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[REVISION THR] Dislocation

kkmcgill

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hello, I had a bilateral THR in Dec 2015. My hips were a mess from congenital hip dysplasia. I was perfectly fine for 3 years.

December 15, 2018 I was walking and had a sharp pain, followed by squeaking of my hip joint. It was caused by subluxation. The doctor operated and replaced the cup liner and femoral head. The plastic liner was broken and deformed. The surgeon had no answers as to why this might have happened.

The revision surgery was January 18, 2019. Monday I was standing not moving, not doing anything, and suddenly my hip dislocated. Again no answers as to why this happened. I am terrified. Dislocation is definitely the worst pain I have ever been in and the worst pain I can imagine.

I was wondering if anyone had anything similar happen to them? Or if anyone might have an idea as to what has happened? I am not only terrified of every movement I now have no faith in my prosthesis.
 

Jaycey

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@kkmcgill Welcome to BoneSmart! My goodness you have had quite a journey with that hip! So sorry you are going through all this.

Did you have the same surgeon for all your surgeries? I really don't think it's common to have the implant break. But I am not a medical expert. I'm going to tag our Forum Nurse Director @Josephine for her input on your experience.

Meanwhile I'll leave you our recovery reading list:
Hip Recovery: The Guidelines
1. Don’t worry: Your body will heal all by itself. Relax, let it, don't try and hurry it, don’t worry about any symptoms now, they are almost certainly temporary
2. Control discomfort:
rest
elevate
ice
take your pain meds by prescription schedule (not when pain starts!)​
3. Do what you want to do BUT
a. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you
b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.​
4. PT or exercise can be useful BUT take note of this BoneSmart philosophy for sensible post op therapy
5. Here is a week-by-week guide for Activity progression for THRs
6. Access these pages on the website

Pain management and the pain chart
Healing: how long does it take?
Chart representation of THR recovery

Dislocation risk and 90 degree rule
Energy drain for THRs
Pain and swelling control: elevation is the key

Post op blues is a reality - be prepared for it

Myth busting: on getting addicted to pain meds
Sleep deprivation is pretty much inevitable - but what causes it?

BIG TIP: Hips actually don't need any exercise to get better. They do a pretty good job of it all on their own if given half a chance. Trouble is, people don't give them a chance and end up with all sorts of aches and pains and sore spots. All they need is the best therapy which is walking and even then not to excess.

We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery. While members may create as many threads as they like in a majority of BoneSmart's forums, we ask that each member have only one recovery thread. This policy makes it easier to go back and review history before providing advice.
 
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kkmcgill

kkmcgill

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Hi Jaycee,

Thank you for the tips! The surgeon who did the original surgery was no longer practicing at my hospital, so a different surgeaon did the revision. The same surgeon who did the revision was who did a closed reduction on Monday.

He ordered PT but the therapist is afraid (as am I!) to do much with it at this point. She wants me to rest and has recommended a hip immobilizer brace. The surgeon has agreed. I am waiting to hear back from his office about the brace.

Meanwhile, I have contacted a different orthopedist for a second opinion. I feel like I need some real answers at this point. I cannot live the rest of my life with this constant fear of dislocation.
 

Jaycey

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I have contacted a different orthopedist for a second opinion. I feel like I need some real answers at this point.
I think this a very smart move. You need a new set of eyes on all this. And yes, you should not spend the rest of your life worrying about dislocation.

Please keep us updated!
 

Eman85

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WOW! I feel for you. I think about dislocation all of the time but have never had anything even close to having it happen. The one person I do know that had it happen did have it happen twice and then had a revision which corrected it. The idea that a Dr. ordered PT right after a dislocation is surprising, and that the PT made the call not to is probably a very good thing. Another opinion would be a good idea.
 

Josephine

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I'm so sorry you're having this horrid experience. But I must tell you that almost all dislocations are as the result of malalignment of one or both prostheses. The only remedy is a revision of the hip replacement, both parts. You need to find yourself a really good hip revision surgeon to get this done. Not all surgeons are capable of diagnosing and/or dealing with this. I'll tag my colleague to see if she can suggest someone suitable. @Jamie
 

Layla

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Aww, I'm so sorry. What a story!
Welcome to BoneSmart, thanks for joining us here. You'll find lots of support so please stay in touch.

I don't understand the OS prescribing PT either. You'd think your OS would want the prosthetic to settle in place after what you've been through. The therapist is even afraid for you to do PT. Just my opinion, I wouldn't even consider PT at this point.

Following is the Big Tip from the Recovery Guidelines -
BIG TIP: Hips actually don't need any exercise to get better. They do a pretty good job of it all on their own if given half a chance. Trouble is, people don't give them a chance and end up with all sorts of aches and pains and sore spots. All they need is the best therapy which is walking and even then not to excess.

Let us know what you find out after your meeting. Hopefully you get the answers you're seeking.
Wishing you comfort and perfect healing.
@kkmcgill
 

Jamie

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Hi, @kkmcgill....so sorry to hear about all you've been through with your hips. I can help you find a revision surgeon if you want some assistance, but I'll need to know a few things first.

I see that you live in a relatively small town in Illinois. Can you tell me where you had your last surgery done and who the surgeon was? I also need to know if you are willing to travel to a larger city to seek additional opinions...like Springfield, Chicago or Indianapolis? You will need a very experienced surgeon who is used to working with problem hip replacements and fixing another surgeon's work. These guys are out there, but they are usually associated with the larger hospitals in big cities or with university teaching hospitals.
 
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kkmcgill

kkmcgill

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Hi @Jamie,

I got a call back from the Fransican bone and joint center in Indianapolis yesterday. I have an appointment for a second opinion on April 8. They are rated very well. I have had all my surgeries done here in Paris. Dr. John Rowe did the original THAs. Dr Ronald Wheeler has done the revision and the closed reduction.
 

Jamie

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Who is your second opinion doctor in Indianapolis? Be sure and ask how many revisions he does and his success rate with them. Also ask how many revisions he has done on cases similar to yours. You want a surgeon who sees a lot of problems and is good at fixing them. You are wise to have chosen to drive to Indianapolis.
 
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kkmcgill

kkmcgill

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Who is your second opinion doctor in Indianapolis? Be sure and ask how many revisions he does and his success rate with them. Also ask how many revisions he has done on cases similar to yours. You want a surgeon who sees a lot of problems and is good at fixing them. You are wise to have chosen to drive to Indianapolis.
Dr. Timothy Williams is who I am going to see, he practices at Franciscan Health Bone and Joint in Mooresville, Indiana (just outside of Indianapolis.)
 

Jamie

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In looking at their website, I didn't see that the Mooresville location surgeons did revisions, so it will be very important to ask Dr. Williams about his work in this area. But his philosophy of choosing the right surgeon (in his video) sounded like he agrees completely with what we tell people here on BoneSmart. You want a surgeon who has done a lot of surgeries like yours in order to have the best chance for success. I look forward to hearing how your meeting with him goes. Be sure and keep us up to date and good luck!
 
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kkmcgill

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I went to see the surgeon who did the revision and closed reduction today. He wants to do another revision (posterior this time) and replace the entire prosthesis. His theory is that the femoral stem is rotating causing the dislocation. He doesn’t like the length of the stem that was used during the original surgery. He also is concerned about the angle of the acetabular component. I am waiting for his nurse to call back, for now they are bracing the hip. I am not doing anything, especially another surgery, until I see the other surgeon. Attached is a pic of the dislocation from Monday (3/18/19)
 

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SurreyGirl

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Omg! I feel queasy even looking at that! Hope you get the best outcome soon.
 

Mojo333

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You poor thing. Oweee!
Much sympathy here.
We are rooting for you.
 

Mojo333

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:hi:Hope all is going well with you and you are back to life!:yes:
 

Newbie tkr

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Hi KK: my name is Diana, otherwise known on BoneSmart as Newbie.
I, too, had a revision done (LTHR) on April 1st of this year.
At some point after the surgery, within a day and a half of the actual surgery, my hip became dislocated too. I just didn't know it until they tried to get me up and walking. I fainted instead and my blood pressure plummeted. That's how I found out about the dislocation.
I really wish that I had some wisdom or advice to give you about your situation. My OS was able to manually manipulate my hip back into its' proper place while I was still in my hospital bed, thank God.
I just wanted to let you know that this website has been of huge help to me. I first came onto BoneSmart when I had a full left knee replacement done in 2015. This website got me through it, as it was really hard recovering from that for me. So of course, when I knew I had to have the revision done on my left hip, I came right back to this website for support, advice, information, and general encouragement altogether. I advise you strongly to check in here with people like Layla, Mojo, Josephine and others.
I'll be thinking of you and wishing you the best in terms of getting this hip straightened out once and for all. I'll check back into bonesmart from time to time to ask how you're doing. Good luck to you!
 

RobertHip1

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Hi I'm really sorry about your situation. I'm not in a great place either. Can you tell me was your cup fixed in place with screw's? Also what did subluxation feel like?
 

Layla

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Hello @RobertHip1
Sorry you're not in a good place.
Let's tag @kkmcgill in the hopes she gets a notification that you've posted on her thread.
It appears she hasn't been here in almost four months so fingers crossed you hear from her. :fingersx:
If there is any way we can be of assistance, please let us know on your thread.

Hi @kkmcgill
How are you doing? Please leave an update when you have time.
We're here for support if you need us.
 
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Hi, so sorry to read through your story. Check out my thread. I literally feel your pain. I dislocated in my sleep 2 weeks after my revision. I’m fearful of this happening again. Surgeon said this is more common in revision patients bc the tissue was already operated on once and is comprised. Still trying to process all this. I know, it sucks! The upside to my surgery is the pain I went in for is gone. But at the moment I’m not sure which is worse, the before or after surgery.
 

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