Golden Rules

Golden Rules

On the eve of a hip operation a patient should be aware of the following:Golden Rules

*If a hip operation no longer can be avoided it should also be performed as soon as possible in stead of delaying it as much as possible, as we hear our surgeons and general practitioners say so often.

With the aid of this photo: prostheses you can see how the different methodes (and prostheses) compare initially and over time. No one should have to see his or her life destroyed needlessly for many years!

Don’t forget that for a hip resurfacing prosthesise a minimal amount of good strong bone is required, if the femoral head has been allowed to wear too much been weakened and riddled with large cysts it will no longer work.

*Never decide directly after consulation with the first and more over after having only consulted just one surgeon. Require certainty by first consulting a number of surgeons who are all specialized in hip resurfacing and comparing their conclusions. The opinion of one surgeon and who doesn’t even have much experience with hip resurfacing is of no value.
If needed you can contact and I will gladly advise and help you further.

*Your age or gender should not be used as factor to determine your suitability for hip resurfacing.

Only the total package of all your specific and unique factors together can show if a hip resurfacing prosthesis is regarded suitable in your situation, possibly further examination can be required, for example with aid of a DEXA-scan, MRI of CT-Scan.

*Give yourself an honest chance to learn more about the hip resurfacing method; do also participate in a forum or discussion group where this subject is in full focus.

Om the Internet and particularly in English a lot can be found. Our own groups can be found here: Nordens Hippies     Heupen-Ned

*A hip resurfacing should only be given by a specialist in the method who has at least performed the procedure a few hundred times and who continues to perform it daily. The experience and proficiency of the surgeon will determine the success.

International research shows that every orthopedic surgeon who starts with hip resurfacing goes through a real learning period in which a number of faults are made. You can avoid becoming a victim of this by selecting a specialist who already has the necessary experience and proficiency.

*The surgeon should with reasonable certainty be able to guarantee up front that you will be given a hip resurfacing prosthesis.

If there is already doubt from his side in the beginning then you will be best of by cancelling the operation and first wait for conclusions through a couple of seconds opinions, with which I can help if you like. Otherwise there is a real chance that you will unjustified finish up with a traditional hip prosthesis.

*Sadly enough hip resurfacing is not suitable to everyone, but this conclusion should never be accepted from an orthopedic surgeon who himself does not perform this operation and will not have the experience either to allow a trustworthy verdict.

Please contact me for assistance. Patients in the above named circumstance may very well be a good candiate for the newer BMHR prosthesis! Again, you will hereby need the opinion from a couple of real hip resurfacing specialists who all use the BHR and BMHR prostheses. Please also see the following PDF file in German that shows the differences between the BHR and BMHR: BHR/BMHR

*It will be worth for your operation to be performed by the best possible surgeon; the one that is so comfortably closeby can very well prove itself in the future as the worst possible choice you’ve made.

Don’t limit yourself to a surgeon in your own city only or state or even country if the best surgeon is not found there. Only the highest guarantee and best possible results should be your aim. Don’t forget that this operation and its succes (or failure) will determine a large part of your remaining life.

*Try and keep your condition as high as possible under the given circumstances and maintain good health.

Remaining seated for longer periods raises your weight and causes even loss of muscle mass  and strength. If this continues for a longer time even the quality of the limbs and joints will diminish, just as the bone density. As a result of all this the rehabilitation after a later hip operation will be prolonged and cause more pain than really had been necessary.

*Be aware that there are about 15 different hip resurfacing prostheses in existence but they do not all have the same good figures.

On the Internet (including on my website) you can read about what other patients have written on the specific prosthesis that your your surgeon intends to use. With any doubts and refusal of your surgeon to use another make or when he clearly lacks the required experience you would do wise to consider another surgeon who can give you a prosthesis with a long and good track record.

*Avoid using too large amounts of painkillers for prolonged periods of time, this does also apply to repeated injections with cortisone.

Some agents can influence the skeleton (and thereby the hip also) negatively while under the given circumstances the skeleton should to the contrary be protected as much as possible. Rather than cortisone try if for example glucosamine can contribute in the relief of pain and other complaints. Glucosamine is sold in different forms as you will notice, before rejecting please test the different forms to see if there is one that works for you. There are also tablets with additionally some chondroitine which also might help. Avoid under certain circumstances glucosamine tablets that also contain MSM bevat, see further done for the reason why.

*During the weeks before and the months after the hip operation the condition in your mouth should be so good that no intervention by a dentist will be needed.

Dental care, for example teeth cleaning by a dental hygienist that as a consequence also causes bleeding should preferably have taken place long before the hip operation. If for any reason intervention by a dentist is required in the weeks before or months after the operation then only after first having been given a profhylactic treatment with antibiotics. Ask your surgeon also for advice and he will likely also appreciate it if you report him about the intended dental treatment. Mouth bacteria can be really nasty and very difficult to treat when they via the bloodstream reach the recently operated hip.

*In the week before the operation no glucosamin with MSM should be used. If painkillers are used you will have to report this to your surgeon and ask him for an opinion/recommendation!

MSM and certain painkillers thin the blood so much that they can cause hard to stop bleeding and complicate the hip operation. Some medicines (both those on recipe as well as the “over the counter” sold) can influence the agents (medines and anaesthetic) that you need during the operation and either weaken or strenghten their expected effectivity!

Ron van Mierlo 2015-05-27