Tim Samoff // Weblog (old)

September 14, 2007

What's the hippest joint around?

So, are there any orthopaedic surgeons who read my blog? I’m assuming that there aren’t, but if you’re out there, I need some advice…

Admittedly, one of the most annoying aspect of the medical industry in the United States is that (1) doctors advise patients based on the doctor’s interests, not the patient’s and (2) patients don’t know any better unless they are their own advocates and do their own research. Some of this knowledge has come from my own challenges over the years; some has come from talking to people like my good friend Katy Raymond, who has had to learn the hard way as well.

(thumbnail)When approaching something as major — and life-altering — as a bilateral total hip replacement, it would be reassuring to know that doctors are selfless enough to recommend whatever the best procedure is. But, unfourtunately, that’s a fantasy. In real life, most doctors prescribe whatever will keep the business under their roof (i.e., whatever will make them money). Now, these prescriptions may all be well and good (even more than adequate), but what if there was a better procedure or a better surgreon available? Doesn’t it seem logical that those options would be discussed in favor of a patient’s well-being (and maybe even their life)? But, it’s just not so.

Ever since finding out that this issue I have was a possibility, my wife and I have been studying up. We’ve been reading about the disease and the various procedures, talking to friends who are doctors and physical therapists, and even receiving materials to read from friends who are also, kindly, doing some research on our behalf (in which we are grateful). After much wading through all sorts of published studies and opinions, I think we are, at least, ready to ask doctors the right questions. But, we still have some questions too… And, that’s why I’m looking for some help.

There are a few ways that AVN can be treated:

1. Core decompression and bone grafting (which I’ve been told I’m too late to try)
2. Total hip replacement (which is my current recommendation)
3. Hip resurfacing (which is a newer, less invasive form of hip replacement)

And, even with these different methods, there are different ways to go… THRs can be done with ceramics, titanium, cobalt chrome, polyethylene, etc. Hip resurfacing isn’t for everyone and it is only available in a few places nationwide. The first doctor I went to uses ceramic materials in their THRs. Likewise, we have also found out that one of the few places that performs hip resurfacing is right around the corner from where we live (by the way, if you’re not too squeemish and want to see what a hip resurfacing surgery entails, go to that site, click on “Surgery Webcasts,” and then go to “Birmingham Hip Resurfacing).

Can anyone offer me some unbiased advice of what to look for, what to ask, and what to request? I am really at a loss right now.

Last, I’d like to describe the picture you see up there… That is an actual MRI scan of my pelvis and hips. If you can find the hip joints, you’ll see that mine aren’t quite as smooth and round as you’d expect them to be (a healthy joint should look like this).

If you’d like to help out, but don’t feel comfortable leaving a comment, please emai me. I appreciate it.

Posted at 2:45 pm

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