I saw the NJ OS a few days ago, he was great! He specializes in revisions and other problem cases and he put my mind at ease.
First, he assured me that my previous surgeries were done correctly and the best hardware was used for both. He said has done revisions where the stems have slipped right out for no apparent reason, he said it can just happen - basically just bad luck and I shouldn't be concerned or worry about it anymore. As far as the hip I have in now, he said he would have used the same type, an AML, and he said it is known to have a longer period of "settling" or "modeling" time b/c of the type of metal it is made out of. He has had patients who have had pain for 1-1 1/2 years after surgery, but it goes away and then they are fine. There are other types of implants that he uses in revisions, but they are not built to last as long as the AML. Revisions are often done on elderly people who do not need their revision hip to last as long as their original hip. He said b/c I am so young, the "normal" hip put in for revisions wouldn't have been the best choice for me, which makes sense.
Second, he came up with a game plan that makes me feel like I am not going to have to live in pain forever....
Here is the plan:
Within the next could of weeks....
-I will be doing the Dual Isotope bone scan up here in NY to see if we can get a better idea of the size and scope of inflammation on my femur. This scan can maybe help determine if it is infected, loose, or a stress fracture.
-We will run more bloodwork to check for infection - A SED Rate, CRP, CBC w/Platelets, BMP, PT, PTT, and INR (I am not sure what the last three are - I haven't googled them yet!).
-I will have a rare test called an Alpha Defensin test. It is one of the best, if not the best, tests for periprosthetic joint infection. The NJ OS was able to find a test kit in NJ, so I will be going down to a hospital ASAP to have a hip aspiration done, the fluid they get out of the aspiration is put into the tubes of the kit which is then hand delivered to a lab that is able to perform the test/observe the tubes for growth in order to determine if there is any infection. They will also run the normal hip aspiration tests too.
-If the tests come back positive, I will need two more surgeries to take care of the infection. I truly don't think it is infected! I am keeping my fingers and toes crossed that it isn't. If it is, I will go into the details of the surgeries I will need to have. But right now, I am keeping positive thoughts that it is just a stress fracture - kind of crazy that a stress fracture is my BEST case scenario!
-If it is NOT infected or loose and it is a stress fracture, I am going to wait it out for a little while longer. The NJ OS suggested I wait to do anything until I am 1 - 1 1/2 years out from my revision surgery (which was in 6/17) which would be around early December of this year. He said in a very serious way, "If it isn't infected DO NOT let anyone open you up until you are 1 - 1 1/2 out from your last surgery." He stressed the fact that after having 3 major surgeries in a year I am more susceptible than ever to become infected. He said If I am still having pain in December, he could do a bone splint on the outside of the femur bone where the stress fracture is. He would take a small piece of bone from somewhere else and wire it onto my femur. He said the implant looks well fit and he wouldn't want to try to take it out. I was told once we rule out infection for sure, I can start doing no impact exercise on the stationary bike or elliptical.
So that is where I am at right now. The next two week will be very informative! I'll keep you posted!
@Josephine have you heard of the alpha defensing test? We are leaning on it to determine whether or not infection is my problem.
United Kingdom
