THR 9 months post op for hip replacement & still having problems

[KristinL]

If I could, maybe there is a way to work the system better. What if, you put in for the second UNRELATED opinion? okay it takes 6 months. you are in pain. You might think about trying a pain doctor in the meantime. BUT wait, not masking the pain - a new pain doctor will want to find out what is causing the pain beofre they throw meds at it.

May I suggest you try a pain doctor that uses may means to help you ie acupuncture, TENS. My pain doctor got be sorted with everyday pain, We tried all the things including the shots. But it will determine if the pain is from a nerve (mine is - total bummer) or in movement or in the spine. That way you can rule out all the things except the cup loosening so the new ortho can see what you've tried and why it doesn't or does work. And hopefully, manage the pain you are in.

My first doctor swore it was the spine, spine guy (same practice) said it was hip. second doctor was complete idiot wanted 3D MRI (at my expense was $900) and didn't even look at it. Total wanker. Pain guy eliminated spine down to the nerve that is the problem. I have a new ortho now to repair elbow tendon that has ripped. Am considering him for any revision to the hip somewhere in the future. my THR has an aggravated L knee and may need another clean out. It is not easy being the exception to to the rule. In fact, it is miserable. But here we are. must mange it all. I have been surgery shy and have put off getting L elbow "fixed" for months now. too afraid that will be messed up. I get how frustrating it all is.

I feel your frustration everyday. I know how miserable it is to be looked at like you're a slacker or crazy. You are neither. xoK

 

[kitskid]

Hello Canadianlps,

I live in Calgary, Alberta, Canada and there is a wait time of 9 to 11 months to see an OS here in western Canada, I agree that the referral should come from your GP. Canadianlps, you live in the same area as the Cambie Clinic , you will have to pay to go there as it is a private clinic but they have a fabulous reputation for their hip & knee replacements. Google them, they used to post their fees on the web sight, I have not looked at their sight for a long time. I had my RTHR on Dec. 18th, 2012, and I had an x-ray at 1 week post-op and I will have another one on Feb. 4th, that will make it 6 weeks after the post-op.

All the best to you,

kitskid

 

[Vida]

I forgot to mention I had xrays and folo ups with my surgeon, who I first saw at the Cambie Clinic, at 2 weeks, six weeks and will again at 12 weeks. You can find a list of private clinics online but I believe you can only get a private THR/revision done at a private clinic in Quebec or go to the states...

 

[canadianlps]

Hi Everyone,,,I'm back after following through with a different doctor in a different city.
What a good move!
I had my family dr refer me to the clinic at Toronto Western and I met an amazing Dr. who ordered
an xray and said, 'slipped cup' (halos around the screws).
Apparently, the cup never adhered to the bone.
Be it improperly put in, infection or my body didn't accept it, he actually sat and talked to me!
Cripes, never had that with the two bone heads here in Ottawa.
Wants to arrange through my family dr here to have some tests to rule out a deeper infection
that would not show up on the gallium scan..with possible fluid aspiration.
Either way, more surgery to come, but I least I have something to work with.

Two interesting comments he made and I nearly missed were
'the surgery was done somewhat ok" and (I had to make him repeat that)
and "if this is infection related, it definitely happened during surgery"

I told him, please just fix this and I'll go from there….

At least I do have hope!

Thanks
Linda in Ottawa
Left THR
Jan/12

 

[Vida]

Hi Linda, I am so sorry you are going through this. Good for you for finding the right surgeon who will give you confidence going forward. I know it will make all the difference in your recovery. Hang in there and let us know how we can support you. Take care, Vicki

 

[Jaycey]

Sounds like you found yourself a winner of a surgeon Linda! Well done! All that counts now is moving forward. Do keep us updated!

 

[Poppet]

What a relief to find a surgeon who listens Linda. Now you have a way forward and a plan. Stick with us, if it does come to surgery we will help you through this

 

[bottomshollow]

So relieved for you that you have found the "right" surgeon and that things are looking up for you now. Please keep us updated with what's going on with you. We're here to support you and be your cheering squad.

Take care, we care.

 

[canadianlps]

Thanks Everyone for the support!
Now I await appointments for the tests but in the mean time, I would like to know a little more about what the new surgeon is suspecting.

The is no bone growth to acetabular cup, thus the screws have moved back and forth quite a bit.

Dr made mention of two things that could be cause.
1 - my body didn't allow bone growth to adhere: he's not sure why not. Any ideas?
2 - infection: I did have the gallium studies but Dr noted that there is only a 76% success of detecting infection. Therefore he is recommending a test that has a 96% rate of detecting infection. Also possible aspirate but that is down the list a bit for now.

Any thoughts on what reasons that my body would not we accepting of the cup (Crossfire). My original surgeon would have known that I am on meds for inflammatory arthritis.

Factor?
Poorly put in?
or Other medical reason?

I am of course worried about the infection concern. This would be a much bigger surgery with more risks.

I can't jump to any conclusions about what will be done, but I would like to get any info that would make going in to this with a little more positive face!

These past 3 years has been so horrible for me. I run a large dog daycare business and an in home cat sitting business. The depression and feeling of being thought of as lazy when I was doing PT and not achieving anything nearly did cost me my life. I felt so alone and then to have the OS treat me like rubbish. Couple that along with the other severe pain of osteoarthritis and psoriatic arthritis and undetermined anaemia, things just get worse, not better. I do hope that this will be a turning point for my health.

It's good to share with others who feel the pain!
Thanks
Linda in Ottawa

 

[bottomshollow]

Going to tag Josephine for you.

 

[Josephine]

1 - my body didn't allow bone growth to adhere: he's not sure why not. Any ideas? My original surgeon would have known that I am on meds for inflammatory arthritis.

That could very well be the issue. It is well known that NSAIDs suppress bone growth and can therefore inhibit the ingrowth of bone into the special coating on uncemented implants. Most surgeons (with any sense) have their patients stop anti-inflammatory medications for a few months around a joint replacement.

broken link removed: https://www.bjj.boneandjoint.org.uk/content/76-B/5/831.full.pdf (1994)broken link removed: https://www.bjj.boneandjoint.org.uk/content/76-B/5/831.full.pdf"The effect of diclofenac on hydroxyapatite-coated implants"
SA Jacobsson, K Djerf, I Ivarsson, O Wahlstrom J Bone Joint Surg Br September 1994 76-B: 831-833

broken link removed: https://www.bjj.boneandjoint.org.uk/content/76-B/5/831 (2002)
"Researchers at the medical center have found that selective COX-2 inhibitors - a class of medications widely prescribed for painful inflammatory conditions such as osteoarthritis and rheumatoid arthritis - interfere with the healing process after a bone fracture or cementless joint implant surgery."

 

[canadianlps]

Update on my nearly 2 year post op THR...surgery for revision now booked for Jan 2014
Been doing a little reading, revisions are more complicated?
No infection so will it really be more difficult?

Now a little worried, however, the pain is back so I am looking forward to getting this done
and this surgeon is suppose to be excellent, so not stressed by that.

Anyone else with thoughts/comments related to revision that is not linked to infection nor long term
use?

I have no idea what a recovery would be like as I never had a normal recovery.
The limitation for movement has neither improved nor declined, but even to this day
just as it was two weeks post of, still can't stand full weight on that leg, nor raise to same
height as the other really bad hip!

Thanks

 

[sharonslp]

Hi Linda. I hope this revision gets you back on your feet....literally!! Revisions can be a more prolonged recovery, but I don't think they HAVE to be. I have a good friend who just had a revision that was due to infection....his recovery has been quite amazing and easy. Lots of variables, but the important thing is that you will be back on a forward path.

I'm tagging Josephine to comment far more knowledgably about revisions.

Sharon

 

[Josephine]

Been doing a little reading, revisions are more complicated?
No infection so will it really be more difficult?

Not necessarily. Some can be fairly straightforward and others can be a heck of a struggle. There's no way of knowing, really. But most (in my experience) tend towards to former rather than the latter. In which case, the recovery should be fairly straightforward too!

 

[alexthecat]

You know, danni appears to be on the forum right now. Maybe she would like to tell you about her experience with a successful revision.

 

[canadianlps]

Thanks Josephine!

 

[Roofmaster]

Oh my god I want to punch that doctor in his face.Who is this guy?Your leg was a quarter inch short before surgery and maybe shorter after and he thought that no big deal?No x-rays after surgery?Next time you see this guy lean close to him then smash the top of your forhead into the bridge of his nose shove a finger into his eye punch him in the throat and shove a knee into his groin as he falls to the floor.Then take a seat and calmly wait for the police as you revell in primative justice.And get a second opinion.Maybe talk to a lawyer.Keep us posted Im curious about this.Guy sounds like a bully.I hate bullys.Peace.

 

[marg34]

Linda,
I am very interested in your case as I am 57, in Toronto, have psoriatic arthritis (35 years and on prednisone for 12) had my LTHR in January 2013 at Toronto Western and am still having a lot of problems since. The doctor I had sounded like the doc you had in Ottawa. I continued to tell him of the pain but he just said 'there's nothing wrong with your hip' - no physical, just looked at the xrays.

My rheumy sent me for an MRI which showed a possible tear in the hamstring near the ischial tuberosity, and the screw was impinging on the gluteous minimus, as well as tendinopathies in several areas. The surgeon said I had a 'bit of tendinitis and told me to go back to the pain doctor. I felt he was brushing me off so asked my gp to send me for a second opinion, which I have just had.

The ortho surgeon sent me for a bone scan and gallium study. But no on mentioned there is only a 76% chance of showing infection.

When I saw the OS he said there is nothing I can do for you surgically, there doesn't appear to be an infection or loosening. He also told me that 3% of THR patients have longterm ongoing problems and I'm one of them.
Very distressing.

What test are you having that is 96% accurate ?

My buttock at the hip swells up daily 1-4 times and I'm always in pain, altho it is only a 3-6 depending on the day. I can't help but think somethings not right in there but don't know what else to do.

Josephine can you make an suggestions? Thanks

Marg

 

[marg34]

Also, can you tell me who you saw at Tor Western?

 

[canadianlps]

Saga #2...just out of hospital for third time since Feb 13...when I had my revision surgery done at Toronto Western...things went downhill fast...still don't remember everything as it has been two months of pure agony.

I do not want to frighten off new people going in for THR surgery as I know for a fact it does work! However, I feel that I am just one of those people who are not favoured to have have much success in such health issues.

Quick History since I went in for hip revision from THR that was performed in 2012 (Jan)
Had surgery in Toront on on the 13 of Feb. Surgeon replaced cup, put new head on stem to give back height Post surgery, had issues, lots of pain when I left the hospital for the ride home 4 days later. The in patient rehab is no longer available here.

Two weeks later, still horrible pain when standing or walking..went to family dr. who said revisions are a little longer to recover from. That night I couldn't take the pain any longer and asked a friend to drive me to hospital. She called an ambulance instead as she said I was very pale. Next six weeks a bit of a blur but after complaining and crying my eyes out, the dr. on call that w/e suggested a fine needle aspirate as I was running a fever. Came back with said infection..now I had the doctors attention! Scheduled for and had a major clean out of the wound and put on a two month minimum picc line and antibiotics.

Dr also said the cup liner had slipped halfway out, replaced. Sent home after a week. Same day I came home, (I was really sick), back to hospital as the wound was non-stop bleeding. Nurses putting pressure bandaging on for two days. Never saw the dr who did surgery or any other dr. I was finally getting upset as the pain had increased and the wound still leaked so on second day back in hospital, I told the nurse I wanted to see dr before 10 PM or I was leaving and going to another hospital!

Right at 10 as I was sitting in the lobby waiting to get picked up, the dr showed up! I actually had to yell and stomp my feet and tell him I was still in horrible pain and said there was still something seriously wrong!

PS: At this point I found out that nothing grew in the culture! Bacteria found was probably from the skin at site of fine needle!

Finally agreed to a hip xray that night and a cat scan next day. Results, huge hematoma at wound site, plus a fracture in the cup. It paid to stomp my feet and yell!

New surgeon on case...suggested that I do non weight bearing for 6 weeks to allow cup and fracture to be set in bone plus maybe having surgery if it didn't work. Or have surgery right away and put in a plate but would still have to non weight bear for 6 weeks.

Decided I had enough of waiting around and had surgery next day. Result: I think hip is ok but still non weight bearing as of yet However, lucky me, I had nerve damage that resulted in horrible pain in my foot and calf.

That is where I am now. Home finally after six weeks. On a pile of meds to help with the nerve pain - novatraphiline (sp), pregabin.

Go back to see dr next week for 4 week post op. Dr. is a bit sarcastic and is not interested in the pain issue but I can work with my family doctor who has been very helpful on getting me on the right meds for my different types of arthritis. Still on daily antibiotics through picc line though.

So, question (as I know experience and honesty is great here!) .. this nerve pain and numbness etc that has affected 3/4 of my foot and ankle, plus leg swelling and my leg going red at night - will all this really come back soon? And for the nerve damage, any idea on what would help to repair it like electical stimulations, acupuntare, physio?????

Getting tired, noticed my spelling has gone downhill fast
Nite and thanks