@TerryB_TX Pretty much the same for me in terms of a longer and beefier stem. My first implant was a Corin, but the stem looks short compared to what I have now (and the first was the anterior approach, which supposedly is harder to use longer stems with, but don't know enough about that). I now have a longer, rounder more porous surface Stryker, with three screws from the cup, posterior/lateral approach.
So far as HA coating, my surgeon said that research has shown it doesn't make much of a difference. For awhile, the HA coating seemed just the ticket in the industry, but it hasn't turned out as anticipated (which coincides with my research too--and what Josephine reported to me; incidentally, my first stem was HA coated, and I also think coated with Vit. E), but it certainly shouldn't hurt to have it.
As I said somewhere in my thread, I was told by all 3 revision surgeons that they would not do a cemented implant, unless something very compelling and surprising was happening when they went in. My surgeon said to me the leg/hip are measured by software and same with the fit, along with the surgeon's eye and expertise. I was reassured about the LLD issue by him, this was a big deal to me, I don't want to be limping if I can help it; limping in recovery is one thing, but I would like to walk as normally as possible in the longer term (and the first surgeon gave me no such assurances, in fact, quite the opposite).
And of course from the xrays, my cup looked OK to 2 surgeons and possibly loose to 2 other surgeons. If the cup is OK, the question then becomes using a femoral stem etc. that fits perfectly with that already existing hardware--whether the same or a different manufacturer. I am sure your surgeon will check the cup during the surgery, and will take it from there. Surgeons like to use hardware they know well, and that is fine by me IF IT WORKS. FWIW, my surgery took only 2 hours.
I also had the needle aspiration just to rule out infection. I think some infections can remain silent but all my other numbers were so low, it was highly unlikely and indeed I did not have an infection.
I was to be partial weight bearing (50%) on 2 crutches for 2 weeks, then weight bearing as tolerated after surgery. I did discuss this the other day when my surgeon called to clarify, as there were two different sets of instructions from the hospital NP. He said that current research shows that what is more important than the weight bearing and restrictions is not to do any extreme motions or activities, that weight bearing even for the 50% usually devolves into weight bearing as tolerated. If it hurts, dial back, and absolutely no sudden movements or twists.
I had violated that twice inadvertently when I first came home, felt the pain and haven't twisted like that again. You get cured pretty quickly of doing things that hurt and conservative treatments and approaches seem to be better all in. I will go down to using one crutch once I feel a little more stable (but for me this is related to a torn rotator cuff that is getting irritated!). I am on a blood thinner for 4 weeks and am wearing compression socks for that period of time, they haven't been a bother at all. I have been walking two laps of my house every hour on the hour, and yesterday was a good day--it felt good and I really wanted to just move.
My surgeon prescribed Celebrex for 2 weeks only. But as you noted, I had to stop taking it anyway, as it turns out for the massive heartburn issue that would not go away--but I didn't see the need to take it, given the bone growth issue. The ice/cold water machine has kept swelling (and I guess inflammation) to a minimum, I think. I use it for hours every day, and have no knee swelling or other ill effects.
I am really quite sorry that you are going through all of this, but your visit to the first revision surgeon showed you that in a way it could truly be worse---all the pain you feel could actually still be a huge, frustrating puzzle to unravel if your stem was actually fixed properly.
That is what my hip seemed to me for the 2 plus years before I was told it was loose--I have never been so frustrated in purpose. Nothing I tried ever lasted for very long.
Obviously, no one wants to be told they need a revision. But it seems like you tried a whole panoply of solutions to get better; it would be great if just 6 weeks of PT cured what ails you but to my untrained eye, it seems unlikely given all that you have done for yourself, along with Josephine's comments and the fact that 2 revision surgeons have said that your stem is loose.
All good lessons for anyone who needs a revision--go to a number of surgeons and LISTEN to what they opine, and ask a lot of questions because the first opinion you get might not be the prevailing opinions of the other surgeons. And as in my case, how surgeons read x-rays is also important!
So I guess what I am saying inelegantly is that needing a revision gives you something tangible to focus on, and some glimmer of hope that the elusive pains you have suffered actually might come to an end. I am still waiting for my full outcome, certainly so far, really good, and I know that having the revision was the right step--I couldn't go on as I had been doing. And I must say you sound very balanced about all of this, and way ahead of me in terms of your current mental preparation!
So I assume your next step is choosing the surgeon and the date. I took into account whether the hospital was a city or more suburban hospital. I personally avoid hospitals in the heart of a city if possible - lots of germs - but also don't want a very small hospital in case something goes wildly wrong). The MRSA rating of the institution, does the surgeon have two surgeries going on at the same time (yes, this happened right here in Boston at a major teaching hospital, it was very controversial, and now New England Baptist will actually tell you that its surgeons do only one surgery at a time, start to finish). Whether the surgeon is skilled in revisions (asking my doctor friends for inside info, numbers of revisions done in last 2 years, etc.), whether it is the revision surgeon who does the most important work of the surgery and not an intern. And lastly in my case, I had a choice to go to an orthopedic-only hospital (btw, I would never go to an orthopedic "clinic", have heard enough stories to not do that, but an ortho-only hospital is different).
I booked the surgery well in advance to get acclimated to the idea of having it and getting things in order. Looking back, it really would have been fine to have surgery somewhat earlier, but I am glad I got my work in order, as I am resting and recuperating with no guilty conscience at all. Once booked, time carries you forward, and I did not dwell on the surgery, just prepared for it, if that makes sense. I am pretty stoic and I dislike drama and did not tell my friends or work colleagues what was being done (only a couple of family members, and 1 friend who helps out with our pet). The last thing I wanted to do was repeat the story endlessly, and get needless sympathy which would actually only wear me down because most people are not on Bonesmart and really just do not understand why revisions become necessary. I did use this site for all my needs, and continue to do so, and have not been disappointed!
Let me know if there are any other questions you have, and I will be happy to answer to the best of my (very limited) ability. I can say that revision surgery is not the end of things or the worst thing I have been through, and in fact, I am still hopeful it is actually the beginning of regaining some of my life back. I will continue to ask questions here as needed. I have gotten through the first 2 weeks without a hitch, and hope it continues. I certainly hope the same for you!
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