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

[Horseshoe]

How frustrating for you. Really hope you can get to the HSS or an outside revisionist. Josephine mentioned the bone appeared to not grow over the implant and your symptoms coincide with her opinion. Leaving you in pain without a forward strategy is remiss on the drs part.

 

[GrannyC]

I am so sorry for all you are having to endure. I am no medical professional but if I were in that much pain all the time, I would definitely do an all out search for a revision specialist that would see me. I think I'd start with my GP and ask if he could recommend one and if not, I would keep on looking and not give up until I found one. I'm not sure where you live in NY but if it is NYC, surely there are some there. If you live upstate, there must be some in Albany, Syracuse, Rochester and Buffalo. Even if I had to travel to another state, maybe Boston, I'd keep,looking. You can't go on like you are.

Also, if you OS won't even give you something for the pain, I have to think I'd be looking for a more caring OS. You could also try your GP formpain meds. After my surgery, my OS office told me I could getmpsin meds from them or from my GP.

These are just my thoughts that I wanted to share. I don't blame you for feeling frustrated but I feel sure there has to be a solution. Keep searching!!!

 

[AMR1879]

Have you tried contacting several revision specialists? I know you said it was hard to find one who would see you so soon after surgery, but there has to be someone. Have you tried not telling them you've had surgery when calling, just stating you have hip pain? It's more difficult for a dr to say no when you're standing right in front of him.

Really hope you can get to the HSS or an outside revisionist. Josephine mentioned the bone appeared to not grow over the implant and your symptoms coincide with her opinion.

I have a short list of revision specialists in NYC that I will be sending my records to once all this preliminary testing is done. Every OS would do the bloodwork and scans as part of the diagnostics, so I might as well get it done here and then send it to the OS in NYC. It is just a matter of dealing with the pain while doing all the diagnostics and I feel like my current OS will not take me seriously until something wrong shows up...everything right now "looks normal".

I would definitely do an all out search for a revision specialist that would see me. I think I'd start with my GP and ask if he could recommend one and if not, I would keep on looking and not give up until I found one. I'm not sure where you live in NY but if it is NYC, surely there are some there. If you live upstate, there must be some in Albany, Syracuse, Rochester and Buffalo. Even if I had to travel to another state, maybe Boston, I'd keep,looking. You can't go on like you are.

I did get some names from my GP and I will be heading down to the city if need be. I prefer to only get meds from my OS b/c your "team" of Drs will think you are trying to get meds from too many Drs and are an addict, they are very strict when it comes to opioid prescribing in NY.

Thanks everyone for their input, it is much appreciated!! I'll keep you posted.

 

[AMR1879]

Are you using walking aids?

As much as I HATE using a walking aid, the pain is so bad that I have had to use crutches.

 

[AMR1879]

I don't understand why the doctor can't give you pain medication until you get those results on Tuesday. You are hurting now, have been hurting a long time, and it's getting worse. Why wait?

Until my Dr actually sees something wrong, I don't think he truly believes me! Crazy, right? They are really strict about opioid prescribing in NY, so that makes the Drs afraid of prescribing it, even when it is needed and legit.

 

[Krista]

@AMR1879, yes, it IS crazy! You are in such pain that you need to use crutches!

It sounds like a good idea to have all the testing done, and then present to the revision docs. I am so sorry you are having to go through all of this.

 

[KarriB]

I'm glad you're continuing to seek out a revision specialist and hoping someone can help you.

 

[AMR1879]

Sed Rate and C Reative protein levels came back in the normal range, so it doesn't look like an infection is the culprit. So now I am set up for a repeat bone scan next week. I am once again thankful for the good news of normal bloodwork, yet disappointed to not have a lead on what is going on.

 

[Krista]

It's excellent that you don't seem to have an infection, @AMR1879!

When a revision specialist finally sees your x-rays, perhaps he will see evidence of loosening, as Josephine has indicated might be the case when she saw them, and which would explain your pain symptoms. I wish you could get definite news sooner, so you could get on with treatment and recovery.

 

[AMR1879]

@Krista, yes, an infection would have been a shocker and a real bummer! I am having a bone scan on Tues, hoping maybe that will show evidence of the suspected loosening, fingers crossed! I also want my OS to look into the scar tissue that the Dr found last week at my 4th opinion appointment (different practice, different Dr and different approach to ortho treatments-if you missed that part of my "saga". Lol!). That could be a reason for some or all of my problems.

 

[AMR1879]

@Josephine you were right! I am in the hospital recovering from s LTHR revision. The stem was loose!! The Dr was able to remove it without breaking the femur so that is wonderful. He is pretty certain there wasn't any infection, but he did send a number of cultures and tissue sample to the lab to make sure they were infection free. I will be in the hospital until Monday, waiting on those results. We are all hoping and praying that infection doesn't rear its ugly head! The question we are left w/right now, is why didn't my bone grow around the prosthetic? So it's back square one in regards to recovery!


Sent from my iPhone using BoneSmart Forum

 

[Horseshoe]

@AMR1879 congratulations, you did it!! So very happy that you found an OS who listened to you.

Hope your tests come back clear, will be interesting to discover why the bone didn't grow over the implant.

Josephine def knows her stuff -and her xrays! Kudos to you for persevering through the pain, think you're going to have a wonderful summer after all

 

[Irish Joe]

Amr1879.
Really happy to see that post. I bet this will be the beginning of the end of a long tough road for you.
Please do keep us up to speed on your progress.
Get well.
Joe.......

 

[GrannyC]

Wow! So great to see you found a OS who listened and saw the problem. Your perseverance paid off. I wish you all the best with your recovery.

 

[Jaycey]

Another one for our Josephine! Well done on getting that revision @AMR1879 ! I was worried about you waiting too long. Fingers crossed on the test results for infection. Please update us when you can.

 

[Irish Joe]

I'm just waiting until the day you change your signature to
(x)Wks post op-- "Less pain than before"
Joe.......

 

[KarriB]

Wow! I'm glad you found someone to do the revision!

 

[Krista]

That's terrific news, @AMR1879! I'm very glad you were able to find a surgeon willing to see you and give his diagnosis, and that you got the revision surgery done quickly before any serious damage was done to your femur. It's not good for your bone to be walking around with a loose stem. I, too, am wondering why your stem was loose. You have known that something was wrong since week 7, so it may be that it was never properly implanted in the first place with that perfect tight fit that is required for successful THR. I am sure there are a number of possible reasons. May you have a complication-free recovery this time, so that you can get back to your active, happy life!

 

[AMR1879]

As I mentioned above, the revision went well. The mystery is why didn't my bone adhere to and grow around the stem?? The Dr said although it wasn't super easy to remove, when it did slide out, it was totally clean (it didn't have any bone attached). Any one have thoughts about why my body reacted this way?? @Josephine any thoughts??


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[Josephine]

The Dr was able to remove it without breaking the femur so that is wonderful.

I've seen that a lot. On one occasion a cemented stem was literally lifted out of the femur by the surgeon using just his fingers! The cement was totally smooth which accounted for the loosening. Obviously this was some years ago. But I still have that device upstairs in my junk box of old implants!! I'll get it out and photograph it for you!

The question we are left w/right now, is why didn't my bone grow around the prosthetic?

The main reasons why this happens are
1. the femoral canal hadn't been cleaned out and dried correctly leaving blood clots, fat and bone debris to cause an obstruction between the bone and the metal. In uncemented devices, it's absolutely essential that the site is made clean and dry to give the bony ingrowth the best chance of success.
2. the stem wasn't seated in securely and with precision. This could be either the fit or the amount of impaction that was applied
3. 'of unknown aetiology' meaning nobody really knows! Sometimes, though all the above have been attended to with due diligence, the bone just doesn't want to co-operate. This is nobody's fault, it just happens.

I'm sorry I was right though. It's nice to know but it gives me no pleasure that you had to have a revision.