THR Heterotopic ossification, not what I expected

[Jamie]

@Mr. Fun….it sounds as though you may have received a good diagnosis of your problem from this second surgeon. I’m sorry it’s going to take you so long to verify that is the problem and find someone who can offer you options to help. Heterotopic Ossification is actually a fairly common occurrence after hip replacement, but as you’ve learned, it can be mild or much more extensive. You are very wise to seek out someone who deals with it on a routine basis as it may be more likely to return to some degree if the surgeon is not careful. Even if things go well with the surgery, it may still return to some degree.

Since you have to wait so long for your imaging, would you be able to pay out of pocket and make a trip to get the imaging done in the US? If you can afford that, it might speed things up for you.

 

[Mr.fun]

@Jamie Hello Jamie. I have just been notified that I have a CT scan Dec 6. So hopefully a more detailed image will give me some answers. I am still hesitant to accept the HO diagnoses but will wait for the CT SCAN and radiologist report. Also waiting for referrals outside of my area. No one will be operating on me until I am convinced that it is HO. I'm hesitant to accept the diagnoses only because these symptoms that I have where straight out of the gate after surgery. Like I said before, I was getting better until I hit 5 weeks and stayed at the same spot. My original surgeon said that once the bone is removed all my symtoms/complaints will resolve. A list of complaints is in my threads. To me it does not seem like HO would give the issues that I have. From what I have read. But I am not a doctor. I am still leaning on a misplace cup because my hip feels more forward and the extra curve I have acquired in my back from surgery is more pronounced and painful. I'm hoping that the Ct SCAN will dictate how my hip placement is.

 

[Jamie]

Hey….HOORAY!!! That’s good news. You are right to question things and be sure the diagnosis makes sense to you. We all need to be our own advocates for medical care these days. You have legitimate concerns and questions because of how you felt right out of surgery and the changes you’re describing with your spine. It’s also possible to have the ossification AND an additional problem, so that could be the case. Body alignment can be a huge issue with hip replacements. Research is showing there is much more of a relationship between hip problems and spine issues than people realized. Often surgeons focus on just the hip and get that replaced only to have the patient start experiencing alignment problems associated with the spine. Keep on it and hopefully you’ll get to the bottom of what’s going on.

 

[Mr.fun]

Finally got my hands on some of xrays.
first one is Feb 8 day of surgery.

2nd one is May 9 (3 months post op) when HO was discovered

3rd is Oct 25- most recent XRAY.
It appears that nasty HO is worse then I thought and it appears to be getting worse

 

[Jasmacc]

Finally got my hands on some of xrays.
first one is Feb 8 day of surgery.

2nd one is May 9 (3 months post op) when HO was discovered

3rd is Oct 25- most recent XRAY.
It appears that nasty HO is worse then I thought and it appears to be getting worse

Wow! That is terrifying!
did they indicate why this happened to you?

 

[Mojo333]

Hi @Mr.fun
It does look like the Xrays show definitive HO, and though, not, I am sure what you wanted to hear....

It is hard to determine why this happens in some cases but according to a paper from the U.S. National Institute of Health that extensive rim trimming, anchor placement, and male gender can be relevant predisposing factors.
Here is the paper's link

Heterotopic ossification after hip arthroscopy

Heterotopic ossification (HO) after hip arthroscopy is the abnormal formation of mature lamellar bone within extra skeletal soft tissues. HO may lead to pain, impaired range of motion and possibly revision surgery. There has been a substantial amount ...

www.google.com

I don't know alot about H.O. but there have been some members that have had to have surgery to resolve...as it obviously needs to be addressed.

Hope having some definitive answers can give you peace as you go forward.

 

[Hotchocolate]

Ouch ouch ouch. Human bodies are fascinating and horrifying

 

[Mr.fun]

@Jasmacc no answers to why this has happened to me. I'm the lucky 4% I guess.
My surgeon does not do the excision for this. Not sure where to go from here. I have a CT Scan Dec 6 to get a better view of the exact location. Will follow up with my surgeon and he will refer me to the proper surgeon. This Has been Such a long road. Not only to deal with waiting to get the hip replacement (2yrs) but also when you don't heal properly it's mentally fatiguing. My pain is worse now then PRE OP. It's around a 4-7. Any kind of sitting sucks. Walking feels better but I pay for it later. Can't help but think there is more going on with my hip the just HO. But I guess I have to have trust in my surgeon. Will be interesting to hear what the CT SCAN says for cup placement. It looks angled to far down to me. It's a waiting game.

 

[Klaudia]

Hold on a little longer. When this nightmare is over, champagne will be popped around the globe

 

[Mr.fun]

I'm OK witht the lack of range of motion. It's the tenderness on my hip flexors. Still getting severe zaps and zingers. I wonder if it the bone growth casuing these sensation. tearing burning and pulling of my hip flexor is fun. I push forward and go to work. My family needs me to work to keep a roof over our head. That is my purpose. I will not fail at this and will come out a better man mentally and physically.

 

[Layla]

Respectfully...while it's a necessary part of your role as husband / father, your purpose is more than putting food on the table and a roof over your family's heads. I am quite certain your family looks to you as their protector, encourager, disciplinarian, trusted listener, supporter. You are a teacher of patience, honesty, humility, compassion, self discipline and respect of others...to name a few. Don't sell yourself, or your role as husband and father short. Your family loves you and your presence and the time you spend with them is one of the greatest gifts you give them.

Hopefully this will be a blip on the screen one day and something your kids may not even remember, if they're young enough. I am so sorry for the physical discomfort and mental fatigue this is causing you. It looks like December 6th is your first step toward resolving the issue.
I wish you only the best and lots of comfort as you go through the motions. Please keep us posted, we do care.
I hope today is a good day, Mr.fun!
@Mr.fun

 

[AllieBucks]

I’m so sorry to hear about the chronic pain. I know it must be so frustrating. I agree that the HO is a problem but in your opinion, doesn’t it seem that your acetabular cup does overhang more than usual? I compared it to my X-ray and looked up others online. My cup fits into the bone area completely and in your X-ray it extends out. Just thinking that that would certainly pinch if you raised your knee up, sitting, etc. I think this might also be adding to the problem. Very curious to seeing what your doctor says with the new imaging. Hoping that you are moving forward to some solutions soon!

 

[Mr.fun]

@AllieBucks HI Allie interesting that you would notice cup placement. I have also notice my cup placement as well. I have brought that up to my surgeon and he says that cup placement is proper. 2nd surgeon (his colleague) also said placement is proper.(biased opinion) One of the reasons I pushed for a CT SCAN was in hopes that the radiologist would say in millimeters the over hang if any. I have complained right from surgery of the pinching and Extreme lack In RANGE OF MOTION. I do not believe I ever had a feeling that I was getting better and then deterioted. I am petrified to go through HO excision only for their to be a cup placement issue. I had anterior hip replacement and I feel that all my impingment is under the scar are. I'm not sure what iliososas impingment feels like. However when I read up on the symptoms of HO and iliosoas impingment the symtoms overlap. My pain does not feel deep. It's an extreme pinching more to the surface. In the beginning I tried to steer the surgeon towards iliosoas impingment but he said my pain would be a deep ache. I'm confused and over the top frustrated. I will however push for another surgeon out of my area for another opinion. Thank you for lending an ear.

 

[AllieBucks]

Just throwing it out there - could you possibly try getting a virtual second opinion while you wait? Glad your CT scan date is soon though, and hoping that the scan reveals some more details.

NYU offers one (not sure if US residency is required).

Hang in there

 

[Mr.fun]

@AllieBucks I live in Otario, Canada. Our healthcare system is incredibly slow. Referrals to other surgeons take 6 months to a yr and then surgery is most likely a 2yr wait. I'm In for a long Road. Thank you for your advice though it is appreciated.

 

[AllieBucks]

Absolutely. Sending you well wishes and hoping things get resolved for you sooner than later.

 

[Mr.fun]

CT SCAN RESULTS
I see my surgeon nxt week and will ask to see someone who specializes in heteroptic ossification excision. I'm still being patient at 10 months out though. Pain around 4-7. Still can't put right shoe or sock on and sitting still sucks. I Still have a limp. I did not have these complaints before surgery. Definitely worse now then before the hip replacement. I am hesitant to go through with another surgery for fear of coming out even worse. Will definitely be ready with my questions for the new surgeon whenever that may be.

 

[Layla]

I am sorry you continue to struggle with this and for the physical pain you're suffering and the limitations you're dealing with. It is easy to understand why you're feeling a hesitancy to act on resolving the issue. While I am not in your shoes, please forgive the example I'm using to TRY to relate to your feelings...the best I can. I will compare it to the fear and anxiety many of us felt pre joint surgery. For many we soldiered on needlessly through pain and physical limitations out of fear of the outcome of a surgery yet scheduled. What if it didn't help, what if I had a major complication, what if I didn't make it off the table in the OR?!! I believe a good share of us can relate to those thoughts. But...we took a chance for a brighter future, just as you did. Sadly, you're one of the unfortunate still dealing with pain, uncertainty and an unfavorable outcome and for that, my heart goes out to you, truly. However, I do feel that brighter future is still a possibility for you. You can not go on like this for your sanity, or the welfare of your family watching you struggle in pain. Your current condition hurts them also. My hope for you is that you research until you find the best surgeon for the job, put trust in him and go through a procedure that will hopefully bring perfect healing and the life you imagined you'd have post joint replacement. I hope you don't mind, but on this day, I am lifting a prayer to that end, for you.
Know that we're here, know that we care.
@Mr.fun

 

[Constanze]

@Mr.fun, I'm also sorry you continue to struggle. Everything else is well said by Layla. I wish you all the best for your appointment at your surgeon. What's preoccupying me: If you can't put right shoe or sock on - are you dependent on spouse/relatives to do so or can you at least work around this problem with aids like a shoe horn or "sock putting on aid"? It must be pretty frustrating after all this time. So maybe heteroptic ossification excision would help if this is an option. Do carry on reporting about the outcome to us. We're interested .

 

[Mr.fun]

@Constanze depending on who is around I may ask for assistance. I usually slide my foot in. Bend at the knee and grab the heel from behind. Then put my foot down and wiggle the rest in place.