THR Mako vs traditional THR

[PWW]

I'm new to this forum and could use some advice. I'm 73 and have always been pretty active but in the last year have slowed down because of my hip pain. Can't do the construction work I've always done. I can get by without much pain if I take it easy and use naproxen. Osteoarthritis has gotten worse over the last year so I scheduled surgery for next month. I skipped trying the shots as it seems they are only a stop gap to replacement. Do you think that is true or would you give them a try?

My surgeon uses Mako and it is going to cost me $5000 because I'm told Medicare doesn't cover that portion of it. Has anyone else had Mako surgery and had to pay for it? Do you think it is better than the traditional approach and worth the extra money?
Any comments would be appreciated, Thanks

 

[benne68]

Welcome to BoneSmart, @PWW. Please give us the date of your surgery so we can create a signature for you. It helps us provide better feedback.

We have lots of members who have had MAKO procedures and I'm sure someone will come along to share their experience.

That said, BoneSmart believes strongly that you should choose a highly qualified surgeon who does a lot of replacements each year and then trust that surgeon to use the right approach and implant for your specific situation.
Choosing a surgeon and a prosthesis

Since your surgery is scheduled, I will share BoneSmart's helpful pre-op guide.
Score Chart: How bad is my arthritic hip?
Longevity of implants and revisions: How long will my new joint last?
Recovery Aids: A comprehensive list for hospital and home
Recliner Chairs: Things you need to know if buying one for your recovery
Pre-Op Interviews: What's involved?

Good nutrition is very important for your recovery:
Dietary Tips for Recovery
Nutrition Basics

And if you want to picture what your life might be like with a replaced hip, take a look at the posts and threads from other BoneSmarties provided in this link:
Stories of amazing hip recoveries

We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery.

 

[PWW]

Thanks for your reply. Surgery scheduled for 4/11.

 

[benne68]

Thanks for the date, @PWW. Forgot to ask you which hip you are having replaced!

 

[benne68]

Also, I just noticed that a link I provided above didn't work, so I will try it again!

Here's the article: Choosing a surgeon and a prosthesis

 

[Eman85]

No clue about Mako, whatever that is. The shot is just a stop gap and it doesn't make the hip any better. If you need a hip you need a hip. The Naproxen and any other NSAIDS will get your stomach and kidneys eventually.
Did Medicare or your OS office tell you it's not covered? Either way 5k to get rid of the pain would be worth it. If you picked a surgeon and that's what they use I'd say go for it. my OS just used a regular posterior approach, worked for me.

 

[PWW]

Thanks for the info. A left hip.

 

[PWW]

Mako is the robotic tool used which Medicare doesn't cover. I know you're right about the shot which is why I haven't done them. Just second guessing myself as some days I don't notice the pain and then I ask myself why I'm getting it replaced. Then I think it's only getting worse and if I want to still be active why would I wait. Other than hoping they come up with some foam product that replaces cartilage. Thanks for taking the time to respond.

 

[benne68]

Just second guessing myself as some days I don't notice the pain and then I ask myself why I'm getting it replaced.

I can relate to this -- because I did the same thing. I kept putting off the replacement because I would have a few good days and somehow convinced myself it might get better. Big mistake! My hip suddenly went downhill -- to the point that I couldn't walk without a cane. Of course, the surgeon was booked up and I had to wait two months for a surgical date.

The new hip -- now 4+ years old -- is great. I can do everything I want, and actually forget that it's not a natural joint.

Just do it! If you are happy with the surgeon, go with whatever he recommends.

 

[Going4fun]

I've over-researched hip replacement and hip surgeons. Mako is not inherently superior to non-mako hip replacement.

If you were to ask hip surgeons to name top colleagues, most of these colleagues do NOT do Mako. It's still the surgeon doing the operation. The robot is an assist. Something about "robotic" makes it sound great and all. But what you want is a great surgeon, period. Mako doesn't turn mediocre surgeons into great surgeons. Same kind of hype follows surgery with the anterior approach. Using that approach does not mean you are a better surgeon than surgeons who use another approach.

BTW: I'm starting to see ads mentioning robotic surgery. I notice that the ads do NOT claim better results for that surgery. The voice just uses the term as if it is inherently impressive.

If you want a Mako surgeon, make sure it's a great Mako surgeon. BTW: my second hip was done by a surgeon who uses Mako. He definitely would NOT say his approach is superior to other approaches. He would say Mako works for him and has some advantages. One advantage is he is really comfortable with that method.

 

[djklaugh]

@PWW Who is telling you that Medicare will not cover a robotic assisted hip replacement? I just did a quick Google search for "Medicare + Mako" and information was that when considered "medically necessary" Medicare will cover such a procedure. And that information is available at the Medicare website. Do please check again with who ever is giving you this information ... it seems to me they are incorrect.

But as others have said here the skill of the surgeon is the biggest factor in a successful outcome. I've been coming here to BoneSmart for over 13 years and have seen reports of folks getting hip replacements via every possible incision site, technique and via every possible medical device. There are good out comes with all .... and occasionally not so good outcomes with all. In addition to the skill of the surgeon the other factors most needed for a successful hip replacement (IMO) are the general good health of the patient and the patient's willingness to be patient and heal first before trying to get back to strenuous work or fun activities.

 

[PWW]

Thanks for the information. I'll check it out.

 

[Solar7]

I can't speak for the medicare coverage, but I had a Mako assist and was quite happy with it - I'm on an Obamacare/ACA plan and indeed it was covered as part of the full cost of the total surgery.

As I mentioned, I was very happy with it - the primary reason being I came out of the surgery with absolutely zero leg length discrepancy. It's 100% perfect and has been since day one, which I credit a lot to the assist of the tech to measure everything out.

Good luck!

 

[Layla]

Best Wishes tomorrow, PWW
Please join us on the healing side once you're home and resting comfortably.
We will share our Recovery Guidelines with you on your recovery thread and hope to see you there soon!
@PWW

 

[Music_Man]

I'm also in need of THR on both hips! In fact, I'm years beyond needing it done!

Doing due diligence, I ran across the Mako process. My thoughts, if the Mako process or others like-it have a slightly better outcome, with essentially no negatives, why not opt for it?

Obviously, the surgeon and their expertise is the vital element -- their tools are secondary.

That's the same whether the approach is the direct anterior or mini-posterior etc. The studies I've read suggest that they're similar results wise, with the deciding factor being the surgeon's expertise! And like location, location, location is to real estate, experience, experience, experience in the form of volume, is a very important factor in choosing a physician.

One thing I did find was the Mako start-up and yearly maintenance cost isn't inexpensive! Thus, my supposition is that if a doctor isn't using an instrument like the Mako, it's more because of the cost, than what the technology will, or won't do. That is more than a bit irritating.

Here is a link to one study regarding the use of robotics:

"Robotic-assisted compared with conventional total hip arthroplasty: systematic review and meta-analysis"