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2 months post OP. Came home with bad news :(

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tapan

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Hello my dear fellow hippies. I have come to you for advise and help once again. Yesterday was my 2 months post OP appointment. After taking the X-rays, my surgeon noticed a small gap (i guess you can call it dead-space) between the new metal joint and my natural pelvic bone. I don't know if I am making myself clear but I am referring to the area where the new metal joint (not the femur) is snug/attached tightly to the pelvic bone. In normal hips, you would be able to see a layer of cartilage instead of this gap.

Although my surgeon said its nothing to worry about as most likely the bone will grow back in its place, I am pretty worried about it. What if the gap increases? I was assured that hip dislocation WILL NOT happen as its too late for that now. If my hip was to be dislocated after surgery, it would have happened a long time ago.

Any advises/tips for me guys? Has anyone of you or your friends ever gone through the same thing? I would really hate to get a revision surgery as I don't want to be spending an additional year in university.
 

Texas

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Hey Tapan, Im a knee but Im sure others will post and help. I hope everything works out for you think positive.............) you will be in my prayers take it easy...........
 

Judles

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Hi Tap! I am so sorry about your snag! I don't know what you mean you have a space, but then your OS tells you not to worry! If HE assures you that....and now the risk of dislocation. is so much less....what does this mean in the future? Please stay positive! I would call your OS and have him explain more clearly what this means for you! Good luck!
 
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tapan

tapan

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Hi Tap! I am so sorry about your snag! I don't know what you mean you have a space, but then your OS tells you not to worry! If HE assures you that....and now the risk of dislocation. is so much less....what does this mean in the future? Please stay positive! I would call your OS and have him explain more clearly what this means for you! Good luck!
Hi Judles. I am not very descriptive/clear when it comes to scientific understanding. I am still waiting for a copy of my X-rays on a CD which I should be receiving hopefully by tomorrow. I will post two x-ray images (WITH and WITHOUT the gap) of mine for a better visual representation. Stay tuned guys. Thanks
 

JudyS

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I'm kind of with Judles, if your OS says not to worry. I wouldn't . When are you supposed to go back to the surgeon?
judy
 
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tapan

tapan

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I'm kind of with Judles, if your OS says not to worry. I wouldn't . When are you supposed to go back to the surgeon?
judy
My surgeon said that he likes to follow up on his young ones sooner than most hippies. I am scheduled for a 4 month post OP after 2 months - on Nov. 19/09. However, I am making an appointment with him in a couple of days to get some more insight and knowledge on this issue. I have done extensive research on the internet and I wasn't able to find a single website that described the same situation as mine. Also, all of the X-ray images posted on websites had a perfect fit of the new prosthesis. I wasn't able to fine a single image with a slight gap/dead-space like mine. This is the main reason why I am so worried about it. Maybe its an extremely uncommon problem but I would certainly like to know its associated life risks.:pray:
 

JudyS

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WEll I have to admit i would probably do the same thing. Let us know what he says .
judy
 

Jamie

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I'm pretty confused about it myself, Tapan....if you can post the xrays, it will help. Josephine will be the best person to comment once she sees the xrays. In the meantime try not to worry!
 

Josephine

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I understand what you're describing, Tapan. You didn't do a bad job, actually!

Was your hip cemented or uncemented? Makes a difference tha knos! I'll check on the xray when you post it.
 

Jamie

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Jo to the rescue once again!!!!
 
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tapan

tapan

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Josephine. Here are my X-rays sorted by the date they were taken.



This was taken on the day of surgery.



This was taken the day following the surgery.



This was taken 3 weeks post OP.



This was taken 8 weeks post OP. This was the X-ray I was specifically referring to. Notice the thin black space between the metal prosthesis and the pelvic bone. I just noticed that a similar type of space was to be observed in all of the 4 X-rays; however, not in the same position. See it for yourself. Can you lead any advises/conclusions out of this Josephine? I really appreciate your input guys. Thank you. Btw, my surgeon used an uncemented prosthesis for me.

I apologize for the poor/yellowish image quality. The cd shows perfect colour contrast and proportions; however, it looks yellowish upon exporting it to an image.
 

Josephine

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Yes, I see it and the images are fine. The apparently changing positions might be caused by slight differences in angle showing different densities of bone when the xray was taken.

One thing I notice though, is that although in xrays 1 and 2 the implant is tight to the bone at the 'equator' of the cup, a small gap between 11 o'clock and 12 o'clock seems to have appeared on xray 1.

On the Aug xray, the bone is still tight around the 'equator' but there is a wider 'flare' of dark between
11 o'clock and 12 o'clock.

On the Sept xray, it would appear that the flare starting at
12 o'clock has progressed all the way down the left hand side of the cup to the edge. There also appears to be a similar fine space from about 2o'clock to the other edge.

Now this just might be the contrast between the intense white of the implant or it might be a slight gap between implant and bone. To be honest, I'm thinking this is more likely to be a gap and therefore a bit of a problem but how much its difficult to say because only see the horizon of the implant can be seen - obviously.

You haven't said you're experiencing any pain which is good. And dislocation was never an issue anyway. What is an issue is the commonest of complications in joint replacement surgery and that is 'micro-movement' meaning the cup's not about to fall out but it can shift
a little bit as you walk or move because the bone has not fusing with the implant into a perfect, solid fit.

If I were you, I'd get a second opinion from another hip surgeon not connected with this one, and see what he says. After this you'll never be happy until you have a proper review of it. (Hope I haven't scared the wits out of you!)
 
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tapan

tapan

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Thanks Josephine. Don't worry, you haven't scared me at all. In fact I am glad you confirmed my observations about varying gap levels in all x-ray images. The unfortunate part about Ontario (province I live in) in Canada is that health system is not privatized. This means that I can't just go to any other OS and get a second opinion until I get a reference for them and this process takes weeks to even months. I am sure you have heard bad reviews about the Canadian health system.

Btw, this so called 'gap' isn't causing me any pain. In fact I feel that my pain levels are on a decline as days go by. My range of motion seems to be improving daily and I just got off the cane a couple of days ago! :D Hooray.

I have booked an appointment with my original surgeon for day after tomorrow. I will keep you guys updated. Thanks a million for the input. :p
 

Josephine

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Well, I'm glad it's asympotmatic at the moment. That's good. There may well be lots of people walking around with similar issues but they don't ever move in such a way as causes pain.
 
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tapan

tapan

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Hi Jo. I spoke to my OS today and he assured me that everything is ok and I shouldn't worry about anything. According to him, the joint wasn't PERFECTLY snugged in its place; however, that poses no harm in the future IF the gap doesn't increase. The reason being is because of the type of hip joint used in me which isn't too common and requires much more custom fitting than most other patients. This is true as my surgery took about 2.5 hours when most patients get their hips replaced in about 45 mins or so. According to him, this gap should decrease as my age is very young (just 21 years) and my bone will most likely grow in the gap. Also, he said that I don't have micro-movement as that will cause extreme pain and it would feel as if someone's taking a knife and stabbing you in the leg. Although, the magnitude of the length of the gap will be diagnosed again after 2 months. What a relief! Finally I can spend my days without worry...:wink:
 

Texas

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Hey Tappan 21 yea it might just do that and for your sake i sure hope so..If he has done a good job so far then i would trust him like you do....I agree let it o if it doesnt hurt...Take care you will be out and about in no time..............)
 
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