Selecting Surgeon

How to Choose A Surgeon by Patricia Walter
1/20/2010

Selection of a surgeon is a personal choice. It is a choice
that makes you feel confident that your surgery will go
well, that your surgeon has a good bedside manner and you
can ask questions anytime you need answers.

When buying real estate the old saying about what is
important is "Location, Location and Location." In many
people’s minds the most important factor in choosing a
surgeon for hip resurfacing is "Experience, Experience and
Experience." I realize that every hip resurfacing surgeon
has to start somewhere to do his first operation, but I
feel, in layman’s terms, that hip resurfacing is as much of
an art as it is a learned skill. The angle of the cup in the
acetabulum is very important, the proper amount of inpact to place the stem is important, shaping the femur bone for
the cap is important, how the surgeon approaches the hip
itself is important.  There are many, many factors
involved in a successful hip resurfacing operation.

There have been studies done to determine the learning
curve for Hip Resurfacing with the BHR
. These studies and others indicate
that a surgeon needs 50, 100 or more hip resurfacing operations to become
experienced. I have personally been told by a very
experienced doctor that a surgeon should do many hundreds of hip
resurfacings before a patient decides to use them. There is
a LARGE AMOUNT of debate over this number and
subject.  Many people feel that a surgeon is already
experienced if he has been performing THR’s for many years.
Hip Resurfacing, however, is a much more demanding and
technical surgery than a THR.

I personally feel that experience can only be learned, it
can not be taught. Many professional sportsmen have learned
the technical skills to play the game – but you generally
see the most experienced quarterbacks, pitchers, or goalies
playing in the pros.  The difference is the experience.
These people learn almost instinctively what to do, they
don’t take time to reason and figure out what to do. 
That is the kind of surgeon I want to do my hip resurfacing
– a surgeon that has seen it all and done it all. 
Unfortunately a surgeon that has only done 10 or 50 hip
resurfacings has not seen it all and done it all.  My
personal surgeon, Dr. De Smet, even told me that he still
has very difficult surgeries and he has done over 3000 hip
resurfacings.

I feel if a person has a more difficult hip problem such as
advanced AVN, cysts, misaligned hips or an unusual physical
problem – they need a very experienced
surgeon. If you are an older female or even male, many
surgeons will suggest a THR instead of a hip resurfacing.  The more
experienced doctors are willing to tackle more
difficult problems since they have the experience.

I have personally read thousands of emails from hip
resurfacing patients and my personal
observation of post-op results show that the patients of the
very experienced surgeons usually have a quicker and
easier recovery. There are always exceptions due to
the prior medical conditions of a patients hips, but the
post op recoveries are often related to the surgeon’s
experience in my opinion.

There are many possible problems for the failure of a hip
resurfacing surgery. Using a more experienced doctor will
often help alleviate these problems, but it is not a 100%
guarantee. There have been many more slipped cups and femur
neck fractures since the newer surgeons began doing hip
resurfacing in the US in 2006.

To sum up the question of "How to Select a Surgeon",
choose a doctor that you feel comfortable with. Ask the
doctor:

  • How many hip resurfacings has he/she
    done
  • How many femur neck fractures have they
    had
  • How many infections have the had
  • How many of the hip resurfacing
    operations have required a revision to a THR
  • When they trained to do hip resurfacing
  • Who did they train with
  • What is the chance of them changing
    their mind during the hip resurfacing
    operation to do a THR instead


Click Here to Print the Surface Hippy List of Questions to Ask Your
Surgeon

Some of the newer doctors are not as comfortable with hip
resurfacing and will revert to a THR if they encounter
problems.  A THR is an easier operation than a Hip
Resurfacing.  Make sure your doctor is a true advocate
of hip resurfacing. Some of the new
doctors have told me that they only use hip resurfacing in
special situations and still prefer doing a THR in most
cases.
The very experienced hip resurfacing
doctors will always give a person a hip resurfacing if
possible – some have even changed their mind during a THR
and ended up giving a patient a hip resurfacing.

Ask questions and opinions from other people, then
trust your own instincts and make up your own mind
. It
is your hip and your life.