I did cartwheels to celebrate!
When Dr. Gross resurfaced my right hip in August of 2013, he told me that I would be able to do all the activities that I normally enjoyed doing. He was right! This photo was taken the day I regained my number one ranking in the world for pole vaulting women ages 60-64. I was thrilled to be the only female to pole vault with a resurfaced hip! I did cartwheels to celebrate!
You gave me renewed hope and a resurfaced hip.
Dr. Gross, Lee Webb, Nancy Smith, et al.
A delayed note of gratitude for your excellent work. On December 4th, 2013 you gave me renewed hope and a resurfaced hip, to pursue my long time passion of ultra-running. In June 2014, with six months full recovery, I ventured back into the mountains and trails to begin renewing the lifestyle I knew before.
I can surf again!
Thank you again for all your help with my hips. I was 29 at the time of the hip replacements. Here about 9 months and 12 months out from my surgeries, I am feeling much better. I would not say I am 100% yet, but I am continually improving. I have no discomfort sitting, standing, or walking.
I know I can trust my newly resurfaced hips.
It has been 14 months since you performed my bilateral hip resurfacing and I am writing to inform you of how the newly resurfaced hips are performing. In one word; FANTASTIC! To describe my results more completely, I will relate one particularly noteworthy experience since the operations.
Apart from the expected discomforts in the first week following surgery and the agony of waiting the six months to be free of the limitations I agreed to follow, the recovery period was really very easy considering the fact that, well, both hips had just been replaced. It would be reasonable to expect much worse.
Dr. Gross performs multiple types of joint replacement including revision surgery. We monitor all of our patient’s results long-term. The American population is highly mobile, and 80% of our patients come from outside of South Carolina. But we still manage to maintain up-to-date follow-up in 96% of cases (many of our patients do not feel the need to follow-up since they have excellent results with no pain; even if this is the case, we still recommend routine follow-up). We periodically update results for the most common procedures performed.
Survivorship Curves: We use the Kaplan-Meier method. This takes into account patients being lost to follow-up as well as deaths due to unrelated causes. Each failure is time weighted by this method. The resulting curve provides the odds of an implant still being in place in the patient at any chosen time point from surgery. Joint replacements are not permanent. The longer that you follow a group of patients, the higher the failure rate that you record. It is very difficult to compare previous results to more recent cases because of the difference in follow-up. But if techniques improve, the survivorship curve of the latest group of patients will be higher and flatter than the previous group. The following results are some of the best in the world; see our publication section for comparison of these results to other surgeons.
1. Hip Resurfacing
We include three distinct groups for your review. The first was the Corin Hybrid from 2001-2005, the next was the Biomet Hybrid 2005-2007, and the final is the Biomet uncemented which we have used since 2007. You can see that results are improving in each group. It is difficult to prove the exact reasons for improvement. Some surgeons advocate patient selection to improve their results (perform total hips instead of resurfacing on higher risk patients). I disagree with this approach. I have focused on studying the root causes of hip resurfacing complications and then modifying both techniques and implants to improve results in all patients. My goal is to allow all patients to realize the advantages of hip resurfacing. The rising survivorship curves in unselected patients prove that my philosophy works.
- Survivorship curve for all three implants, as of 2016. Note that the survivorship y-axis begins at 85%.
- There have been NO instances of adverse metal wear since perfection of our RAIL guidelines in 2009.
- Below are survivorship curves seperated by age. Note the y-axes start at 80%. P-values less than 0.05 indicate that each new implant has outperformed its precursor, with our current uncemented ReCap option presenting the greatest survivorship.
- Many centers report greater rates of failure in young, active patients than in their elderly population. Our surgical technique gives us better results than these centers, and we pride ourselves in providing an arthroplasty option which allows young patients to maintain their high levels of activity without compromise to implant durability.
- Survivorship for the Hybrid (H) ReCap implant at 12 years is 95.1% for patients over 50 and 95.6% for patients under 50 (no statistical difference between the two age groups)
- Survivorship for the Uncemented (UC) ReCap implant at 9 years is 99% for both age groups.
- Our Biomet implants outperform the outdated Corin device. Below shows results of this device (cemented and uncemented included) grouped by gender. Note the y-axis BEGINS at 95%.
- Many hip replacement surgeons opt to exclude women from receiving surgery because of poor published results. We, however, elected to find out WHY implants in women were underperforming and to CORRECT implant design and surgical technique instead of excluding women from surgery. After implementation of new protocols from 2007-2009, outcomes in women at our center have improved drastically (see our publication section ). With continued collection of results, women are on track to present similar survivorship outcomes as men at our practice.
2. Total Hip Replacement
The need for hip replacement continues to shrink as the complication rate for resurfacing falls. Hip resurfacing started out as a temporizing measure for younger patients to preserve bone. Most surgeons still prefer plastic bearing hip replacement to hip resurfacing. My first choice is usually hip resurfacing. In the few patients that are not good resurfacing candidates, my next choice is large metal bearing total hip replacement. Hip dislocations are completely eliminated by this choice. Other surgeons are reluctant to use these implants because of a fear of adverse metal wear related failure (AWRF). This has been a common failure mode among some brands (DePuy ASR recall 2010). But this a rare problem with the Biomet design. AWRF is now completely avoidable if you take advantage of our recent published data on proper cup positioning. A 28mm plastic bearing hip carries a 4-5% dislocation risk and requires permanent restrictions. I generally perform hip replacement in the very obese (BMI >35), patients older than 70 years, those with severe osteoporosis, or severe bone deformities.
- Survivorship curve for Magnum THR
- Failures n=198
- Complications n=198
3. Revision of Hip Resurfacing
More complicated than primary surgery. Our results are very close to those of our primary resurfacing cases. Our most problematic group is revision for loose acetabular components. Other surgeons have had extremely poor results in revision for adverse wear related failures (AWRF). Using an approach of limited debridement and repositioning of new metal bearing acetabular components in more ideal inclination angles we have had a 100% success rate in this problematic group.
- UPDATED PUBLICATION (as of 2016) IN DRAFT WILL INCLUDE:
- Survivorship curve
4. Total Knee Replacement
Publications and data coming soon. Please see our Current Topics and Related Links on the subject.
5. Complex Revision Total Knee Replacement
Publications and data coming soon. Please see our Current Topics and Related Links on the subject.
I'm happy to walk pain-free!
I'm 10 weeks post-op. I enjoyed the article that was written about me and how Dr. Gross became my doctor as well as a bit about "resurfacings." I'm trying to educate! The picture was pre-surgery, so I will look forward to getting another photo when I start to work my way back a year after surgery! In the meantime, I'm happy to walk pain-free!
Read the article here.
- K. G.
60-year-old pole vaulting gymnast from Iowa
Do your research and select the best surgeon possible – like I did.
In 2010 and early 2011 my arthritic right hip finally forced me to give up or cut back on a lot of the activities I loved–competing in triathlons with my son, winter hiking on snowshoes, and barefoot water skiing.
In addition, snow skiing, slalom water skiing, and just plain walking without limping became problematic. As I researched hip resurfacing and found Dr. Gross, I began to have hope for the resumption of a lot of the activities, but I must admit I was skeptical when Dr. Gross told me I could resume ALL of my prior activities, even barefoot water skiing. I had the surgery in October 2011 and my recovery went very well–the hardest part was holding back from TOO much activity.
I've been able to return to a very active lifestyle.
I've had both of my hips resurfaced by Dr. Gross, one in 2008 and the other in 2013. Post surgery, I've been able to return to a very active lifestyle. During the week, I work for an investment management firm. But most weekends find me whitewater kayaking in the mountains of North Georgia or Western North Carolina. This photo is from the Cheoah River in Robbinsville, NC.
Bilateral Biomet Uncemented Hip Resurfacing
2008 / 2013
I am so grateful to Dr. Gross and Nurse Webb.
I have just been for my one year check up on my bilateral hip resurfacing and everything looks perfect. I had reached the point where I had constant pain and stiffness in both hips that was affecting every aspect of my working and private life. I am a dressage instructor so having functioning hips is crucial.
I had been told that I had to have a THR but felt I was too young and active and fortunately met someone who had had a HR done by Dr. Gross. Dr. Gross told me I could do them both in the same week which would mean less time off work and I had them done in April 2012. I started back riding in October and was back to full strength by January 2013.
I couldn't have done ANY of this without this amazing surgery!
Not sure how many 64-year-old gals you have to show off Dr. Gross's work and both of your superb care. There are two NC state medals–one for a winning softball senior games team (55-60) and the other for winning the NC racquetball in my age group (60-64.)
Both qualified me for the Nationals in 2013. The larger medals are for a first and second place in an Eastern National Senior Racquetball event. Bottom line–I couldn't have done ANY of this without this amazing surgery!
Hope all's well with everyone–best always!