Hip Replacement, Surgeon Replacement Expert advice sought!!

[Billinsd]

https://www.microportortho.com/products/hips/tissue-sparing-surgical-approaches/anterior-pathr-hip-approach

 

[Billinsd]

I found an excellent improvement on the Anterior approach. It's called Path anterior approach and it's less invasive than the regular anterior. I'm not concerned at all about a scar, but the anterior path looks more precise and less chance for infection.

 

[Billinsd]

 

[Texasbuckeye]

I found an excellent improvement on the Anterior approach. It's called Path anterior approach and it's less invasive than the regular anterior. I'm not concerned at all about a scar, but the anterior path looks more precise and less chance for infection.

Leave the medicine to the doctors, but do ask questions about the why and how of the approach. I would not recommend going doctor searching for a specific approach as this can become a self fulfilling prophecy where you ignore more medically sound advice because you “think” you found the holy grail. I have seen that all too often in the ophthalmology field where people search after specific technology or procedures without really knowing anything at all about the why or the how and they end up spending a bunch more money and have a worse or at best no better outcome, but many times it was worse than it should have been.

 

[Billinsd]

Leave the medicine to the doctors, but do ask questions about the why and how of the approach. I would not recommend going doctor searching for a specific approach as this can become a self fulfilling prophecy where you ignore more medically sound advice because you “think” you found the holy grail. I have seen that all too often in the ophthalmology field where people search after specific technology or procedures without really knowing anything at all about the why or the how and they end up spending a bunch more money and have a worse or at best no better outcome, but many times it was worse than it should have been.

Yes, what I found looks extremely rare. Thanks

 

[simarden]

To be honest, you're the first person who doesn't trust a more experienced specialist. Of course, I wouldn't go to an elderly surgeon for surgery whose hand, in which he holds a scalpel, is shaking. However, if I were offered to go to a surgeon with a lot of experience in a narrow field, I'd choose him. Just as we need the help of a professional orthopedic doctor, we must choose professional surgeons. The staff should be friendly and nice, but also it shouldn't just be nice-looking people. They should be good doctors with a good education.

 

[ODB]

With all due respect. I cannot disagree more. I've experienced both worlds and from a patient stand point, my outcome was better than others I have spoken with. Without exception.

My latest example is a need for genetic testing due to a second primary cancer. The doctor 30 years in to practice did not know who was available or what was even possible. Said he would call if he could find out. Talented surgeon for sure. But has no idea (admittedly) what the current offering of the most recent medicine practices are.

One phone call to my prior hospital and they had all of the answers.

It is not a university that I know of, but there are a lot of new doctors so it probably is one of the learning places.

I have had better care pre, during and post surgery/treatment from places that specialize in the need I have. That's where I would go. Not to someone who occasionally shrugs on the joint you need repaired. Find someone who does hips. And its known for it. Not someone who can do everything and anything as needed.



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that’s hit or miss regarding an old timer knowing his shit.
My wife’s endocrinologist has retired but still is absolutely at the edge of the most current practices of the voodoo that is endocrinology. To the point that two other young doctors my wife saw (because we moved) gave such shitty, counterintuitive advice that we simply refused to take it. We contacted her now-retired old doctor (has to be mid-70s now) and he helped us out. Was flabbergasted at the advice we had gotten as it did not comport with latest practices.

Point being, be your own advocate, always. If you get a bad feeling about a doc, move on.

 

[Mosby]

Ask your Dr to refer you to the nearest Mayo Clinic and go there. If there is better care out there, I haven't found it. For checks up and minor stuff we stay local. When we have real issues or problems, we go there. It is a 7 hour drive for us and well worth every minute of it. They assign a medical team to you.

 

[BadDogPSD]

@Billinsd. Have you had your surgery yet?

 

[Billinsd]

@Billinsd. Have you had your surgery yet?

No, I put it off for now. The hip has been pretty tolerable. Thanks

 

[BadDogPSD]

Cool, glad to hear it! My doctors are recommending getting my right hip replaced, so I'm looking for info from others that have had it done.

 

[MattB]

Find a company that sells the prosthetic hips, find out how to contact a local rep, and ask them who they recommend. I have a friend in Sac who sells and oversees the knee/hip surgeries and I had him ask the local rep for this company who they recommended. My friend who was having the surgery asked around and learned from a few different sources that the recommendation my friend gave was “the guy” locally. He had the surgery done by the referral and his PT was shocked at how well he was doing early in his recovery. Lots of that is due to quality work by the surgeon.

 

[Ridley]

You can fire your doctor, and your doctor can fire you. Tell your primary care doctor who you want to see. You are your own advocate.

 

[Tbonespop]

No, I put it off for now. The hip has been pretty tolerable. Thanks

Not sure if you have access to Mayo, but I had hip replacement at the Mayo clinic back in March. Dr Spangehl. I had no idea how good he was until I reached out to a friend who had a very complex double hip surgery (not replacement). She had gone to a "world renowned" specialist in San Diego. She asked if I wanted a second opinion with her surgeon, and I said sure. She asked who my surgeon was and I said Spangehl. She laughed and said, "he's the best in the business". She said her surgeon won't even see me if I was going to Spangehl.

Anyway, fast forward 3 months from then. I got the hip replacement - anterior. Out patient surgery. 5:30 am appointment, in surgery by 7:30 am, out of surgery by 10:00 am. Up and Walking by noon, discharged by about 4:00 pm (had to be able to pee before they could let me leave, which took a while to get feeling back in the groin lol). Back at home by 5:30 pm. 12 hours and I was at home with a new hip. Crazy to wrap my head around it. Only used the walker to get into the house and then never used it again, or a cane. Doc said new hip was full weight bearing and it was just up to me on whether I wanted to use the walker or cane. Never touched either after getting into the house. Took one Oxy for pain and had a reaction to it, so ditched the pain meds (they told me to take them). Turns out, never needed them. Pain on a scale of 1-10 was maybe a 2. Took Tylenol for about 3-4 days then was good. Surgery was on a Friday, went to the bank on the following Monday. Was walking pretty much normal (excluding some stiffness) by the following Wednesday. I actually could jog by the following Saturday just to see if I could (which I do NOT recommend). 6 months later I'm back doing everything I love - riding motocross, hunting, hiking, playing softball, working out, etc.

I put it off and put it off until I couldn't tolerate it. Then I wished I hadn't waited because due to Covid, the wait for elective surgeries was getting long.

Dr Spangehl was fantastic. I chose him because he was the only hip surgeon that told me it was ok to ride motocross after I was all healed up after surgery. Turns out, I had no idea he was that good. If you can get to Mayo, go see Spangehl. Fantastic experience. Regret waiting as long as I did. Now I just have to do my best to not wear this bad boy out....

 

[Billinsd]

. I chose him because he was the only hip surgeon that told me it was ok to ride motocross after I was all healed up after surgery. Now I just have to do my best to not wear this bad boy out....

That's the biggest reason I'm putting it off. The Mayo Clinic is highly rated, however your surgeon has some very poor reviews, most are great however. I'd be real concerned if your surgeon was the only one who said motocross is ok after. The new hips are all pretty much the same. I think there was a misunderstanding. One of the surgeons I saw said I could ski after and so does he. I said "do you ski real hard and fast on the mogals and bumps?" He said "why no, of course not." He skis on groomed blue runs. He recommended that I stay away from mogals and aggressive skiing.
I said "what kind of things are bad for the new hip?" He said don't bounce up and down a lot. If you ski don't bounce up and down a lot, if you rid a dirt bike don't stand on the pegs and bounce up and down a lot. That will wear out the hip faster. I said how fast, he said he didn't know. If you fall and injure the hip, it's much easier for it to get dislocated. One of the members on this site that's a physician, I think on this thread recommended picking a surgeon by reviews and that's what a physician buddy of mine said too. And pick a guy who has done a lot of hips, but he's not an old guy. Lots of folks have recommended the anterior method, however, my surgeon said he doesn't do it, because it's harder to see what he's doing and the surgery is longer than the posterior way, so there is greater chance of infection. The Anterior method was new and is the best according to social media, but few surgeons do it and my surgeon has cleaned up after some of their mistakes. The anterior method is supposed to heal quicker, but my surgeon said not much and the big danger is infection and the less time in surgery the better.

Just my educated opinion. The vast majority of surgeries go really well!!

 

[Billinsd]

I too am in the medical field (PA-C). If it were my hip I would want the absolute best surgeon. Some of the best surgeons, in my experience, may not have the best bedside manners. I can deal with that if my joint is done correctly. Of course, if I find a surgeon that is one of the best with great bedside manners it's a done deal.

I totally agree!! I found a great surgeon with a great bedside manner. He's got great staff too.

 

[Billinsd]

when they heard my age i almost got ref had back surgery last year and was going to switch surgeons for a second opinion and i had to write a letter saying i did not want the surgeon i had and wanted another ---just for a second opinion. of course after the letter my surgeon would not have had anything to do with me.

In San Diego, I had some difficulty getting a second opinion. Surgeons don't want to take other surgeons patients. It's all in the semantics. I had to tell the new surgeon I wanted to see him for a second opinion and that was fine. I saw him and said I wanted him to do my surgery and it was fine. As far as going back to the previous surgeon? I don't know? Good point.

 

[Billinsd]

Find a company that sells the prosthetic hips, find out how to contact a local rep, and ask them who they recommend. I have a friend in Sac who sells and oversees the knee/hip surgeries and I had him ask the local rep for this company who they recommended. My friend who was having the surgery asked around and learned from a few different sources that the recommendation my friend gave was “the guy” locally. He had the surgery done by the referral and his PT was shocked at how well he was doing early in his recovery. Lots of that is due to quality work by the surgeon.

Excellent, hadn't thought of this!

 

[Billinsd]

You can fire your doctor, and your doctor can fire you. Tell your primary care doctor who you want to see. You are your own advocate.

Yep!! I've been slow on this....

 

[Tbonespop]

That's the biggest reason I'm putting it off. The Mayo Clinic is highly rated, however your surgeon has some very poor reviews, most are great however. I'd be real concerned if your surgeon was the only one who said motocross is ok after. The new hips are all pretty much the same. I think there was a misunderstanding. One of the surgeons I saw said I could ski after and so does he. I said "do you ski real hard and fast on the mogals and bumps?" He said "why no, of course not." He skis on groomed blue runs. He recommended that I stay away from mogals and aggressive skiing.
I said "what kind of things are bad for the new hip?" He said don't bounce up and down a lot. If you ski don't bounce up and down a lot, if you rid a dirt bike don't stand on the pegs and bounce up and down a lot. That will wear out the hip faster. I said how fast, he said he didn't know. If you fall and injure the hip, it's much easier for it to get dislocated. One of the members on this site that's a physician, I think on this thread recommended picking a surgeon by reviews and that's what a physician buddy of mine said too. And pick a guy who has done a lot of hips, but he's not an old guy. Lots of folks have recommended the anterior method, however, my surgeon said he doesn't do it, because it's harder to see what he's doing and the surgery is longer than the posterior way, so there is greater chance of infection. The Anterior method was new and is the best according to social media, but few surgeons do it and my surgeon has cleaned up after some of their mistakes. The anterior method is supposed to heal quicker, but my surgeon said not much and the big danger is infection and the less time in surgery the better.

Just my educated opinion. The vast majority of surgeries go really well!!

Spangehl told me there were two movements he didn't want me doing - water skiing and snow skiing. He said if I crashed in a MX crash, that hip dislocation would likely be one of the minor injuries to worry about - but he said it wouldn't be fun if I dislocated it. I have dozens of friends who have had hip replacement and still ride MX. Seems like plenty of surgeons are good with it - or everybody just doesn't care and do what they want - which is pretty much me. I don't need to snow or water ski anymore. I can snowboard and I'm perfectly fine just hanging in the boat, no need to ski.

With respect to riding MX, he said the suspension definitely helps with the hip. Its the constant pounding of running that is really bad for a hip. Suspension smooths out the abrupt jarring that hurts the hip, according to the Doc.

Surprising to hear mixed reviews on Spangehl. I could see that maybe someone might not like his bedside manner, but as for the surgery it was fantastic. People are always shocked to hear and learn I've had hip replacement.