Dislocation Risk? Knee Pain after THR

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nickji

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Hi Again,
I'm now 13 days post op for a RTHR non-cemented 36 mm metal on poly. Two questions I'd like to ask.
1. My surgeon tells me that with this large head the risk of dislocation is almost zero. Anyone have thoughts on this please?
2. I'm pain free in the hip, but have had knee problems since the op - feels like maybe bursitis, pain comes when I move the knee by muscular effort, I think using the rectus femoris (??)

Also, if anyone would like to know some of the pro's and con's of having this procedure done in India, I'd be happy to give what information I can. Maybe that should be in another thread?

Thanks everyone for all this great support. this site is a god-send.

Nick
 
Hi Peta, I hope they're up now - I just hit the wrong key while I was typing. If they're not there now, please let me know and I'll re-post.
Thanks,
Nick
 
Jo will no doubt be able to answer your questions in greater detail than I can Nick - but in my own personal experience my OS said the reason I was able to be fully weight bearing from the word go was because I had very strong bone (I'm only 49)- not because I had a large prosthetic head put in. If your OS says there is almost zero risk of dislocation (as mine did) then just have faith and believe him. I know how scary it is initially, but once you realise you CAN weight bear without any problems it will get easier and easier.
As for the knee pain - I've had a similar occurrence. Not bad enough that I had to see my OS about it - but certainly painful. I believe mine was because for the first time in about 3 years I was suddenly walking correctly - after so long with a limp and walking with a cane. My muscles etc. just weren't used to it and had to re-adjust. In fact, I still have muscle pain down the front of my thigh - mainly when getting in and out of the car or in and out of bed. It is lessening with time - but it's a slow process. Not only are all those poor muscles cut during the op - but then they are expected to move in a completely different way to what they had been accustomed to!
That is just my own opinion on what might be happening with your knee - I'm sure Jo will be able to give you her expert opinion when she is next on-line.
How is everything going otherwise?

Peta
 
~ it's not uncommon to get knee/thigh pain after a THR for the reasons Peta gave. Can't improve on that. I suggest you see the physio or a chiropractor and get some deep massage.

~ larger heads do have a lesser risk of dislocation but from what I have learned from my learned (ex) colleagues, it's a little over-rated. The surest way to guard against dislocations is to have the implants properly positioned in the first place. IOW dislocations almost always have their root cause in poor surgical technique. These complications are rarely if ever the fault of the implant. Charnley's famous small headed prosthesis was pretty secure but got a bad rep because people weren't placing them properly. The old saying about workmen and tools comes to mind!

~ surgery overseas is great when everything goes swimmingly! The nightmares begin if you get problems - anything from thrombosis to dislocations, loosening and infection. If you have no surgeon here in the UK, to whom to you go for treatment? Your local surgeons won't want to know (even privately) as they didn't do the surgery. There was a documentary on BBCtv (I think) some months back that dealt with this issue. It would be the same if you simply went to another county, incidentally. I was considering having my knee done at the RNOH in London but I met with the local surgeon and asked him if he would undertake my post-op care which he agreed to do - but then he does know me! (He's doing my knee anyway now!)

As I said - it's fine if all goes well and 99% do go well. But someone has to be in that other 1% and personally, I'd like my surgeon on hand, not 4½ thousand miles away!
 
Hi Josephine,
thanks for the reply. Agreed completely about overseas operations, and I'm glad you drew my attention to the problem of aftercare, which I hadn't thought through before. But there are always going to be people who do elect to come to somewhere like India for cost reasons, and I wonder if it might be useful for those who do come to have some info on the pitfalls and advantages as seen by a long-time resident of the sub-continent, as well as on the problems you've raised. I'd like to offer something back to the forum, if it's useful.
all the best
Nick
 
Hi Nick,

I've had what sounds like some of the same knee pain you are experiencing. Mine actually started before surgery and my dr. told me it was probably bursitis. He also said it could be because of the limp, that my body was not properly balanced. Kind of an ache on the outside of the knee - is that what yours is? Hopefully we'll both get over that as our bodies continuing healing and get more balanced! Mine was also non-cemented metal (cobalt chromium) on x-linked poly, I think my ball was 38 mm.

Karen
 
I wonder if it might be useful for those who do come to have some info on the pitfalls and advantages as seen by a long-time resident of the sub-continent, as well as on the problems you've raised. I'd like to offer something back to the forum, if it's useful.
all the best
Nick

Of course, provided you don't mention any clinic, doctor or agency by name.
 
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