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[REVISION THR] A new year and new hope: revision for loosened THR

Discussion in 'Hip Replacement Recovery Area' started by prairienut, Jan 1, 2019.

  1. prairienut

    prairienut senior
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    @inthebeginning, Nice to hear that my story gives you a more hopeful state of mind for your own revision. That makes it worth the time it takes to put up these posts. I look forward to hearing the OS's theories on why the femoral implant loosened. I realize they probably don't know for sure, but they should have some suspicions. I'm glad to hear they are doing a thorough work up prior to surgery so they know what to expect when they go in. You want no surprises on surgery day. The best of luck in your revision. The month will go fast. Before you know it, the surgery will be over, and you will be on the healing side. Revisions Rock!
     
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  2. Layla

    Layla FORUM ADVISOR Forum Advisor

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    It's the Three Month Anniversary of your Revision.
    I hope you're doing well as that's reason enough to celebrate it all.
    Wishing you a happy day and continued healing!
    @prairienut
     
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  3. prairienut

    prairienut senior
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    Thanks, Layla. My revision is performing magnificently. I still have very minor aches at times and a twinge now and then, but nothing that slows me down. I can almost forget about that hip being replaced although I still have my precautions to consider. I am now able to sleep on either side. I do take a single 500mg Tylenol if the hip gets achy at night. Better than my primary THR even in the early years. My surgeon Dr. Waddell just sent a letter out to his patients that his practice is growing due to the many referrals by his patients to family and friends. He was announcing the hiring of a PA to help him with routine office visits assuring us that they will be working closely together and conferring daily. I have no problem with that. I'm not surprised his practice is growing. I am highly satisfied with my revision experience. I was a little concerned about his young age at first, but relied on the referral from Dr. Westrich at HSS to give me the confidence that he was the right surgeon for my situation.

    Revisions Rock!
     
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  4. Layla

    Layla FORUM ADVISOR Forum Advisor

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    Great news! You're doing well. I'm happy for you.
    Nothing better than having confidence in your surgeon.
    May it only get better and better! :)
    @prairienut
     
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  5. Mojo333

    Mojo333 FORUM ADVISOR Forum Advisor

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    :egypdance::happydance::egypdance:

    So glad to see you are doing so well!
    It's nice to know with all the uncertainty we experience, that we don't have CTO settle with the status quo.

    You rock, @prairienut !:yes:
     
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  6. inthebeginning

    inthebeginning graduate

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    Way to go! I am 18 days away from mine and getting excited. The only downside was the PA at my pre-op said 'PWB' for a couple weeks. Don't know if I will be bale to handle that. Last time I 'Hit The Ground Runnin', or at least that was my recovery thread name. :snork:
     
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    Last edited: Apr 5, 2019
  7. Layla

    Layla FORUM ADVISOR Forum Advisor

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    Happy Four Month Anniversary!
    Four months already since your revision. Wondering how you're doing over the past month?
    Hopefully still seeing improvement and feeling great.
    Leave an update next time you stop by. We'd love to read all about your progress.
    Happy Spring!
    @prairienut
     
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  8. prairienut

    prairienut senior
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    Hi. Yes, I have reached the 4-month milestone following my hip revision surgery for a loose femoral component (mechanical loosening, no infection, no metallosis). I have been assiduously "cheating a little" on my hip restrictions as directed by my surgeon, just not bending past 90 degrees AND twisting at the same time. I can report no hip pain beyond some mild aches now and then. I can trundle up our grassy hill in back with no problem. One important milestone for me -- I can easily step into a pair of jeans without leaning on anything. It sounds like a trivial thing, but to me it represents a return to normalcy. Another milestone is being able to put on socks and tie my shoes without aids, even trim my own toenails. Had a scare last week. I took both of our hound-type dogs for a walk across our sloping meadow. Everything was fine until towards the end when coming down the hill to the house, a neighbor's dog started to bark. Both my dogs bolted to investigate and pulled me right to the ground. The bad news is that I landed on my operated side. The good news is that it was soft ground and a relatively graceful fall. I got up and brushed myself off, still hanging onto the dogs, no worse for wear. Our dogs love to course through the woods, so if I had let go, they would have been a mile away in a few minutes. Even so, next time, I think I will let go rather than be pulled over again. Here are the culprits:
     

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  9. Layla

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    Hi :hi: @prairienut
    Cute culprits.
    Thanks for the update. It's nice to read you're doing well. May it long continue.
    I hope you have a wonderful week!
     
  10. prairienut

    prairienut senior
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    And yesterday was the opening for my "Winslow Homer in Hurley" exhibit. Great success! I am very proud of my committee and grateful that my hip recovered quickly enough to stay in the game. I was so worried we would have to delay the opening. The picture is a little out of focus, but you can get the idea. Between my hip and my husband's abdominal surgery, we lost January through March as productive months. April was a busy time for us!
     

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  11. Mojo333

    Mojo333 FORUM ADVISOR Forum Advisor

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    Beautiful exhibit, and beautiful recovery!:tada:
    So glad to see such an inspiring update.
    Hope all goes well this week!
     
  12. sansabosa

    sansabosa senior

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    Great news from you
     
  13. prairienut

    prairienut senior
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    Five-month milestone: My hip revision continues to perform well with very little or no pain. I am back at the gym twice a week doing stretching and a light workout. I still do not have full range of motion on my right side, but then I didn't before the revision either. Occasionally I get a mild pain in the front of my thigh. I will ask my surgeon about that next week at my follow-up. I'm walking the dogs at least once a day up and down hills on our property. They have not managed to pull me over recently. Good dogs! I am finally giving my garden some attention, getting down on my knees to weed and root around, crawling up the steep bank in the backyard to reach those taunting weeds that seem to know they are just out of reach. I probably look amusing getting down and up because I do it in a way that does not overly stress my operated side. I still feel I want to baby that side a little. Technically, I'm still under precautions. I am allowed to bend beyond 90 degrees but not twist at the same time. I marched in a Memorial Day parade with no pain or issues. The best news is that my hubby has recovered from his colon resection surgery and has gained weight steadily so he is nearly back to a normal weight. Without the surgery, he was headed towards his demise. I had to consider how I was going to look after our big property without his help and companionship. A sobering does of reality for me. Every day I can go about my normal business and hobbies seems even more precious now. I am savoring the moments, speaking of which, I think I'll go do some more weeding on this lovely cool and sunny day. Thank you to all out there in Bonesmart land for a lively support group that helps us all get through our challenges with a little more confidence.
     
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  14. inthebeginning

    inthebeginning graduate

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    AWESOME!!!
    Hooray for getting down and dirty in the yard. Feels good. I’ve actually done a little of that already...shhhhh, don’t tell @Layla

    Walking the dogs is great as well. :dogwalk:

    Keep up the great revision recovery! I’m right behind you.
     

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  15. Mojo333

    Mojo333 FORUM ADVISOR Forum Advisor

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    :wave:So glad to see your update and wonderful to hear DH is doing well also!
    Wishing you all the Best as you go forward!:egypdance:
     
  16. prairienut

    prairienut senior
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    Yesterday, I had my 5-1/2 month follow-up with Dr. Bradford Waddell at the Hospital for Special Surgery (HSS) center in Stamford, CT. He said the x-rays of my right hip revision looked "perfect." I am having no pain except for a very mild occasional ache in the front of my thigh. He said this was end-of-stem pain and was common. It usually fades within one year from surgery but not always. It is certainly something I could live with and doesn't slow me down. I am still on restrictions but I can break them "one at a time" i.e. don't bend past 90 degrees AND twist at the same time. I am highly satisfied with my revision so far. The hip feels more natural than it has in years. I can even comfortably jog a little on my meadow walks with the dogs. I did not do this with my original THR. My next follow-up is at the one-year point, January 2020!

    I asked what I could do or not do that would affect the long-term outcome of my revision. He said at this point it is fully fixed and the bone ingrown. Infection could compromise the implant so be sure to take the prophylactic antibiotics prior to dental procedures or the removal of a bone spur on my toe. A traumatic injury where the bones around the implant are broken would certainly affect the implant. And finally, bad luck could hit again and the implant loosen for some unpredictable reason. Let's hope my luck holds out this time.

    I was also curious about how an uncemented prosthesis bonds the second time around and what is the limit on repeated revisions if they become necessary (of course, I'm hoping they don't!). I know that a revision requires the surgeon to use a longer femoral stem so it extends into "fresh bone." How many times can you do this before running out of femur!? He said I had enough femur for four more surgeries. That sounds like enough to cover my remaining time on earth, even with serious bad luck! Regarding the ingrowth of bone into the prosthesis, in addition to preparing a fresh area beyond the length of the first implant, he reamed out the top part of the femur to create a wider channel until it was "bloodied up." These fresh surfaces trigger the bone to grow into the implant all along its length, both top and bottom.

    I have read opinions that you only get one chance at an uncemented prosthesis, that subsequent revisions have to be cemented. This is not the practice of the vast majority of surgeons at HSS. Revisions there are nearly always uncemented. In fact, it is a cemented prosthesis that cannot be repeated during a revision with equal effectiveness as with the original THR. Once the cement has entered and filled the honeycomb layer of the bone the first time around, you no longer have that open, porous area to accept the fresh cement and assist in holding the bond the second time around. It must work well enough for certain situations because surgeons still do cemented revisions, but it is definitely not the only way.

    The above information is offered in the spirit of discussion. I do not pretend to be an orthopedic expert. I did feel it was important to relay to others how my questions were answered by my OS. I have learned a lot from him and appreciate his taking the time to explain the concepts and procedures. I'm sure different OSs have different procedures that work for them.
     
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  17. inthebeginning

    inthebeginning graduate

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    Great update! My first THR and recent revision were both uncemented, anterior approach. My doc did however add one screw to the cup this time. Different manufacturer I guess?

    Anyway, I was also wondering how much bone is left for future revisions if needed. I haven’t asked, but will when I see the doc on Jul 11. If I only have 4 left and God forbid these only last 6 years each, that puts me at 79. Of course we hope this one goes longer than 6 years! Like you, he banged in a longer stem with a different geometry at the top to enhance the bone in growth hopefully.

    When he came out to talk to my wife post-op, he was bloodied up on the pants of his scrubs and shoes! So we know he found some fresh bone!

    Congrats on the great progress and healing!
     
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  18. Mojo333

    Mojo333 FORUM ADVISOR Forum Advisor

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    So glad to hear all is well @prairienut !:egypdance:
    Thank you for the detailed description of your followup!
    Hopefully this is your forever hip.
    You deserve to have all the best in life!
     
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  19. Layla

    Layla FORUM ADVISOR Forum Advisor

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    :hi: Happy Friday to you!
    That was one of the most informative and interesting updates I've read in awhile.
    Thank you so much for taking the time to share.
    I'm happy to read you're doing so well at 5 1/2 months. May it only get better!
    Best wishes for a wonderful weekend and Summer. Please don't be a stranger here.
    @prairienut
     
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  20. Izabel

    Izabel senior

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    Thank you so much for your update @prairienut. I found it very informative. Both my original and revision THRs were/is uncemented. I don't believe they are very keen on cemented here.

    Wishing you continued positive recovery.
     
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