THR Heterotopic Ossification after Total Hip Replacement

[Josephine]

The question I still don't have an answer to is that there are drugs that can be given just after a THP that may have prevented the HO. However, I'm not a doctor and I don't know if there are side effects to these drugs

The drug of which you speak is Fosamax, generic name alendronate, which is part of a group of drugs called bisphosphonates and they do have some quite horrid side effects not least of which is a rare one of jaw bone death. This is when the bone dies back from the teeth and they drop out. It's painful and debilitating. I wouldn't want to take them. Alternatives are ibuprofen and radiotherapy.

 

[CalciumHip]

Josephine, Thanks for this info and I will make sure my wife doesn't take that drug. I'm really hoping she will be able to live with the calcium build up she has now and hoping that some of it will be reabsorbed back into her body.

We are working to get her muscles more strength in both legs but especially in the leg with the HO. The biggest problem she still has is not being able to put on her socks or shoe on the leg with the HO. She is getting closer to being able to reach her foot on that leg but she is not there yet.

I don't want her to have to have the operation to remove part or all of the HO for fear of the calcium coming back or her having to go through radiotherapy. The Orthopaedic Oncology that she saw at Emory Orthopedics in Atlanta felt he would not have to do this surgery on her with her range of motion she has now.

We will know more at the end of a year from her hip replacement surgery which will be September 2017.

 

[Josephine]

All very good! Keep it up.

 

[Jamie]

I'm glad your meeting with this new specialist went well. He sounds like the right person for your wife's case. Good for you for locating such a great resource! Sorry this has to be such a waiting game for a few months. Hopefully you can find some things that your wife can do without pain to enjoy the summer months and help time pass. I'll be hopeful that her condition will continue to improve too! Not needing the surgery after a year would be wonderful!

I am going to make a donation to your web-site as I have really appreciated the help and information I have gotten from you guys.

We so appreciate you making a donation to BoneSmart. No matter what amount is given, it helps us be able to continue our work here for hip and knee replacement patients. We depend on member support so much! Thank you.

 

[CalciumHip]

I haven't posted about my wife in a while and I thought I would give you an update. She is doing somewhat better but still needs a rolling walker to get around when she is outside.

She still doesn't drive herself although I let her take her car out by herself once and she did OK. She is saying (and I'm sure she is right) that the calcium (HO) is growing larger. Her hip replacement was on Sept 4, 2016. We have to wait until after a year to go back to the doctor to see if she needs surgery to remove the calcium or hopefully she can live and function with the calcium build up.

 

[Josephine]

Oh well, nice and easy does it, okay?

 

[Jamie]

Thanks for the update. I've been wondering how your wife was doing. I know this waiting seems never ending, but hopefully you both will be through all of this soon. I'm just glad to hear she is mobile and able to cope with all this. You have been such a helpful partner for her.

 

[CalciumHip]

Sorry but it's been a while since I have made a posting on this website about my wife's problems after her hip replacement last year after which she developed a very rare condition called Heterotopic Ossification (calcium buildup which has harden into new bone matter). To recap, Anna had her left knee replaced on Aug 25, 2016 by Dr. Charles DeCook in Cummings, GA (well known hip and knee surgeon). A week later (over Labor Day) she fell in our house and broke her right hip. She had to have a total hip replacement on Sept 5, 2016 (a new knee and a new hip within one week). In January we were out and she fell getting into our car (actually she collapsed). I took her back to the surgeon who replaced her hip to see if she had done any damage to the hip or the knee. The good news was that she hadn't. The really bad news was that she had developed calcium buildup in the right hip (Hetorotopic Ossification). It's very rare (maybe 5% of people have this condition from knee or hip replacement surgery and usually it's associated with trauma and that's why she did not get it with the knee replacement but did with the hip that she broke by falling).

We did a lot of rehab (over 75 two hour visits) and she did it at home as well for a long time. However, rehab doesn't do anything to help the HO. I did a lot of research on HO (including this site) and I finally found a doctor who knows about HO and does the surgery to remove it (Dr. Shervin Oskouei, Musculoskeletal Oncology at Emory Orthopaedics Center in Atlanta). Anna had to wait a year to see if the calcium has quit growing. Today we went to the Imaging Center her in Gainesville, GA and she had a full body scan where they have her an injection of radioactive chemicals and three hours later she had the body scans including a 3D scan. We will know in about two days if the calcium has stopped growing in her hip. If it has then we plan on having Dr. Oskouei do the surgery to remove the growth of calcium which is about the size of a tennis ball on the inside of her right femur (between the femur and her pelvis) . She will then have to have a treatment of radiation to help prevent the calcium from just coming back. Which it might do but hopefully with the radiation treatment it will not or if it does it will not be as bad as it is now.

Right now Anna can not walk outside without her rolling walker. Around the house she walks without it most of the time but she get really tired very quickly. She will never have a normal mobility with her right leg without the surgery. And I doubt she will ever been as she was before she broke her hip and the development of HO.

Thank God it's not something that happens to a lot of Hip and Knee Replacements. I will keep you posted when she has the surgery (hopefully this Fall) and how she does afterwards. Comments and prayers welcomed. Thanks, Jerry Carter/ Gainesville, GA/ USA

 

[Pumpkin]

CalciumHip,
Your wives history is important to have in one place and I have merged your earlier thread with your new thread.
For several reasons, we prefer that you only have one recovery thread:

• That way, we have all your information in one place. This makes it easier to go back and review your history before providing advice.
• If you keep starting new threads, you miss the posts and advice others have left for you in the old threads, and some information may be unnecessarily repeated
• Having only one thread will act as a diary of your progress that you can look back on.

So please post any updates, questions or concerns about your recovery here. If you prefer a different thread title, just post what you want and we'll get it changed for you.
If you need an urgent response to a question, just tag a member of staff.
How to tag another member; how to answer when someone tags you

Here are the instructions on finding your thread, How can I find my threads and posts? . Many members bookmark their thread, so they can find it when they log on.

 

[Pumpkin]

Glad to hear you have found a specialist to address the HO, sending positive thoughts to your way.

 

[CalciumHip]

Pumpkin, Thanks for your help with my new posting. I did read a posting from another member about his problems with Hetortopic Ossification. And I believe there was another person who also had this very rare disorder. There is just not a lot of information on HO. It's a very bad condition with not a lot of stories about positive outcomes. Hopefully my wife can be one. Thanks again.

 

[Pumpkin]

Try this list from a search.
https://bonesmart.org/forum/search/?q=Heterotopic+ossification&o=date&c[node]=5

 

[CalciumHip]

This is a note to the imging center about the order my wife's doctor gave her for the NM Full Body Scan to see if the calcium is still active:


Attached Order Requisition for

Nuclear Medicine Whole Body Scan W/Spect

From: Dr. Shervin V. Oskouei,

Emory Orthopaedics Center/ Atlanta, GA


We would like to schedule this whole body scan for Anna on one of the following days: August 22/ 23/24, 2017. Anna would like to come in about 10AM to have the injection and then return 3 hours later (about 1PM) for the whole body scan. She has Heterotopic Ossification in her right hip/right leg.

It's called Nuclear Medicine because they inject a chemical that has a very small amount of radioactive medicine into her blood system and then she would come back for the full body scan three hours later. She did well with the scan which is a lot quicker and not noisy as an MRI. We will know by the end of this week the results.

 

[CalciumHip]

To update everyone on my wife's NM Full Body Scan she had done this past Tuesday. The scan shows that she still has calicum activity in her right hip (Hetorotopic Ossification). The nurse at the doctor's office at Emory told us that everyone is different and that she will have to wait another six months and have the NM Body Scan again. Please continue to pray for Anna and we will continue her expercise and therapy at home.

 

[Josephine]

Most certainly will do! Bless her heart!

 

[HOBooker3]

@CalciumHip
I'm sorry your wife didn't get better news. Will keep you both in my prayers. I don't know if she has some of hip assistance items, but amazon has a hip kit that includes a long shoe horn, a reacher, a sock assist , and some other things. My wife bought some elastic shoe laces that help to make tie shoes easy to slip on, with or without the long shoe horn depending on the shoe. We have talked with an occupational therapist and physical therapist about getting up off the couch or chair. Basically, they've told us to buy or make higher legs for the chair and make sure it has arms. I think they also sell taller chairs. I find it very difficult to get in or out cars unless they are higher off the ground and the seat needs to go back far. I then have to almost lay down to get in.
However I am still working and driving. It seems the more I move , the more limber I feel. Oh, you can also buy a specialized seat cushion , firm, and place it wherever she is sitting. I have one but it really doesn't work for me with the furniture we have. I will try to update at a later date about my drs. Visit.

 

[HOBooker3]

@CalciumHip
I should add that when I move around a bit , I don't feel as stiff. I still do not have full ROM . It much less than the 90 degrees needed to sit etc. just to clarify what I meant by limber.

 

[CalciumHip]

Thanks HOBooker3, Anna and I will pray for you as well. We know what you are going though as Anna is going through it has well.

We have all the items you talked about in your post (except for the fill cushions). I would also like to tell you of something I bought for my wife when she was in assisted care (she and I felt that with her left knee replacement and right hip replacement, I would not be able to take care of her. Actually I wish I had just bought her home because I ended up doing most of what they were supposed to do.)

But, I bought her a toilet seat chair that can go over your regular toilet and it has arms. It's adjustable so you can put it over any toilet. I will find the name of it and post it later. My wife wouldn't do it but you could put a cushion over the toilet seat opening and use it as a high chair. My wife has a lot of trouble getting up especially when we go out to eat and she is sitting in a booth. It was gotten worst as the HO has grown bigger.

A PA at her doctor's office told us yesterday that the scan shows that the calcium is still active and she will have to wait six months and have the NM Full Body Scan again. We are going to try to do it at 3 months. However, my wife and I are not really excited about her having the surgery to remove the HO.

I have never talked with anyone who has had this operation. Have you? Good luck to you and be careful. Let's stay in touch.

 

[Josephine]

I bought her a toilet seat chair that can go over your regular toilet and it has arms. It's adjustable so you can put it over any toilet

Do you mean one like this?

I was able to get two of these on loan as I have loos upstairs and downstairs!

 

[CalciumHip]

Josephine, No the one I bought my wife was like this (see attached photo). It was a seat with a hole and flange that goes into the toilet, a back and arms on both sides. It is adjustable up and down to fit different height toilets. Now she no longer needs this much help in the toilet and has a four or five inch riser that goes on top of the toilet. We also have what is called (in the USA) comfort height toilets which we have installed about eight years ago. We are both tall and the regular height toilets were just too low. Now that my wife has this condition the extra height helps her a lot. Here is a photo of her toilet with the riser attached.