Revision THR 8wks post op - more pain than before<<

[Jaycey]

So you don't think the bone will adhere over time?

Unfortunately no it won't. As Jo said, any growth should have occurred by 6-8 weeks.

If it were me, I would seek a good revision surgeon totally not connected to the surgeon that performed your first op.

 

[Krista]

@AMR1879, I agree with Jaycey about getting a second opinion from a hip revision specialist surgeon. I didn't think that stems would be loose, even right after surgery, even when cementless. I had a cementless THR and was allowed to fully weight-bear from the beginning. There was never a suggestion made that my stem would be loose for any reason.

Here is an article from the Bonesmart library that has some info about loosening.
Revisions: what makes them necessary?

 

[Josephine]

Did I mention my Ortho Surg told me to take 2000mg of Vit D to help with bone growth.

Vit D is good for improving bone quality in osteoporosis but I doubt it will be much help in this kind of situation. However, it won't do you any harm anyway!

I didn't think that stems would be loose, even right after surgery, even when cementless.

The commonest reason for revision is loosening of either stem or cup and cemented hips are least at risk for this.

 

[AMR1879]

If it were me, I would seek a good revision surgeon totally not connected to the surgeon that performed your first op.

I will be seeking a second opinion for sure. But I do really like my current surgeon and I don't think it is his fault that it has become loose, it is just my bad luck. I actually would like him to do the revision.

I had a cementless THR and was allowed to fully weight-bear from the beginning. There was never a suggestion made that my stem would be loose for any reason.

@Krista what did you end up doing about your pain? Did you have a revision?

After doing some research on revisions of a loose stem. It seems there are different ways to go about it. Either removing the hip replacement and putting in a new one, I think this seems to be done more for people with infection and it is done in two procedures. I also read about anchoring the the stem that is already there. Any thoughts?

 

[Krista]

@AMR1879, I am not a medical professional and don't know anything about anchoring loose stems. Everyone whose threads I have read who have had loose stems (not infections), ended up with a new stem. I'll tag @Josephine for you to answer that question, in case she doesn't see it.

To answer your question about me, I had a THR and then 15 months later, I had hip surgery to repair two gluteal tendons. Two surgeons were in on that second op. One did the tendon repairs, and the other dislocated my hip replacement implants and checked everything over to see if there was loosening, infection and if replacing the hardware was necessary. Fortunately, it was not. He also removed the bursa on my greater trochanter, and smoothed out the trochanter. Nothing in my x-rays or any other testing showed that replacement would be necessary, but since I was being opened for the tendon repair, they wanted to look at the actual site as well. These procedures have done much to relieve my pain.

 

[Josephine]

I think I answered it already

 

[Irish Joe]

@AMR1879 It's a loose stem all right. You definitely need revision surgery and I'd move on it fairly quickly with a revision surgeon which your original one may not be even if you like him.

A setback all right but not the end of the world as it can be sorted. But you need to go (preferably to another OS that won't tell you "stories")

Best Wishes.
Joe.......

 

[Irish Joe]

@AMR1879
Apologies if my previous post seems abrupt. I don't mean to scare you.
I know that a good revision surgeon will be able to sort you out.
One of the forum advisers can help you with pick one. I forget who it is but I'll tag @Jaycey and she'll point you in the right direction.
Lets Get You Sorted.
Joe.......

 

[Jaycey]

But I do really like my current surgeon and I don't think it is his fault that it has become loose, it is just my bad luck.

Sorry but it was your surgeon's fault. He put in the wrong size implant and expected your bone to grow around it. To me that is a major red flag.

Up to you if you want to give him another chance. But if it were me I would be seeking another surgeon.

 

[AMR1879]

@Krista it sounds like you have been through a lot, I am glad it has all helped relieve your pain!

It's a loose stem all right. You Definitely need revision surgery and I'd move on it fairly quickly with a revision surgeon which your original one may not be even if you like him.

Apologies if my previous post seems abrupt. I don't mean to scare you.
I know that a good revision surgeon will be able to sort you out.

@Irish Joe No need to apologize! I like reading more definitive responses than, it could be this or it could be that. I will start looking up revision OSs in my area.

If it were me, I would seek a good revision surgeon totally not connected to the surgeon that performed your first op.

@Jaycey I am going to start my search now! Even if my current OS says he can fix it, it can never hurt to get a second opinion!
Thank you all for your help and support, it really gives me hope that I will not be living with hip pain for the rest of my life. I can't remember what it is like to walk normally without pain!

 

[AMR1879]

Has anyone had complications from or issues with a THR and had a revision as soon as 4-6 months after the first surgery?? I have been reading a lot about people having to live with pain for over a year before a revision was done.

 

[Josephine]

@AMR1879 I've added your new post to your existing recovery thread as we prefer that members in recovery only have one thread.

This is for three reasons
1. if you keep starting new threads, you miss the posts others have left you in the old threads
2. it often ends up that information is unnecessarily repeated
3. it's best if we can keep all your recovery story in one place so it's easily accessed if necessary

 

[Josephine]

Where have you been "reading a lot about people having to live with pain for over a year before a revision was done"? Not on BoneSmart, surely?

 

[AMR1879]

@Josephine will the new question be noticeable to other members of the forum who have not seen my original thread? I was hoping to reach out to other members to hear their experiences can we edit the title of the thread?

 

[Josephine]

If it wouldn't be, I wouldn't have moved it.

You might also do a little research in this forum for yourself. If you look in the topics list, you will see that all the threads have a coloured prefix. Some are

. If you spot one of these threads, then click on the yellow prefix and you will get a search of all the threads of members who have had revisions.

 

[AMR1879]

@Josephine I have been reading all over the internet.... I have read a lot of people who are older than me needing revisions after dealing with pain for extended periods of time. There seems to be a lot of "it may be this" or "it could be that" and "let's do this test and that scan" from OS's before the actual problem is found. I am hoping to hear experiences of more immediate revisions due to incorrect sizing or other complications.

 

[AMR1879]

Josephine, I will definitely do that! Thanks for the tip....

 

[Horseshoe]

@AMR1879 you can also use the search bar and type in revision, stem loosening etc. which will bring up some older posts that are very helpful. I've seen a couple members get early revisions from implant failures. I hear ya about not wanting to delay esp when you're in significant pain. Drs run certain tests and xrays to rule out issues and while some drs can spot the problem immediately others cannot and the patient waits. It's one of the advantages of BS, Josephine really knows her stuff and can point you in the right direction. That's why it's good to see a revisionist OS, it's his/her specialty.

My RTHR was a couple of weeks after you and believe I should be walking normally w/o pain at this point. I get pain up and down the femur after I get up from sitting. After a few steps it eases up but still have a slight limp and was wondering about stem fixation. Pain doesn't seem to be as severe, mostly 2-3, and may see OS for an xray.

 

[AMR1879]

@Josephine in my skimming through forum posts, I read you are the expert at looking at xrays... I thought I would post mine to see if you noticed anything odd about the stem.

 

[VThereandnow]

I had an improper fit with my implant and eventually needed a revision. With an uncemented hip, the fit has to be perfect for the bone to grow in. The socket is a porous thing and the bone grows into it. Bone cannot jump over to something, therefore the fit has to be perfect! How old you are or how much time it is between surgery and revision is not really the full story.

I knew something was wrong WAY before my surgeon would admit anything, and in fact, he never did. I had to do my own research, lean on the bonesmart admin and moderators, go to an osteopath and then another surgeon in a neighboring state for them to run a test and figure things out, and pretty darn quickly too.

So you see yes, it was a long time but not for any good reason. So save yourself some time and get a 2nd opinion whether you like your surgeon or not and whether you see him or not again. There is absolutely nothing wrong with getting a 2nd opinion. This is you body.

I ended up waiting too long and trusting my surgeon and ended up with nerve damage. Now I am not saying that is what is going to happen to you, but why wait till something does. I don't have the answers for you or pretend to know what is wrong, but if you are not getting answers that feel adequate, then look somewhere else. There is a nuclear medicine test that can help determine whether it is loose or not. Obviously I have strong feelings about this LOL, so sorry if I overdid it, but I like to let people learn from my mistakes. Trust your gut, it is usually right! -Cathy