Hip Resurfacing in India

Robert Vacca, of Sag Harbor, New York, had always been an athlete. As a young man, he was drafted by the Milwaukee Bucks and played with basketball star Kareem AbdulJabbar. But he had also experienced symptoms of a bone disease since he was 14, and doctors could not figure out the cause of his brittle bones. He underwent a series of six operations to remove bone chips from his joints, and eventually the disability forced his retirement. Even caddying at the Atlantic Golf Club in Bridgehampton eventually became too difficult. His hips deteriorated to the point where he was confined to a wheelchair and in constant pain. At age 55, his future looked dismal.

A friend at the Sag Harbor Gym told Mr. Vacca of a “60 Minutes” episode he had seen about new hip resurfacing treatment available in India. Unlike the standard hip replacement, in which the head and neck of the thighbone are removed, hip resurfacing does not remove bone. Instead, a metal cap is fitted over the end of the thighbone and fitted into a metal socket in the hip. There are a number of advantages to this procedure. The usual hip replacement involves polyethylene, which produces wear particles that damage the surrounding bone, often requiring revision surgeries. With hip resurfacing, only metal is used, and the bone actually grows stronger, with no need for revision surgery. Hip resurfacing takes less than two hours and patients can resume strenuous physical activity in about three to six weeks. Range of motion is greater, and movement is not restricted as it is after conventional hip replacement, to prevent dislocation and excessive wear of the prosthesis. In fact, hip resurfacing patients are urged to be physically active after the surgery. This innovative procedure has become popular in many countries but is still waiting for approval by the Food and Drug Administration in the United States. Vacca had the option of getting into an experimental clinical trial in the U.S. — at a cost of about $28,000 to $32,000. Or he could go to India, for a cost of about $6,000.

He read a New York Times article about Dr.Vijay Bose, at the Apollo Hospital in Chennai, who was considered one of the best resurfacing specialists in the world. So Vacca scheduled his own hip resurfac

ing with Dr. Bose, and after a 20hour flight he arrived in Chennai. Dr. Bose met with him for an hour before the first surgery to discuss his condition and the procedures, and after the surgery he checked on Vacca twice a day. Vacca then spent a week of additional recovery time at Fisherman’s Cove, a lavish resort spa over looking the Indian Ocean. Since he needed both hips resurfaced, the total cost amounted to $12,000 for his two surgeries, 14 days in the hospital and resort, anes thesia, and prescription drugs. A month later, his friend was astonished to see him walking and exercising — and because Vacca no longer stooped from pain, he appeared to be four inches taller.

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"When I arrived,no one asked me if I had insurance, no one inquired as to my
method of payment, and no one asked me to fill out one form. When I asked who
should I give the bank draft to,Iwastold, ‘That’s not important right now. You have sur
gery in the morning. Take care of it when you feel settled.’ ”

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