Sheesh, not an easy decision!!!

I wish I had some "words of wisdom," to swing you one way or another...but I have a friend who did fork over the $35K and get the hard ceramic about 10 years ago; when he was in his 40's (he was shot, and the bullet richoceted around in his gut, shredded that, and then lodged in his hip, shattering the entire joint; forcing a replacement...but initially, his condition was obviously so critical--he was listed as "extremely critical" for two months we didn't know from day-to-day if he'd survive; I got to be friends after providing his pre-hospital care as an EMT in my nursing school days, but he had access to the funds because of a settlement resulting from the shooting); and I called him last week to ask how his hip is holding up, and he said he had no pain, great mobility; and that there appears to be no wear and tear on it at all: it's made of a cemented-type hard ceramic hardware: like your doc said-no metal at all.

The innate problem with any kind of metal implant is essentially twofold: First, your body sees it as a "foreign invader" and the immune system; as with any "transplant" it will begin to reject, but releasing large amounts of immune cells; as well as red blood cells-which leads to clotting. Clotting leads to "pulmonary embolus" or blood clots in the lungs (very deadly), heart attack (if the clots end up in the coronary arteries), or stroke (if the clots go to the brain and lodge there), but the body's natural response to any kind of large metal implants (some cause worse responses than others, one of the multitude of problems with Depuy) is to form clots. And the clots will lodge somewhere, and not always the "Top 3: the lungs, heart and brain" but can lodge in peripheral blood supplies to different limbs, cutting off blood supply there. So many, if not all, patients with the replacements, particularly the hip; are placed on blood thinners, such as Coumadin (which is extremely hard to regulate; and requires a lot of education, because one salad; if it's spinich salad for example, can totally neutralize the coumadin they've taken that day because Vitamin K is the antidote to Coumadin; and spinich is very high in Vitamin K; just one example), otherwise known as Warfarin. The dosing is tricky; like Monday, Wednesday and Friday you take 2.5mg, Tuesday and Thursday you take 1mg, Saturday you take 1.5mg, and skip it Sunday. Who the heck can keep regular track of that??? I know it'd be hard for me. Planners help; but they don't solve the problem.

So, if given the choice, and if they can keep your pain under control, if it were me--I think I'd wait as long as possible. Then there's a higher likelihood that you're going to also have better technology, so that means no metal, no blood thinners; which could potentially make the most minor injuries potentially deadly; emergency surgery trickier than it already is, and so on. My friend is on no medications to thin his blood, and the hardware they used has relieved his pain so well that when he does take anything for pain; it's usually an OTC med, and even if not, it isn't related to anything about his hip.

The question would be: How long can you stand it? It seems that would be what it kind of boils down to. Which means there's no easy answers. But avoid metal implants at all, if you can.

Also, I might consider contacting Johns Hopkins: they are the leaders in bone grafting: taking (yeah, sounds morbid, I know) donor bone from consenting cadavers (obviously before they were cadavers ), and graft the bone into your hip instead of using anything artificial. I don't know, but I believe in some cases, depending on diagnosis, it may be considered experimental, particularly in cases of the hip. But it's had excellent success in crushing injuries, for example, when the tibia would be crushed in a car accident. But in the case of the latter; the health insurance company isn't paying the bill, so the rules of payment are totally different, and straight up, I can tell you-not cheap, so check it all out. And I don't know your particulars, so bone-grafting may not be an option since you've had the resurfacing. But your age needs to be taken into account...being wheelchair bound has to suck, let along spending your mid-life in one...

Just some thoughts. I hope someone/something leads you to the decision that's right for you.

Good Luck.