You're in great hands with Dr. Rogerson and Orthoteam

Dr. Rogerson and his team are with you every step of your BHR procedure. Here is an outline of how your BHR procedure and recovery will proceed.

heading

Complete Physical Examination

Complete Physical Examination

Dr. Rogerson will ask that you have a physical examination and lab work with your family physician within 30 days of your surgery date. This will assist with optimization of medical records prior to the surgery and ensure that you are in the best physical condition possible on surgery day.

Pre-op discussion with a PA at Dr. Rogerson’s office:

Pre-op discussion with a PA at Dr. Rogerson’s office

We take the time to walk you through all needed consent forms, discuss your inpatient hospital course, update x-rays if needed, take range of motion measurements, receive forearm crutches, receive prescriptions for post op use, as well as address any specific questions you may have about the surgery or the recovery process.

Ask about your medications

Ask Dr. Rogerson's PA at your pre-op discussion whether or not you should take your routine prescription medications the morning of your surgery.

image desc

HipHab Rehabilitation Tour

You will receive forearm crutch instructions and tour the facility, including land/pool exercise departments. This is typically same day as pre-op discussion for out-of-town BHR patients. We will also discuss PT and OT post-op exercises.

If you are an out of town BHR patient, these prescriptions will be mailed to you prior to your discussion. You will meet Dr. Rogerson if you have not already and have all of your pre-operative questions answered.

Last minute questions

You will see Dr. Rogerson and have the opportunity to ask any last minute questions prior to going to the operating room.

Surgery Day

We are with you every step of the way.

You will meet and talk with the surgical staff, including the surgical nurse and the anesthetist that will be caring for you during the surgery. You will discuss your anesthesia concerns. After all of your questions are answered, you will be taken to our special high volume air-flow operating room.

Your surgery will last 2.5 to 3 hours. Any friends or family with you will be notified when you are moved to the recovery room. Most patients spend approximately 1-2 hours in recovery room before transferring to the Medical/Surgical unit on the 3rd floor. You will spend the remainder of your hospital stay here.

After Surgery

If you are feeling up to it, you may get out of bed to use the restroom and sit in a chair for comfort. You can also begin basic, sitting PT exercises the same day as your surgery. 

feature-1.jpg

Post-Op - Day 1

You will have PT twice daily. Once you are cleared by a therapist, you may walk the hallways in between therapy sessions, and are encouraged to be as mobile as possible.

feature-1.jpg

Post-Op - Day 3 to 5

Following hospital discharge, you will receive several days of land and aquatic therapy with Dr. Rogerson's innovative HipHab rehabilitation program and stay in a private apartment at Capitol Lakes in downtown Madison. Dr. Rogerson utilizes a Prineo water resistant wound closure reinforced with a waterproof Tegaderm dressing to ensure wound sterility. This innovative approach to rehabilitation seamlessly moves you from hip resurfacing surgery to home. Our HipHab program is modeled after proven programs in Europe to ensure the best-possible outcomes.

feature-1.jpg

Post-Op - Day 2

After your PT session, you will transfer to HipHab and continue therapy for 3-4 additional days. Your therapy will include land and water exercises. A two week wound check appointment with a PA, and a five week post-op appointment with Dr. Rogerson will be made for you, where x-rays will be taken to show you your new prosthesis.

feature-1.jpg

Post-Op - Day 6

You will receive a 1-on-1, land-based, exercise session. Staff will review exercises you can continue at home, and provide recommendations for continued rehabilitation. Based on your PT progress and wound healing, you may be able to leave HipHab that day with Dr. Rogerson's approval.

As of April 14th 2015, I have now performed 797 hip resurfacings since 2006. This number is not including surgeries I have observed or assisted with, or hemi-resurfacings.

I perform all of the hip resurfacings personally, with one of my two PAs as the first assistant. We have a very well-trained team at Stoughton Hospital that also assist in the procedure.

I trained with Dr. McMinn and Dr. Treacy in England in 2005, and also visited and scrubbed in with Dr. DeSmet in Belgium in 2005. Prior to going to Europe for my training, I visited Dr. Schmalzried, Dr. Mont, and Dr. Stachniw and scrubbed in for surgery with those physicians in 2003 and 2004. I also performed metal-on-metal big femoral head arthroplasty for approximately four years prior to starting to pursue metal-on-metal hip resurfacing.

I have used the Smith & Nephew Birmingham hip resurfacing prosthesis since its FDA approval in 2006. Prior to it receiving FDA approval, I performed one Wright Medical hip resurfacing using a compassionate use permit from the FDA. I definitely prefer the Birmingham hip prosthesis compared to others that are presently on the market. This relates to the metallurgy of the prosthesis, particularly the acetabular component, which is an “as cast” metal with large block carbides and better wear characteristics than heat treated metals. The precise instrumentation and the line-to-line fit for the femoral component of the Birmingham is the best on the market, and Drs. McMinn and Treacy’s 16-year results with the BHR are very impressive when compared to total hip arthroplasty results in young, active individuals.

In my series I have seen one superficial and two deep infections. One deep infection started from a drain site, and we no longer use percutaneous drains postoperatively. The second deep infection occurred a year and a half after the hip resurfacing procedure from an infected hernia repair.

I have experienced three femoral neck fractures that went on to revision: two from excess, early high-impact activities against medical advice, and one later stress fracture well below the prosthesis. I have had one revision secondary to recurrent dislocation after the patient fell from a bleacher at six weeks post-op. I have had two deep infections, noted above, that required revision surgery. I have had one metal allergy reaction with pseudotumor that required revision. Overall, our failure rate is extremely low. In my series since 2006, I have a 98.3% survivorship of the prosthesis still functioning well.

The reasons to switch would be inadequate bone quality under the femoral head or inadequate fixation at the time of surgery of the acetabular component, or a technical error with notching of the femoral neck, which would make the patient more susceptible for ultimate femoral neck fracture. At the present time, I would use the Smith & Nephew titanium Polar stem with an Oxinium head and a metal-on-polyethylene socket.

I have had one case, where the patient had significant cystic changes in the femoral head. Preoperatively, I informed the patient that they had a 20% chance of being a candidate for resurfacing. The patient requested to begin the surgery as a resurfacing, with the understanding that they may require a THR. During surgery, I determined that resurfacing was not a possibility, and performed a metal-on-metal, big femoral head arthroplasty for him with good results.

In my series I have had no acetabular cup loosenings or loosening of femoral components. I have performed one revision of a resurfacing done in Belgium by Dr. DeSmet for a loose acetabular component.

I use an uncemented, acetabular component and a cemented, femoral head component, which is the standard for Birmingham hip resurfacing. At the time of surgery, one sees frequently many femoral heads that are deformed and very sclerotic, and do not have good cancellous bone on the superior flattened portion of the femoral head. I believe that these types of arthritic heads do better with a very thin cement mantle within the femoral head component that evens out the forces on the femoral neck and assures good fixation in bone that would otherwise be compromised because of its sclerotic nature. Please read my blog post http://www.orthoteam.com/blog-posts/hip-resurfacing-to-cement-or-not-to-cementthat-is-the-question/ for more information.

A detailed description of your journey and what to expect.

Important information about what medicine and food to avoid prior to your surgery 

Instructions to continue your journey to full recovery.

We have provided some printable exercise sheets for you.

We have provided some printable exercise sheets for you.

Please take the time to fill out our survey. Your satisfaction is very important to us and we appreciate your feedback.

As of June 3rd, 2015, Smith and Nephew (the manufacturer of the BHR prosthesis) has declared that the BHR is now contraindicated for all female patients. For more information, read this letter sent to Dr. Rogerson. For Dr. Rogerson's thoughts refer to his blog about this development.  

Surface Hippy is a forum for sharing information and experiences among patients who have had hip resurfacing surgery. Anyone interested in learning about the procedure is welcome to participate.  A physician listing is included in the site, as well as an interview of Dr. Rogerson by Patricia Walter.

This site serves as a patient-to-patient guide to hip resurfacing. A physician listing is included in the site, as well as an interview of Dr. Rogerson by patient advocate, the late Vicky Marlow.

 

Analysis of wear of retrieved metal-on-metal hip resurfacing implants revised due to pseudotumours. From the Journal of Bone and Joint Surgery, VOL. 92-B, No. 3, March 2010.

Read Smith and Nephew’s response to the JBJS article regarding pseudotumours and resurfacing.

United States Food and Drug Administration information on Metal-on-Metal hip implants

The McMinn Clinic is a family of caregivers who work with our patients as partners to help them reach their maximum potential in mind, body, and spirit. 

Founded in 1933, the Academy is the preeminent provider of musculoskeletal education to orthopaedic surgeons and others in the world. Its continuing medical education activities include a world-renowned Annual Meeting, multiple CME courses held around the country and at the Orthopaedic Learning Center, and various medical and scientific publications and electronic media materials.

Arthroscopy Association of North America exists to "promote, encourage, support and foster...the development and dissemination of knowledge... of arthroscopic surgery in order to improve upon the diagnosis and treatment of diseases and injuries of the musculo-skeletal system.

The Arthritis Foundation is committed to raising awareness and reducing the unacceptable impact of arthritis, a disease which must be taken as seriously as other chronic diseases because of its devastating consequences. We are leading the way to conquer the nation's leading cause of disability through increased education, outreach, research, advocacy and other vital programs and services. Our goal is to reduce by 20 percent the number of people suffering from arthritis-related physical activity limitations by 2030.

Since beginning Birmingham Hip Resurfacing in 2006, a high percentage of our patients have traveled long distance to Madison for their surgery.

heading

undefinedIf you are traveling by air, you will fly into Dane County Regional Airport.

 

 Another option is to fly into Milwaukee’s General Mitchell International Airport, which is approximately 85 miles east of Madison.

For patients who would like to have their caregiver stay in Stoughton during the inpatient hospital stay:

They may sleep in the Stoughton Hospital inpatient room (no bed available - only recliner chair).

We recommend the Stoughton House Inn Bed and Breakfast; a fantastic B & B only minutes away from the Hospital.