confused about possible revision

Status
Not open for further replies.

Antnee334

junior member
Joined
Sep 22, 2008
Messages
43
Age
66
Location
Florida
Country
United States United States
Gender
Male
Josephine

I am scheduled to have a revision on my left hip in two weeks. I have already posted in the post on the Durom cup. My question involves the symptoms of have a possible loose cup. My biggest symptom is that when I sit in the car for longer than half an hour and I try to stand I have an incredible pain in my leg and it can not bare my weight. After a few moments and I begin to walk it off I can walk for a very extended period. If I try to speed walk it again begins to hurt. I have been unable to go any faster than a medium walk since the operation last year. Also I can’t bring my knee to my chest. These are things I can do with my replacement on my right hip.

I have been unable to stand on my left leg without leaning over to the left. On my right this is not a problem. In therapy and the surgeons office strength of the muscles has been ruled out. Half kneeling, keeping my left foot on the ground and going to my right knee cause pain in my left buttocks and weakens my leg for a few minutes when I stand. I have wondered about my SI joint but the surgeon dismisses this.

Because of the devices they have been unsuccessful at doing an MRI. I have been in therapy for most of the year including additional massage therapy as my IT band and piraformis were both very unhappy.


My surgeon wants to go in and check if the cup is loose. I assume but will verify that he will also check on the stem. My fear is that he gets in there and finds the parts okay and I am left to deal with recovery and maybe less use than I have now.

Do you know of anyway of telling what the problem is or have you heard of any similar symptoms.

Thanks for all you do here.
 
Hi Antnee: There is a site, www.bananarepublican.info, which might be helpful to you. Once on the site, go to "hip surface replacement". From there, you can go to the section that lists the symtoms of common failures of both hip replacement and hip resurfacing components. In the "failure symptoms" section, you'll see listed the symptoms of acetabular cup loosening or migrating.

I know just having your questions answered in a general way can give some comfort. From what I understand, according to the experiences of several post resurfacing patients who had acetabular cup failures, this can be corrected and people can go on to have active, healthy lives again, once the problem is taken care of.

I am so sorry you are still in pain. I can imagine you must be very worried and anxious.

I am sending you good thoughts, and hope you get some answers soon.

Take good care,
Ruth Z
 
Antnee
I am so sorry you are still in pain . I hope that website helps you. I will be thinking about you and hope you find the answer to get out of pain soon
Judy
 
Antnee, to answer your questions, there is no real specific way to know for sure if the cup of a THR is loose or not and basically it's down to the expertise of the surgeon who knows what signs and symptoms to look for.

From what you have said, a loose cup sounds very likely. Thing is, when you do various actions the cup moves a little differently each time and so gives slight variations in the symptoms. All that you have described COULD indicate a loosening of one part or the other.

And for a surgeon to go in and only check one component would be a gross dereliction of duty. Check with him by all means but it would be akin to going to a dentist with toothache and him only looking at that one tooth! They just wouldn't because it might not be that part (cup or tooth) that is causing the problem.

Do ask me again if you have more questions.
 
Thank you all so much. I have read that there is a type of ultra sound machine in England that is used in conjuction with an xray to detect if a part is loose, but my luck I am across the pond. I think the surgeon is relying on the fact that it is a Durom cup and therefore it must have come loose.

The surgeon stated that sometimes you don't see radiolucent lines and sometimes you do. Dr. Dorr in California, the one who first complained to Zimmer about the Durom cup. Here is a statement from his press release.This failure rate has occurred within the first two years. In the first year the x-rays looked perfect. We have revised four that did not have any radiolucent lines or migration (and John Moreland revised one). These early cups fooled us, but the symptoms were so classic for a loose implant that we operated the patients. When we hit on the edge of the cup it would just pop free. As time goes by the cups begin developing radiolucent lines. We now have one cup at two years that has actually migrated a short distance. It has tilted into varus. We do not believe the fixation surface is good on these cups. Also there is a circular cutting surface on the periphery of the cup that we believe prevents the cup from fully seating. We stopped using the cup after the first revisions.

So while I have a lot of faith in my surgeon, I have been seeing him for 7 years for my hip dysplasia, and he also has undergone a knee replacement, so I know he knows how some of us feel, I have to wonder if this is the right course.

Of course, nothing else seems to relieve the problem.

How would I go about finding out what Dr. Dorr (California) used to determine this in his patients and what did he use to revise the Durom cup.

I am in Florida and surgery is16 days away. Do you think a surgeon would answer this and I don't want to offend my surgeon (he is also highly rated) by second guessing his opinion.

Other surgeons I have contacted are not interested in giving an opinion while I am in another surgeons care.

Thanks again and I will keep you posted. The next appointment is on the 8th and surgery is the 14th.

Antnee
 
Rutz

What an incredible website. Thanks for taking time to document all of that.

Antnee
 
Hi Antnee: I've sent you a private message, but wanted to post this in response to your fear of offending your surgeon.

The most important thing here is your hip joint and your continued health throughout your life. I feel you have a right to continue to seek information about what is going on with your prosthesis - you have questions that haven't been answered, and concerns that have not been addressed.

This doesn't mean that you haven't had a good relationship with your surgeon, or that he isn't highly skilled. Each situation is different, and I would tell you to trust your instincts. You have nothing to lose by getting another surgeon's opinion. Second and even third opinions are not unususal. Some insurance companies will even cover those, depending on the situation and the particulars of the insurance policy.

Ultimately, you are in charge of your body and your health. I've got you in my thoughts.

Take good care,
Ruth Z
 
The last thing you should worry about is offending your surgeon! As Ruth said, it's YOUR body and YOUR hip and you owe yourself a duty of care to have all possible points covered to your satisfaction. No surgeon I know of would be offended anyway, they are used to it and as a general rule a pretty unoffendable lot!

I'm familiar with the statement from Dr Corr and the difficulties involved in an accurate diagnoses.
We over here have used ultrasound on occasions but even then the results can be inconclusive. Truth is, there is often no way of being sure without going in to see what's what. Your only real recourse is to ask other surgeons for a second opinion and I am amazed that some have turned you away because that is the usual way of going about things. I urge you to postpone any surgery until you are satisfied that you have explored all avenues and got as many answers as you can.
 
Status
Not open for further replies.

BoneSmart #1 Best Blog

Staff online

  • Jaycey
    ADMINISTRATOR Staff member since February 2011
  • Roy Gardiner
    Staff member since February, 23, 2013

Members online

Forum statistics

Threads
65,167
Messages
1,596,863
BoneSmarties
39,356
Latest member
JanieMarie
Recent bookmarks
0
Back
Top Bottom