Revision THR What can I expect?

[Sockeyewillie]

I'm scheduled for a revision of my THR on my right side 5/18/23. My original THR was on 5/4/20.
After approx. 6 months of recovery I began experience occasional pain in my right femur area. I have been unable to run
due to pain. Sometimes when rising from a sitting position I limp from pain for the first minute or two. If I roll onto
it on a hard surface it registers an easy 7-9 out of 10 pain level. I have had 2 bone scans, 1/22 and 1/23 and also an MRI 2/23.
I have been on Meloxicam for several months with no positive results. Stopped due to increased BP. I have done 2 rounds of prednisone, no positive results. Experiencing constant pain of 1 out of 10. I always notice it but sometimes its just what it is. I walk 4-6 miles a day uninhibited. After all examinations, tests, scans, and drugs, my Dr says he can't say exactly what is causing my pain but it's time for a revision. He also said it may not feel any better afterword. Let's hear your thoughts, questions, and ideas. Thanks.

 

[Layla]

Hello, welcome back. I am sorry for the pain you continue to deal with.

Are you willing to get a second opinion from another OS, a revision specialist, totally unrelated to your current surgeon's practice?

my Dr says he can't say exactly what is causing my pain but it's time for a revision.

To be honest, this would make me uncomfortable. No diagnosis, let's just switch it out?

 

[Sockeyewillie]

So my original OS has been with me all the way through this. He referred me to another surgeon within the practice, Atlantic Orthopaedics & Sports Medicine in Portsmouth, NH, to then look over my situation without advice. This surgeon sent me in for my second bone scan and MRI to check for sciatia then evaluated my condition. I completely trust them both, 1st Dr. Ahkil Sastry now Dr. Michael Morwood.

 

[Layla]

If you're comfortable with that. I can't say I would be, I'd want a second opinion and diagnosis from a revision specialist totally unrelated to current surgeon's practice. Can't hurt, right? This is major surgery and while there are never any guarantees, going in blind, with no idea of what's wrong and no reassurance the problem will be fixed wouldn't sit well with me. I'm not trying to confuse you, just wish you had more to go on.

 

[Sockeyewillie]

Let me clarify that I can't say there is no diagnosis. I completely trust my current practice. My Dr. isn't going in blind.
It's just that after this period and my confidence in them, at my last visit I went in expecting and wanting a revision. So when he said it was the next option it took no convincing. I can't live with it as it is for the next 30 years.

 

[Layla]

I am sorry you have to go through this. I wish you only the best. Please stay in touch and share your progress with us. We'd love to support you as you're healing.
Have a nice day, Sockeyewillie!

 

[Sockeyewillie]

Hoping to hear about other peoples experiences

 

[Eman85]

In all of the tests did they see something wrong with the implant in the femur? Is it loose? I just went through an episode where I hurt myself and thought I might have damaged the implant. Went to the OS for a check and they felt it was only muscle. I would want a clear reason for the revision first.

 

[Pumpkin]

@Sockeyewillie
I merged the duplicate thread in the Post op forum to your existing thread in the Pre op forum where you had several responses. You are in pre op for your revision, many post op members check the post op thread and will be able to address your questions and concerns here.

Your recovery from your revision should be similar to a primary THR.

Here is a list of members waiting for revisions, Pre op Revision Threads
Here is a list of members who have had revisions, Post op Revision Threads

 

[Sockeyewillie]

I'm 3 years post-op

 

[Jaycey]

To read about other members experiences with revisions, go to the post op forum and look for the Revision THR prefix on the threads there.

 

[Sockeyewillie]

In all of the tests did they see something wrong with the implant in the femur? Is it loose? I just went through an episode where I hurt myself and thought I might have damaged the implant. Went to the OS for a check and they felt it was only muscle. I would want a clear reason for the revision first.

No sign of any loosening. from the 1/22 to the 1/23 bone scan it showed continued bone growth. The revision surgeon says it may be a bad match. I've scheduled an appt next Friday to talk further.

 

[Pumpkin]

Have you done any metal allergy testing?

 

[InkedMarie]

So my original OS has been with me all the way through this. He referred me to another surgeon within the practice, Atlantic Orthopaedics & Sports Medicine in Portsmouth, NH, to then look over my situation without advice. This surgeon sent me in for my second bone scan and MRI to check for sciatia then evaluated my condition. I completely trust them both, 1st Dr. Ahkil Sastry now Dr. Michael Morwood.

Hello from Gilford, NH! Back in the 90’s, I worked at Portsmouth Hospital. The Ortho guys I remember are Tom King and Dr Sutherland.

Marie

 

[Sockeyewillie]

Have you done any metal allergy testing?

No. Here’s an example of the way the pain can show up. I took my dog for a short walk then spent the next two hours plowing snow. All without any issues. Visiting my mom and her new puppy. Laying on the floor with the puppy playing and when I got back up excruciating pain in my femur. I can’t imagine an allergy would manifest itself in that way.

 

[Jamie]

I agree that if this is the way your pain manifests, it doesn't sound like a metal allergy. But, it also doesn't sound like an implant problem either since you are able to take a dog for a walk and "plow" snow for two hours. I'm not sure what that means in terms of activity (were you shoveling? using a snowblower? sitting on a snow plow?), but two hours of activity is a lot no matter what. The fact that your hip would only hurt after lying on the floor with the puppy to me suggests a soft tissue or impingement problem (assuming that your testing has ruled out a fracture). Where exactly is the pain in your femur? And is it always in the same spot? Does it come more from the pressure of being on a hard surface or also when you are especially active in some way?

I have to admit that your situation is not what we typically see here on the forum, so you probably won't find people who have experienced this and moved beyond it. When you meet with your current surgeon, have a chat with him about how many hip revisions he does in a typical year. You do want someone who is experienced with that particular surgery and that would be my only concern. I see that he has had training in adult reconstruction, which would make him a good choice for your surgery if he's practicing that pretty regularly.

I'll be following your story and hope your surgeon is able to identify the problem. It is good that you've had all these scans to check things out. I'm sure he's told you that sometimes the imaging just doesn't show everything, so it's possible there could be something he would find and fix in a revision procedure.

 

[Sockeyewillie]

Snowplowing means a plow truck. The pain is always the same place, femur area. It isn’t limited to when I’m in a laying position. Sometimes I experience it when rising after an extended period of sitting. Again, I’ve never been able to run since my THR. I can’t land on my right leg. I feel like I can walk all day sometimes and other times I feel like I’m not going to be able to get back home. I plan to hike my first 4000 foot peak of the 48 in the White Mountains before my 5/18 revision. It’s a mystery to me but worlds better than before the THR. I have also lost 110 lbs since my THR 3 years ago which should only make thing easier.

 

[Sockeyewillie]

I have an appt. now for 3/10, next Friday to talk more about it and whether I should get a second opinion.

 

[zauberflöte]

Hi @Sockeyewillie , I'm sorry you are going through all this. The only thing I really have a comment/opinion about is, if somebody told me that my revision (of any surgery!) might not solve my pain, I, being somewhat more aged than you, would max out my medical year's out-of pocket amount looking for other things that are "connected to the, thighbone" only because I myself (and this is definitely me!) would hate to have not looked at everything.

I sometimes have a hip quick pain on getting up, generally after either sitting too long without moving, or sitting after a period of joint-challenging activity. It's always on the right side. Coincidentally (or not), that's the side with the malfunctioning S-I joint, which generally refers pain all the way from above my waist to my foot. Not sure that's apropos of anything here, though.

Keep us posted! I'm glad you have another appointment. And I'm rooting for your 48 4K-ers, too!

 

[Sockeyewillie]

We are going with a mismatch between femoral component and surrounding bone. Surgery will go as scheduled.