Stopping Resurfacing for Women and Metalosis

Bones, joints and muscles
1

Ahead of my operation - at Birmingham Royal Orthopaedic Hospital - I asked my consultant about resurfacing. He told me that they are about to withdraw this as an option for women because long term outcomes were not as good as for men. Has anyone else heard this?

Also on the bay of 4 female patients there were 2 in (neither were originally this hospital patients) for treatment of the devastating effects of reacting to metal on metal replacements - pseudotumours, missing muscle and bone. Really shocking.

2

As far as I am aware resurfacing is done rarely on men these days as well

yes there was quite a lot within the last couple of years about the possible long term effects of metal on metal implants. I know the hospital I was in stopped using them some time ago, and that the research to help those affected is onging

3

Hi.

I had my right hip resurfaced in 2004 and have had no problems whatsoever.  I also had my left hip totally replaced last year, and am totally pain free now.  It does work on some of us.  There is a website on Yahoo called Surafce Hippies, where there are thousands of members who have had successful resurfacg ops.  Of course, I am sure there is bad stories as well, but for me, everything went well.

4

Hi Christine .. when is your surgery ? make your concerns known to your surgeon= are you going to have the resurfacing or THR ? 

wishing you a good and peacful night 

warm hug --- all is well right now

5

Dear Christine2107:

Those problems were surfacing before 2011.  I also thought at the time that resurfacing was a better option than THR.  Turns out it wasn't.  It happens in men also.  It is probable that the fluid in womens joints contain different chemicals that corrode the metal worse than in men or at least cause the women to react worse than men. 

When I became aware of the problems, I posted on this site (check them by clicking on Mikey123.)  In short, any plasic particles or metal particles formed in the joint will cause problems as you mentioned.  Why they still use metal or plastic in the joints is a 'real headbanger.' for me.

I thought to avoid that by using ceramic.  But the problems still occur although to a lesser extent.  The reasons are crevice corrosion where the ball fits the stem. Galvanic corrosion where 2 different metals are in contact.  And taper fretting which occurs when a person walks, weighting and unweighting the joint, this is another type of corrosion.  I find these things serious problems, so much so that I am almost fully convinced to stay on crutches for the rest of my life.  There isn't a cure for those problems that you mentioned and so many people on this site are having problems with that operation.

My purpose is not to tell someone what to do, but to point out all the problems that they might face so that they can make an informed decision.  Most of the people on this site were never told before the operation about these things.   And sooner or later the problems will surface.  Some people are angry or scared by what I wrote, but if they have the implant already, they can get the doctor to monitor the levels of metals in the blood or the fluid around the joint for allergic reactions and bone loss so that they can be on top of the problems before hand.  Other people prefer blissful ignorance until it the damage is done and then they go back to the doctor to get it fixed.  I have a friend who simply doesn't care about the same things that I am concerned with.  I couldn't make the same decision that he did.  At the present time he is very active with no apparent problems.   The doctors know all this stuff that I am saying, but the reasoning I have heard from several of them is that if they revise it once after 10 years or so they can deal with the problems and get most of the population to the grave with the revision.  Hardly a comfort for me.

It seems that the main reason for an implant is to remove the pain.  But lots of people on this site have pain afterwards anyway.  So what was the point.  Maybe there is a different way to diminish the pain without the operation and without the drugs that are damaging their bodies.  

I read today that an imbalance of good bacteria to bad bacteria in the gut can cause or is associated with 170 different diseases.  It is certainly worth consideration to find out the facts.  I asked my doctor early on what causes osteoarthritis and he didn't know and they still don't know, but it's  almost an epidemic.  If the hypothesis is true then it makes sense that if that situation is reversed that healing might occur. I am going to check this out. It doesn't cost anything to try while I wait.

In the meantime, please educate yourself so you can make an informed decision that you can live with.

Mikey     

 

 

 

6

Hi Christine

Interesting.

All I know is that my left hip was resurfaced with the Birmingham hip op with titanium 12 years ago...and is fine...tho apparently resurfacing for men as well as women now phased out. Guess I'm lucky? And Cath too!

The funny thing is even a couple of years ago Birmingham proudly claimed ownership of this hip procedure saying g less invasive and a better option for younger patients.

Confusing this...my new hip is the patented exeter hip.

Sleep well

Mic

X

7

Hi mikey

i am 4 weeks post op,having just had RTHR using the Superpath method with advantages of no dislocation during op and no cutting of muscles, tiny 3.5 inch scar.

I do not know what level,of pain you are at, but I could not have carried on much longer with the dreadful pain I was in day and night, distortion of gait and absolute and utter exhaustion.

My op has changed my life and looking on the bad side,if I only have 10 years of good quality life then I would be quite happy with that

Some of us do not have the option or luxury of debating whether or not to have this operation and have to put our faith in the medical profession. I have to work and support my family and could not have done so without this op.

Life itself is a risk and sometimes you have to bite the bullet and just get on with it

It is great pointing out problems, but it is also on the opposite side of the coin nice to have the advantages and positives pointed out

It just depends whether you are a glass half empty or glass half full type of person. I have always been the former

I cannot understand anyone wishing to stay on crutches for the rest of their life but that is your choice and I respect that

Most of us however want to enjoy our lives and live them to the full and if that involves taking a risk then so be it

I am now free of pain and feel the bright happy person I used to be again, like so many of the folk on this site. 

I would say to anyone who needs this operation to go for it - you will not regret it and will start to feel alive again

Good luck, Mikey, in your quest for whatever outcome it is you are looking for

Kind regards Linda

8

Should have read latter -glass half full ( half asleep!)

9

Hi Mikey

I was 50 and very fit when all of this started and have longevity in the family. I cannot envisage living 40 years in the state  I was in. I could not work, drive, get up slopes or stairs. Remaining in that state was not an option - I have parents I want to care for and could not do that in my state of physical health - as well as getting very down about it all.

My surgeon is someone I have a lot of confidence in and he has been very clear on the potential risks.I have known him 2+ years now. His reputation in the hospital for delivering good results through a conservative approach are legend. He told me what options he considered for me on the basis of what he would let be done to his own wife. 

I took the decision to have both hips done. This is because I do not know what the future holds in store for me medically. I got early arthritis because I had undiagnosed hip dysplasia in one hip and hip impingement - pincer - in the other hip. I am not overweight and healthily but not obssessively sporty.

My mum was late diagnosed with MS after 35 years and a month later had a brain bleed which almost killed her and came right out of the blue. So I take the view that I will deal with my health challenges as they arise and want to be as fit as i can before the next thing hits me. Which is why I went for a new hip whilst waiting for a breast lump to be checked out.  

I also have seen evidence that antibiotic resistance is getting so bad that they are warning that operations where antibiotics are used to help ward off infection - cancer, replacements etc - may be more risky in a few years time. So this actually played a part in my decision to go for it. In the 19th Century 40% of all deaths were from infection and we could be returning to those days in the not too distant future.

Anyway enough of me rabbiting on -  I just wanted to share with everyone the sorts of factors that led to my decision to go ahead with the replacement.

I hope you keep well and active Chris x

 

10

Hi Christine, I had my first BHR on my right hip, 13 years ago, aged 33, then  the left one 8 years later. I have been having issues with my left hip since Feb this year & am having a THR on the 3rd Aug. Unfortunately I was not one of the women that was called for yearly blood tests, even though I had them both done at the same BMI hospital. My blood test shows there are high levels of metal , an x-Ray & MRI shows that the hip has moved. Not sure if this helps. 

Good luck

Donna 

11

Hi Donna

Here is the latest official news:

Voluntary actions initiated to remove smaller size components and change Instructions for Use (IFU) following analysis of recent performance data

No action required from patients; no change to current practice for patient follow-up care

BHR continues to perform amongst the best hip replacements for the right patients

Smith & Nephew (LSE: SN; NYSE: SNN), the global medical technology business, announces the voluntary removal from the market of 46mm diameter and smaller femoral heads and corresponding acetabular cup components for the BIRMINGHAM HIP◊ Resurfacing (BHR) System, and new Instructions for Use (IFU), reflecting recent performance data. Surgeons should maintain their routine follow-up protocol for patients, and patients are not required to take any new action.

Andy Weymann MD, Smith & Nephew's Chief Medical Officer, said: "Patient welfare is Smith & Nephew's top priority. Based on our analysis of our most recent data, we are taking the necessary steps to ensure that the BHR is only used in those patient groups where it has demonstrated strong performance. These represent the vast majority of current patients."

As part of its normal post-market surveillance, Smith & Nephew has conducted an analysis of recent National Joint Registry of England and Wales (NJREW) data. This indicated that the BHR continues to deliver performance in line with the best total hip replacements in male patients under 65 requiring femoral head components 50mm in diameter and larger. However, the revision rates associated with men requiring femoral head sizes 46mm or smaller and with all women patients exceed the current benchmark established by the UK National Institute for Health and Care Excellence (NICE). Based on this information, Smith & Nephew considers that these patient groups may be at a greater risk of revision surgery than previously believed, and is therefore removing small sizes and updating the IFU to contraindicate the BHR for women.

12

Hi Christine

Thanks for this...

My bhr op was carried out when I was under 65, was and am male, and is sill fine touch wood 13 years on. So I kinda fit the criteria well

Mic

X

13

Hi Maggie

They get really good outcomes with resurfacing for men under a certain age so I do not think that they are being removed completely.

However I was surprised to see in the ROH a female patient with a new resufaced hip as recently as late May 2015. Those who pioneer  new techniques seem to be continuing with them.  When I told my surgeon he said he would not let me,  or his wife have a resurface. I thought benchmarking his decision against what he would choose for his life was helpful as thats a hard decision to fake.

2 and a half weeks post THR and hit the brick wall today - so resting on the sofa and being quiet xxx

 

14

Hi Linda,

I hope your decision works out well for you.  At least you are aware of the risks or the certainties of the choice.

This glass being half full or empty depends on whether you just had a good drink or you drank the whole thing and are filling it up again.  But really its a a statement about contentment.  I learned a long time ago that if your 8 oz glass has 4 oz in it  and you feel discontented,  the solution is to pour the water into a 4 oz glass and have a full glass.  The moral behind that is to be content in whatever situation you find yourself in. 

Best wishes for a good 10 years.

Mikey

15

Hi Mikey,

Nice message! It's hard making these decisions, where the personality/views of the surgeon seem to count as much as the clinical evidence, so it's good we all look for that elusive evidence.

And, sometimes, cracking a joke or two as well. thanks for the botMle one!

Warmly

mic

___________

16

Hi Mic71403:

I've been a Carpenter/Cabinetmaker for 42 years and touched lots of wood- it never helped one bit.

After your BHR 13 years ago you say that you are still fine.  I hope you continue to be fine.  

My questions are:  1)  Have you at any time during those 13 years had a blood test for levels of metal ions?

2)  Have you at any time during those 13 years had an X-ray of your hip?

The reason I ask is because if you have no ill effects from this, the researchers might be able to find out what is special about your body chemistry and devise a protocol that will protect others not as fortunate as you.

Mikey 

 

 

17

Hi Christine 2107:

When I was in hospital at 13 years old recovering from a serious injury, I got a card that tried to cheer me up and I've remembered it all these years.  It said:  'Just think of all the people who are worse off than you.' And when I opened the card, inside it said ' There must be at least 20.'

I feel that your method of dealing with life will work for you. Don't forget to monitor your implants so they can serve you well.  Hopefully by the time you need anything else done to your hips, they'll have designed a better solution than the present ones. 

Best wishes and keep your glass full.

Mikey 

18

Hey Mikey - you just gave me my first laugh of the day - thank you very much.

what I do know is OA does not mean I won't get sick with other stuff. Took us 30 years to get mum diagnosed with MS and just a month later she had a totally unrelated brain bleed which nearly killed her aged 60.,

laughter and fun are the best so let's keep spreading the cheer😀

19

Ah Mikey how much less luck in life might you have had if you had not been a carpentered touching woods very day?

BHR Results for younger men with large sockets have been very good. It's just not given the same to all sections of patients and my consultant was adamant that I could only have the treatment he would let his own wife have - which was his test for the care he wanted for his patients. Can't say fairer than that and it's hard for someone with integrity as he has to use your wife to spin a patient a reassuring story so I believed him. I also took number of folks into my appointments with me to make sure I wasn't being over trusting - and they said stick with him.

I guess you have made yourself the most beautiful walking sticks and other aids - in wood of course 😄 xx

20

Hey Christine,

well said,

evidence based thinking plus an intuitive trust in a sound practitioner!

mic

xx