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36 yr old w/ AVN sched. for THR 12/8/09

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Trying2StayHip

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Hi Everyone!

My name is Bryan and I am scheduled for a THR on 12/08/09 with Dr. Muschler at the Cleveland Clinic.

Nine years ago I was diagnosed with AVN in my left hip. Six years ago I opted for a vascularized fibular graft with hope that it would save me from a hip replacement for at least ten years. The graft was a success, however, arthritis has overtaken the hip and I have suffered horrible pain in my left hip, lower left back, and left knee - causing me to limp pretty badly for the past two years. I was also diagnosed with AVN around the knee of the same leg a year ago, but according to my surgeon - there is no need to operate as it is above and below the knee - not actually 'in' the knee.

Now I am trying to decide which prosthesis to go with. My surgeon has recommended ceramic on ceramic. I know he consults and researches for the company...I think its Stryker. A previous surgeon in Pittsburgh recommended a metal ball and plastic cup, which he researches and consults for. So confusing...the decision-making process is actually unpleasant. Obviously I am afraid of choosing the wrong one. So many people I have met have suffered dislocations - its rather disheartening. But reading some of the posts here - is very uplifting.

My wife had our first child, a boy, this past April. He is my pride and joy - but caring for him during the day and working at night has made my body feel even more of a wreck, crippled really. Naturally, I hope the THR will give me back some of my life and the ability to play on the floor and carry my boy at length without pain. Just as much, I hope my THR gives my wife some of her life back as well!

I was very physically fit and active prior to my AVN, but all the pain has made it hard to maintain weight, etc., which obviously makes the pain worse. Such a cruel and vicious cycle.

I am thankful to have found this site and look forward to perusing more threads, as well as making your acquaintances. See you around!

Best,
Bryan Rapp
 

Judles

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:thmb:Welcome Bryan Rapp! And get ready to get your life BACK! I am so excited for your wife and your baby that relief is on the way! Whatever prosthesis is chosen for you......with exercise and PT, you will be better than new! Keep posting so we can follow your progress! You'll do GREAT!!! :thmb::wink:
 

JoeArizona

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Hi Bryan,
Congratulation on your new baby boy! I envy you for the experiences you are about to have. I wish I do do it all over again...it's great.
Good luck with your surgery!
I'm new here also, and am scheduled for a right hip replacement in January.
My dr. suggested I do as much research as possible and we would then decide together on the right material for my replacement. So I'm very interested in your research also.
I want to get the right replacement because although I am 52 I was very active before the intense pain began about a year and a half ago, and could easily pass for 51.5 or so.:D I want to be as active as possible for as long as possible.
I have children ages 9 and 12 and am looking forward to getting back to all our activities together again. Along with their mom we were a pretty active family.
So...welcome and keep us posted on your research.
 

JudyS

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Hi Bryan and WElcome. YOu will get your life back. New hips are great. JUst as long as you have a great surgeon who does many many hips per year. I am 52 and very active. I was a trail runner before my replacement. Of course that is the only activity that my surgeon does not allow after. Although i have done a very little and it feels great.
I have a ceramic ball with a poly cup. My surgeon was originally going to use ceramic on ceramic. Then he told me of the noise of some of that type. I certainly did not want to squeak. So he changed it to ceramic on poly. No squeaking!! It is suppposed to be the longest lasting for very active people. The metal just may cause some particles to be roaming around and the jury is out as to whether there are any long term effects with that.
My ROM is awesome, better than the other hip which is normal.
Congrats on the baby. I have 4 kind of grown ok older kids.
Good Luck i am having surgery on Dec 11th. It will be a good week, i've been waiting a long time for this, back surgery.
judy
 

Josephine

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Both those were true, Judy but things have moved on. Only a very tiny number of people have problems with ceramic on ceramic and the metal ions are only (probably) a real problem for women of child bearing age.

So if you take a tip from one who knows, Bryan, :wink: you'll find a surgeon who uses
a) ceramic on ceramic and
b) a 50mm or bigger head/cup.

I don't usually say this because I am a firm believer in chose the right surgeon and let him chose the implant. Choosing the implant is a skilled job and the surgeon has the skill, that's why you're paying him the big bucks! But on this occasion, I would venture to suggest this.

However you must choose a surgeon who uses these routinely. Never, ever let a surgeon loose on you who normally uses something else. A hip is not "a hip is a hip is a hip"! In this case, different hips have different tools and maybe even a different surgical technique so if you really want to go with this, then find a surgeon who does them. He also needs to do a lot! 500 a year absolute minimum, but 1,000 would be better! Anything less than 500 is just a hobby and you don't want to let a hobbyist loose on you.

Metal on plastic is okay but I'd be looking for something a bit more durable at your age. Why settle for 15-20 year life span when you can get something that's going to last a lot longer? And ceramic will.

Another thing - has anyone suggested hip resurfacing? It might be the avn is too advanced but do look into it as it's a good alternative for a total hip you want to last a while. You can find a lot of information here http://www.somewhere else.info/ and they have a forum here http://www.somewhere else.info/hiptalk/. They'll soon tell you what it's all about! Those sites are nothing but HR!

You should also read the thread How to choose a surgeon and a prosthesis as there is a lot to think about when choosing a surgeon and all.

Please come back and ask more questions if you wish. I'm always here.


BTW my nephew is called Bryan! You're the first other Bryan with a y I've come across!
 

Jamie

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Hi, Bryan....welcome to BoneSmart! Jo has given you such excellent advice. I hope you will begin to feel less anxious about the decisions and your surgery. Don't hesitate to post any time you have a question or concern. We'll always be here for you!!
 
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