Kickas.org Forums Treatments, Drugs and Alternatives Surgery Age 25 best BHR or THR ....Plz Advise....

Hi
Iam 25 years old. I have been affected by AS for about 4.5 years. Life has som what been pack of both roses with thorns,like any one else.
Frm last 3 mons hit by very bad flares. I consulted rheumy and Ortho. Rheumy advises Anti TNFs and Orthos opines for BHR (THR or BHR wuld be majorly decided on operating table , Ortho said)Till now been on medications only,little apprehensive about biologics.

Would really seek advise from senior and same age members to please write abut their experiences.My left leg and hip are affected badly and it hurts alot whereas right feet is somewhat fine. I have to join work and life has come to stand still.

Any views on BHR OR THR are welcome.

Thanks

Hi Hope,

What is BHR and THR?

-Donette

hi donnette, did a little googling:
BHR is birmingham hip resurfacing and THR is total hip replacement.

hope4miracle, sorry i have no experience with this, but there are a few here that could give you good advice i think.

Hi,

I underwent a BHR at age 21, on my left hip and it gave me a new lease of life. At 30 today, its still good as new. THR is definitely a no-no for you given your age and expected function. For somebody our age, THR is very restrictive and may require revisiting every 6-8 years. BHR is a one time thing. You can do all physical activities, the possible exception being bungy jumping.

Go for BHR, I did it in India under Dr. Vijay Bose in Chennai. You can pm me if there's anything specific you would like to discuss.

For more information, you can join a BHR group on Yahoo (Surface Hippy) or on LinkedIN, to get more specific information and experiences.

Ankush

Hi;
I'm 26, and at 22 I had a doctor tell me I needed two new hips, and I was freaked the heck out, so I put it off, and then I ended up trying Low Dose Naltrexone (LDN) and WOW I no longer need new hips. My hips aren't perfect, by any means, but at their current state, I wouldn't want to have surgery at all. The biologics freak me out, too. I tried Remicade for 8 months and it fizzled out for me, and I have to say that the fear and constant worry about things like lymphoma and death weren't worth it (for ME. Lots of folks have a great improvement with it) and I opted to try the LDN instead of Enbrel, and it made a HUGE difference for me. (Almost no side-effects, and it fights depression and cancer, too) (no, I'm not on their payroll) lol.

So, my advice is, make sure you've REALLY researched what all kinds of treatments there are now, and I'm not saying you should try them all before surgery, but I'm saying you should list the ones that seem easier than surgery (to you) and try THOSE first. You may have an awesome result. Or it may not work at all. But in my case I'm very VERY glad I didn't just jump onto the operating table.
,
Bridget

Hi Hope4 - BHR. Big incision although the op is termed 'minimally invasive'. For me, would *always get a second opinion. Go to the best. Don't know where yu are in the UK, but, the Royal Orthopaedic Hospital, London is good. The Wrightington Hospital, Wigan is superb - they only do orthopaedic and rheumatology (so cover AS as well as). Surgeons at the Wrightington are the creme de la creme. Reading has excellent track record. (Nottingham...not so hot! And forget any of the Lincs hospitals!)

Couple of so called 'good' surgeons in London and one in the Midlands whom I wouldn't touch with a barge pole...bad news.

But, whatever you do go get a second opinion. And insist you go for the best. So, for me anyways, that would be the Wrightington - who BTW are squeaky clean, *no record of patient/hospital infections and all the rest! And their pre-op assessments are second to none. VERY thorough - even picked up my myocardial infarction, that had not been spotted by anyone else.

In hip replacements one area to be wary of is the one limb shorter, or even longer, than the other after the op. That is often due to the prothesis settling into the cement, of course that does refer to the THR. But, do 'personally' know of 'a' case in BHR where the operaed leg was 1.75" *longer than the non-operated on leg...and, it stuck out sideways to her body. Appalling surgery. Surgeon just shrugged his shoulders and screamed at the patient! (Me? I'd have sued the £^$T&R#)

So, do be careful in your choice of surgeon - and hospital! Nowadays in the UK the choice is *Yours - you can have your pick of the UK. Fact. Don't accept third rate nor yet second best!

IF you want to watch the actual suirgery go visit or-live.com check out the orthopaedic surgery. Think you will be amazed. They also show soe very interesting operating tables specifically deaigned for lower limb surgery. Facinating.

Wish you well with whatever decision that you choose to take/course of action you choose to make. IF you do decide to go for the BHR ask the surgeon how many he has done - fairly new procedure, the surgeon needs to be *versed in it, and with a good *Demonstrable track record. Your prerogative to ask questions and to receive replies to you questions. Never be shy, you body, you don't want to be living with another's inept, ghastly, surgical mistakes...

P.S. The LDN works pretty good for me as well.

OR-Live.com Birmingham Hip Resurfacing:-

http://www.or-live.com/HartfordHospital/2370/

Webcasts last an hour. This one is archived, but you can catch them live, as happening in real time. Always facinating viewing. No, *not gory, at all. You might have to subscribe in to view, but simple and is free.

Will try and find that table for you - facinating op table, all theatres should have em, but unfortunately not.

Here's another BHResurfacing or-live.com webcast:-

http://www.orlive.com/wfubmc/videos/birmingham-hip-resurfacing

This particular op has been 'approved' by the FDA since 2006. Has a good track record, but, do 'need' to have *Correct prothesis 'fit' and a GOOD surgeon to get it right. This particular webcast is good - surgeon came over fromthe UK where the op was a breakthrough. You'll note the length of the incision - big one, posterior approach

The Birmingham Hip Resurfacing op is certanly the better one, especially for the male and, for a patient with good bone then is the preferred way to go.

The second or-live op gives superb coverage. Many questions addressed. Can recommend.

Will check out UK surgeons for you - one mentioned, Ronan Treacy, had done 3000 BHR (at the point of this web cast, but over 5000 as at 2010). Treacy is the numero uno expert in the UK - he might be based in Birmingham. Will be back with information.

Learning curve for the BHR, average 40 ops, but, could be longer. This surgeon says that one never stops 'learning'. good point. But, about 40 ops is considered the correct number of these BHR ops in order to have a level of competence. So, check out how many yr surgeon has actually done...!

(For myself, I'd opine, 40 BHR ops is insufficient to make for a really proficient and competent surgeon in this BHR discipline - me, I'd be looking for waaaaaaay more!!)

Here ya go - won't do better than this. Royal Orthopaedic Hospital, Mddx, London; Ronan Treacy, head honcho. Treacy made the BHR breakthrough. Go see him. He'll be the best in the country - might have a wait, but worth it to get it right. Do NOT accept second best, stick to your guns, only go for the best there is, and that, is Treacy.

Hip Resurfacing Surgeons list featuring types of hip devices ...
1300 Hip Resurfacings to date. Joint Replacement Institute at St. Vincent ... Birmingham Nuffield Hospital, UK Orthopaedics, Knee and Hip Surgery ...... Glanister@ngh.nhs.uk. Mr. Ronan Treacy, MBCHB 1983, FRCS 1988, FRCS Orth 1995 ...
www.surfacehippy.info/listofdoctors.php - Similar

Ronan Treacy - United Kingdom - Email, Address, Phone number ...
8 Oct 2010 by tim_adamany Three consultants- Ronan Treacy FRCS, Eric Isbister FRCS, ... and a conventional hip replacement is the Birmingham procedure preserved most of the bone of . .... Ronan Treacy 123people.co.uk search disclaimer ...
www.123people.co.uk/s/ronan+treacy - Similar

Mr Ronan Treacy, Consultant Orthopaedic Surgeon - BMI Healthcare
MB CHB, Primary FRCS, Final FRCS, FRCSOrth. Specialty ... Ronan Treacy became a consultant at the famous Royal Orthopaedic ... what is known as "Birmingham Hip Replacement" which has has transformed the hip replacement procedure. ...
www.bmihealthcare.co.uk/consultant/consultantdetails?... - Similar

Mr Derek McMinn MD FRCS Hip Resurfacing Birmingham UK - Hip ...
Sep 13, 2010 ... Derek McMinn & Ronan Treacy honoured by Birmingham Mayor - News article ... a Birmingham Hip Resurfacing after refusing the hip replacement ...
www.mcminncentre.com/news-archive.html - Similar

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McMinn can be recommended, he trained directly under Treacy. Here's McMinn's contact details:-

Mr. Derek McMinn FRCS, Consultant Orthopaedic Surgeon
3095 Hip Resurfacings to date
The McMinn Centre
25 Highfield Road
Edgbaston
Birmingham B15 3DP
Tel: [+44] 0121 455 0411
Fax: 0121 455 0259
email:enquiries@mcminncentre.co.uk
http://www.mcminncentre.co.uk/

Here's Treacy - but don't know IF the info is current. Gives you a NHS contact info, so could make a start theree, thoguh, I'd go direct to Royal Orthopaedic in London, whre it looks like he is 'now' consulting:-

Mr. Ronan Treacy, MBCHB 1983, FRCS 1988, FRCS Orth 1995
5000 Hip Resurfacings to date
Birmingham Nuffield Hospital, UK
Orthopaedics, Knee and Hip Surgery
Tel: 0121 454 6161
http://www.roh.nhs.uk/

(Treacy had done over 5000 BHResurfacing ops to date! Impressive. BTW, excellent rate of success. It is expected that the BHResurfacing should/will last 15 - 20 years, and as a resurfacing then IF ever necessary to convert to a full THR then is easily performed as maximum bone has been preserved.

Think your decision is a no brainer! Go for it. Oh yes, BTW, ensure that you have GOOD P/T rehab programme well in place afore surgery. Good rehab is crucial to excellence of all aspects of outcome.)

Good luck and let's know how you get on. Go well, all the best

Molly C (France)
Keeping on Keeping on