Revision THR Has anyone ever heard of late onset metal hypersensitivity in a ceramic on ceramic hip

[waterman1]

z,
Thanks so much. My os states that for those patients 'needing both hips replaced' he prefers the modular design which aids in many facets of alignment, leg length, and ease of surgery. I feel there is double the exposure to the Cobalt allergic problem, and the 'galvanic problem' you have enlightened me about. From the reading I have done, the allergic problem seems to occur in less than 10% of the patients with one implant. I have found no data on those with two Cobalt and modular implants. He is offering to make the second implant consist of ceramics if I am concerned of doubling my risk with two Cobalt implants. From your experience, if you were having both hips replaced, what would be your choice of implants for the second hip surgery, please? If you want me to sign a waiver, I will, LOL...

 

[Z15]

Waterman1,

My implant IS ceramic on ceramic. All that refers to is the rubbing surfaces between the ball and socket. My surgeon has done thousand+ modular hips and I was the 4th patient of his requiring a swap out.

I would also contend that in wear and tear and excess forces, I push my prosthesis pretty hard. I'm confident that that added to the amount of corrosion that I got mine to produce.

When I do my next hip it will likely be a one piece titanium with ceramic on ceramic.

Z

 

[waterman1]

Roger that, Captain! My OS mentioned he believes ceramics 'burnish' and become noisy. Any thoughts on that, please...

 

[Z15]

I have no squeaking...but I know that some do. Here is an article with some stats from my surgeon.

Not sure if anyone listening in has dealt with this and has better info...

https://www.healio.com/orthopedics/...in-total-hip-replacement-no-cause-for-concern

 

[randy62]

John,
I wanted to check in with you also and thank you for not only your words of wisdom, but also for your words of encouragement. I will be doing the Bellin Run this year and then backing off of running and pure PT for my next hip circa Sept time frame.

 

[waterman1]

Z15,
Whew, read most of what you provided. I believe the ceramic with it's inert properties is the better choice. Thank you for your time, and please let me know if there is anything I can do for you...

 

[waterman1]

Z15,
Man, I am all over the place with decisions to be made about my next hip. I believe you and many others have great experience ahead of me with the best implants, and I must make a choice here in a couple of days. I just received a second opinion from a well known surgeon in hip resurfacing and hip replacement, Dr. Raterman, Tampa, FL. When I told him my first implant was a modular design, posterior surgery, Chromium Cobalt metals, he shook his head and said he wished I had talked to him first. He performs anterior only surgery. He believes my right hip is a candidate for resurfacing. If I don't choose this, he believes in solid stem, non modular, ceramic implants. My question to you: Should I have resurfacing performed if it's an option? Is anterior surgery that much less painful? We already know your answer about the solid stem ceramic implant, so I believe I have found the right surgeon and implant for THR, but of course I am leaning towards resurfacing if my femur ball can handle it. I have about 48 hours to confirm my new surgeon and surgery date of June 23. Any advice?

 

[Z15]

Waterman1,


I am totally unqualified to advise on much of this...but resurfacing especially.

here are things that I am comfortable weighing in on...

I had a posterior approach and was extremely pleased with the results. I think either approach is fine ... depending on the surgeon.

I think that ceramic on ceramic is a fine bearing surface which seems to be well received in comparative studies.

I would go with a one piece prosthesis unless my anatomy really required modular.

I bailed on the resurfacing research early based on what a couple surgeon's saw in the deterioration of my hip socket...so know very little about it.

And don't feel bad about your choice on modular hip for the left. I think the VAST majority of people have no issue with this design, but the science seems to be trending toward it being an overused technology.

Good luck with your decision!

Z

 

[waterman1]

Thanks a lot. I am going with ceramic, non-modular implant on my second surgery with the anterior approach and a different surgeon... Hope your situation is improving, please stay in touch...