet de operatie ook zo snel mogelijk worden uitgevoerd. In mijn situatie was het al veel te laat om een BHR-prothesen toe te passen, het werd daarom de daaropvolgende beste prothese: de BMHR. Deze operatie van mijn rechter heup werd in maart 2013 uitgevoerd en die van de linker heup september 2013. In beide gevallen verliep de operatie prima en werd ik goed behandeld in de ATOS-kliniek.
Nu op het moment van schrijven is het november 2013 en de voorgang van mijn rehabilitatie is goed verlopen. De spieren moeten duidelijk hun sterkte nog terugkrijgen nadat ik die gedeeltelijk verloor onder de operatie en natuurlijk de tijd met de bewegingsbeperkingen zowel in de lange tijd voor de als dierct erna. Tegen de lente hoop ik weer tuinwerk te verrichten en naar mijn werk te fietsen. [hr]

Maria Rojmyr staat 4 maanden na haar operatie weer op skies:

James Roxburgh

Dit is allemaal mogelijk met hip resurfacing prothesen!
James Roxburgh, oftewel ”Jim” is een 51 jarige man uit Wilton in California, USA waar hij sinds 32 jaar terug martial arts heeft beoefend en dit zijn z’n ervaringen: In 1999 ontving hij een 5e graads black belt in Moo Duk Kwan Tae Kwon Do. Jammer genoeg werd er bij een diagnose in 2002 osteo-artrose vastgesteld in beide heupen en serieus genoeg om medisch ingrijpen te eisen met een of andere type prothese. In de tijd daarna begon Jim te zoeken naar informatie over verschillende beschikbare methodes en prothesen, hij kwam tot de conclusie dat Hip Resurfacing het beste zou zijn voor hem. Alles wat over de mogelijkheden bij Hip Resurfacing werd geschreven stemde overeens met de levenstijl en activiteiten van Jim.
U moet weten dat om te kwalificeren als goede candidaat voor Hip Resurfacing te zijn u tot een bepaalde leeftijdsgroep moet behoren en het skelet van hoog genoeg kwaliteit moet zijn en u indien mogelijk een actief persoon moet zijn. Een gespecialiseerde Hip Resurfacing chirurg zal ook een aantal specifieke checkpoints toepassen zoals botziekten en botdichtheid die met röntgen, MRI, CT-scan, DEXA-scan enz. kunnen worden vastgesteld.

Het duurde tot 2004 voordat Jim een dokter ontmoette met de naam Jamali die bepaalde dat Jim een hele goede candidaat was voor de Hip Resurfacing procedure. Jim z’n pijnen waren op dat moment ook ondraaglijk geworden, zijn sportieve leven was helemaal vernield en hij werd depressief. Het was natuurlijk een opsteker voor Jim dat dokter Jamali hem een hele goede candidaat voor Hip Resurfacing vond.

Maar zelfs nu dat Dr. Jamali juist bepaalde dat de enige correcte methode voor Jim een Hip Resurfacing zou zijn en zeker geen THA (Total Hip Arthroplasty) met een traditionele heupprothese wilde Jim’s ziekenverzekering alleen maar een traditionele THA operatie vergoeden.

Natuurlijk kon Jim dit onjuiste besluit van z’n verzekering niet accepteren en het hele verhaal eindigde met dat Jim zelf de volledige kosten voor de operatie betaalde en dit zijn dus zijn ervaringen. Dr. Jamali adviseerde Jim een op dit gebied meer gespecialiseerde orthopeed the kiezen en dit werd Dr. Thomas Schmalzried. Uiteindelijk werd Jim op 22 november 2004 door Dr. Schmalzried geopereerd.

Zoals u zult begrijpen was dit voor Jim en de orthopeed een zwaardere operatie omdat beide heupen tegelijk werden geopereerd, een bilaterale operatie is veel minder gebruikelijk. Een bilaterale operatie heeft ook invloed op de revalidatie, daarom wordt er zowel van de patient als van de betreffende orthopeed doorzettingskrwcht verwacht.
[/pix_column][pix_column type=”2/4″ last=”true”]Jim werd zoals gezegd in November 2004 geopereerd en alles is glad verlopen. De foto’s op deze pagina zijn allemaal sindsdien genomen en spreken meer dan in woorden kan worden verteld. Probeer niets van wat u hier ziet na te doen als u een traditionele prothese heeft. Zelfs velen van ons met een hip resurfacing of zelfs nog met onze eigen ongeopereerde heupen kunnen wat Jim doet benaderen! Jim z’n twee Hip resurfacing prothesen (zie de foto) zijn Conserve® Plus prothesen van Wright Medical.
De twee rijen met nietjes die Jim net na de operatie had zijn duidelijk op de röntgenfoto te zien. als iemand in cantact wil komen met James Roxburgh dan kan dat doormiddel van de Yahoo group ”Surfacehippy” waar hij heeft deelgenomen, zie:
http://health.groups.yahoo.com/group/surfacehippy   of klik hier voor contact via email:  Klik hier

 

 

Andrea

Hello,
My name is Andrea and I am 48. Thinking back I remember that I had my hips x-rayed after my second child, in other words 18 years ago. Then already I could feel that something was not quite right with my right hip. Pain came and subsided again, but since they didn’t discover anything strange with my hips I learned to live with the pain, that as said would disappear every now and then. In autumn 2010 the pain came more often and more intensive, I saw different physiotherapists and a naprapat, but nothing fully helped. Spring 2011 I finally finished up at the county’s orthopedic department here in Kalmar where it was discovered that I had osteo-arthritis. I was recommended to follow a hip-school and training since I was still comparatively young but even received the information that little by little an operation would become necessary to give me a new hip. This was a shock to me then, it felt so bad having to undergo this kind of operation at my age and to be honest I associated hip-diagnoses with older people only. Then I already started to Google and landed on Rons information page. I started to get more and more pain, the daily walks with the dog really started to torment me just like following my youngest girl to school only 300 meters from home. I woke up often and even had pain during the nights and felt more and more frustrated as a result of the pain. Again I contacted the reception of the orthopaedic department where I was offered and operation with a traditional THR prosthesis.
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I should mention that in conversations with my orthopedic surgeon I had named that I was interested in the Hip Resurfacing method and he was not completely negative about the idea since they had done some of them here. But this didn’t lead anywhere since I was a woman with a far too small femoral neck. I even sent email to orthopaedic surgeons in other counties, answering that I had the wrong gender! Ron helped me to send my x-rays to different orthopedic surgeons in Europé. My choice fell on Dr. Faensen in Berlin, from a gut feeling together with appealing information on different prostheses that he gave. Once I had made up my mind things went so fast, the booking for the date of operation and the flight tickets. I was going to be operated in a clinic in Potsdam and if I am not mistaken the operation would come to about 180,000kr, which was and still is a lot of money.
I had a good impression about Dr. Faensen and the clinic. The operation went well, I was post-op free of pain and after a while I went home again, this was after a week. Touch wood I have today no problems whatsoever and don’t even think about the fact that I have a prosthesis. I am modestly active, have been sitting too much due to studies and as a result I have some pains in the loins, but now I have taken up regular training again. I have even registered myself for crossfit.
If I were to sum up things I am today very grateful for all the help and support that I received from Ron in the first place but even the other participants in the hip group Nordenshippies. Today I do not for a second regret this.

Thanks. / Andrea Karabová Bäckström
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Mary Ellis från Austin, Texas, USA

June 2006 meant a change in the life of Mary Ellis when she dared to take up her problem in the Yahoo discussion group ”Surfacehippy”. Mary wrote the group about her osteo-arthritis that by then had reached a serious stage, she also reported on the doctors that she had seen, the x-rays, MRI and bone density-tests that had been done.
Mary, who at the time was 56 years old had until then been unlucky with orthopedic surgeons that only wanted to recommend a traditional total hip prosthesis (THR), and they advised her to book this operation right there and then. Mary on the other hand had the gut feeling that things were going just a little too fast. When the surgeon that she had had up till then even replied negatively on her questions about the hip resurfacing option she turned away from him. She wanted to have a prosthesis that would spare as much bone as possible, just as a Hip Resurfacing could. With the help of another woman from the ”Surfacehippy group” she then turned to a surgeon that is known for his accomplishments in Hip resurfacing, Dr. T. Gross from Midlands Orthopaedics in Columbia, USA.

[pix_column type=”2/4″ first=”true”] Before the operation:
Dr. Thomas P. Gross, Mary and Lee Webb.Lee holds a Biomet ReCap prosthsis of the same type that Mary would get implanted in the hip.
Date: September 2006
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The right hip (marked R) is still in good condition.The left hip (marked L) is in an obvious bad state. The left femoral head has worn through the cartilage, shows bone on bone contact and cystic changes in the load area.
Date: 04-04-2006
[/pix_column] [pix_column type=”2/4″ first=”true”] The incision is here 16 days old. In Marys case it measures 5 inches. This size will differ from patient to patient and surgeon to surgeon.
Date: 09-29-2006
[/pix_column][pix_column type=”2/4″ last=”true”]East or West, home is best! This is certainly true if a patient like Mary has received a resurfacing and able to continue life without any limitations! It is worth mentioning that this photo was taken in the hotel during the post-op days where even her cat was present!
[/pix_column][pix_column type=”3/4″ first=”true”]Mary has two e-mail addresses for anyone with questions:

email: mkellis@flash.net

email: Girl_withthe_goofy_grin@yahoo.com[/pix_column][hr]

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Amy Petersen

Amy Petersen received the diagnosis osteo-arthritis already at the age of 25. In her case it was a bilateral problem, in other words both hip joints were affected. With osteo-arthritis, OA or degenerative arthritis as it is also called, the decrease in cartilage occurs much faster than normal. As a result the bony parts of the pelvis socket and femoral head can meet and grind on each other, leading to inflammation, pain and cyst formation in the femoral head and pelvis socket (acetabulum).
Amy who was 35 years old in 2007 had up till then had an active sports life, she ran a lot (half-marathon), took part in ’Western Boxing’, full contact karate, Muay Thai kickboxing and she trained in Brazilian jiu-jitsu. Just prior to the operation she could only do so bike riding and lighter forms of Yoga.In April 2007 Amy was successfully operated in India by the orthopaedic surgeon Vijay C. Bose.
An x-ray image with Amy’s pelvis from before the operation is shown below.

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Helen Triggs from England

Helen Triggs gave me some interesting photos, taken in a hospital in London. In her left hip she received a Birmingham Hip Resurfacing (BHR) from doctor Koen De Smet in Belgium, February 2006. In her right hip she received the same typ prosthesis but from doctor Justin P. Cobb, August 2006 in the UK. The photos below are all from this last occasion.
The photos were generated with help of Helen’s own x-rays that were imported in a special medical computer program called ”acrobot”. By the way, the program name ”acrobot” has nothing to do with the program “Acrobat Reader”!
Not all the surgeons will use programs like ”acrobot”, this is among other things determined by the prosthesis manufacturer but also the specific wishes of the surgeon or hospitals.

 

 

 

 

 

 

 

 

 

 

Acrobot can help the surgeon to determine the size of the prosthesis and the instruments that he will need and calculate the positioning and angles involved before the operation is started.
As the photos above and below show does the surgeon have a number of device sizes in the list that the can select (depending on the make) that he can place on the patients x-ray to compare for size and positioning. Like always, any damages that did not show up on the x-ray but are only found during the actual operation may call for a slight change in size or positioning from that what was earlier determined with the program

 

 

 

 

 

 

 

 

 

 

Above the top of Helen’s femur is projected together with the selected prosthesis of 44mm. This photo shows the excess of bone in some placed and loss of bone in other places when compared to the prefect round shape of the femoral cap. Reamers and other instruments used in the operation can give the femoral head the required shape. Ideally the surgeon only removes as little bone as possible, while he still creates the perfect fit for the cap that will be used. But it is not uncommon that cysts in the femoral head exist that need to be removed. The judgement whether or not hip resurfacing really can be used requires a surgeon who is experienced and specialized on just Hip Resurfacing, don’t settle for less!
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Placement of the acetabular cup in the pelvis is shown on the photos above and below. Above you can observe the two “inclination” (upward) and “anteversion” (forward) angles that the cup must have. With the correct angles of the cup the wear will be kept under control and the hip will also have the lowest luxation (=dislocation) tendency and lowest chance on causing impingement

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[pix_column type=”2/4″ first=”true”]This last photo gives more information about the pelvis side; the instructions that can be given to the program are listed on the right.[/pix_column][hr]

Lori

Lori is a 46-year old woman from Orlando, USA who has had a milder form of dysplasia, which means that the acetabular cup did not develop correctly; possibly leading to outward pointing feet and one can be regarded short in stature. Her dysplasia and osteoarthritis that developed has not been in the way for application of a Birmingham Hip Resurfacing (BHR) prosthesis, that doctor Vijay C.Bose in India gave her.
Lori has written a lot about her trip from the USA to India and back to the participants in the Yahoo group ”Surfacehippy”, see ”Yahoo Discussion groups” under “Forum”.

On Loris x-ray from before the operation the hip joints can be compared. It is clear that the right hip (left on the photo) must have given her all the problems, where there is obviously much less cartilage than in the other hip.

 

 

 

 

 

 

[pix_column type=”2/4″ first=”true”]On the 18th of September 2006 Lori received a Hip Resurfacing prosthesis of the same type that the surgeon McMinn helped to develop earlier on. The BHR prosthesis (white on the photo) clearly shows on the computer display in the hospital. With my untrained eye I would remark that the acetabular cup is positioned very deep in the pelvis, a result of her specific problem.
Lori works as licensed nurse on a heart surgery department in an American hospital.
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[pix_column type=”1/4″ first=”true”]This photo shows Lori at the Ideal Beach Resort in southern India, 7 days after her operation.[/pix_column]

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[pix_column type=”1/4″] Just 4 days after the operation the incision looks fine.[/pix_column]

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[pix_column type=”3/4″ first=”true”]After 3 weeks Lori drove her car again and went back to work. Anyone wanting to contact Lori can use the following adress:: lorih357@yahoo.com[/pix_column]

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Vicky Marlow’s ervaringen

Vicky is an American woman who had problems with her left hip, she was successfully operated by doctor Vijay C. Bose. This operation was performed 12-01-2005 in the Apollo Speciality Hospital in Chennai, India (see the list under Orthopedic surgeons for more information on this surgeon and others).

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[pix_column type=”2/4″ last=”true”]Here is an x-ray showing Vickys left hip just before the operation 12-01-2005[/pix_column]

 

[pix_column type=”2/3″ first=”true”]Together with Vicky there are many Americans and even Europeans that have their operations for Hip Resurfacing performed abroad from their home countries. The reasons for this stream of patients are diverse:

1. In some situations the patients in the USA have not enough insurance cover or no insurance at all, whereby the operation in the USA itself would have become too expensive. On the other in hand some of the countries abroad, like Belgium and India, where many of these operations are performed the costs are much lower; a quarter or half less than in the home country is no exception
2. There are many examples of surgeons in the home countries that refuse to consider the patients wishes for Hip Resurfacing and in stead stick to traditional hip prosthesis. The reasons for not accepting Hip Resurfacing as a better alternative differ but include the higher costs, the requirements for extra courses and willingness to specialize to gain the needed high experience.
3. With the unacceptably long waiting periods for hip operations in the home country, even more so with the Hip Resurfacing procedure, the patients understandably select alternatives whereby they are helped quicker.
4. Foreign surgeons are much freer in contact and more open to direct contact with their patients. It is possible to send MRI, MRA, Cat-scan and x-ray images to a foreign surgeon for free of charge consultation within minutes; while in the home country patients may have to wait up to 10 months to get a consultation with a specialist.

The points 2, 3 and 4 do in general also apply to the situation in Sweden.[/pix_column]

[pix_column type=”2/4″ first=”true”][/pix_column][pix_column type=”2/4″ last=”true”]On the photo a happy Vicky Marlow and the surgeon Dr. Vijay C. Bose 7 days post-operative, date: 12-08-2005
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[pix_column type=”2/3″ first=”true”]Vicky wanted that as many people as possible should hear how well it went for her and how natural her new Hip Resurfacing actually feels and behaves. She has taken up yoga again and promised to send pictures as proof that there really aren’t any limitations with a Hip Resurfacing prosthesis. She has been very active in the American forum for hip patients “Surfacehippy”.[/pix_column]

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[pix_column type=”2/3″ first=”true”]The incision after a Hip Resurfacing operation can have different appearances depending on differences in the procedures as applied by the surgeons. The patient’s own anatomy, specific wishes of a patient or complicating factors can also produce differences.The photo is from 12-04-2005, taken 3 days after the operation.[/pix_column]

 

[pix_column type=”2/4″ first=”true”]The x-ray of Vicky’s pelvis shows what a Hip Resurfacing (or ytersättningsprotes in Swedish) can look like.[/pix_column]

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[pix_column type=”2/4″ first=”true”][/pix_column][pix_column type=”2/4″ last=”true”] In case someone wonders what is possible with a BHR prosthesis the photo on the left will give a good impression.
At this stage Vicky was 11 months post-operative, date: 11-22-2006

 

 

 

[pix_column type=”2/4″ first=”true”]Vicky Marlow USA[/pix_column]