Heterotopic ossification

Status
Not open for further replies.

BuckeyeSixx

new member
Joined
May 26, 2008
Messages
11
Location
Ohio, United States
Hi all!! I am 8 months out from a left THR and still having issues. Has anyone here had any problems with heterotopic ossification? CT scan a few weeks ago showed it over the greater and lesser trochanter and a lack of bone formation around the acetabular cup. The implant is loose and I can feel it shift and the heterotopic bone is also causing a lot of pain. My Dr wants to do a revision next month but he first wants me to see a Dr that specializes in revisions to make sure he's not missing something before we start hacking at me again.
 
Hi ...I am not sure if this is any help to you but a few years back my hubby had a hip replacement and over the next several months the joint became loose and the muscles on that side of his bum just jiggled. It seemed that he was not doing his exercises right. He thought walking etc. made up for all the other things he was not doing. The surgeon then sent him to a sports clinic for a bit so that he could strengthen his muscles . It worked and he is fine now.
I learned a very good lesson from him and that was to do your exercises correctly for when I just had my TLKR.
I hope this helps you a bit...Carol
 
Thanks for your reply but lack of muscle tone is not the issue that is causing the implant to be loose. It is a lack of bone formation around the acetabular cup. I have bone growing where its not supposed to and no bone growing where it need to be.
 
After reading your post I was wondering if you would have the revision specialist actually do the surgery? Will it then be cemented?
Good Luck with all of it. Keep posting and let us know how everything goes.
Judy
 
I'm not sure who is going to do the surgery, the doctors are partners in a large practice so I think this will be some sort of team effort. I'm fine with either one.

#heterotopicossification
 
Heterotopic just means 'in the wrong place' ~ topic meaning 'a place' and hetero meaning 'elsewhere' or 'outside of' (roughly translated!) as shown in the image below outlined in red. It is genrally caused by abnormal movement such as you have in connection with the loose acetabular cup.

The ossification is a peripheral matter; your principal problem is the loose cup. This has occurred because the primary surgery was wanting in good technique.
Were I in your shoes, I wouldn't go back to him - I'd have the revision surgeon to do it.

And as a matter of comment, revisions are pretty much always cemented. However, you don't say if the femoral component is solid or not. If it is, you should only need the cup redone.

[Bonesmart.org] Heterotopic ossification


 
The femoral stem is in there solid but that will be removed and replaced with one that has a larger ball on it...I partially subluxated it bending over to pick up the dog's bowl. I have issues with scar tissue and there is massive amounts of scar tissue in front from the previous arthroscopies I had before the replacement and when I bend at the waist, it pushes on the joint and tries to push it out of place. I have no problems going back to my surgeron. He's one of the best in the city. I was pressured to go back to work too soon and my job was an extreamly physical one and in doing that, I practically destroyed the new joint before it even had time to heal. My dr has put me on total disability and I will not be going back to that job when I am healed. I'm not sure what they plan on doing about the acetabular cup. I'm assuming that they will cement it. My physical therapist has been working on breaking down the scar tissue so maybe I'll get lucky and the femoral stem can be left alone.
 
You're very forgiving - I'm not sure I would be so. And revisions are nearly always cemented in. I hope you have better luck next time around.
 
**UPDATE**
I seen the revision specialist and he didn't think that the implant was loose. He said there is a majority of bone growth around the acetabular cup so it is in there solid. The looseness is instability of the joint which is resulting from the previous subluxation and the continuning pressure from the arthroscopy scar tissue pushing on the joint. I went back to my surgeron and the solution is still the same...revision. He said I could keep waiting to do the surgery, it would just be a matter of how much longer I can stand the shifting and popping and the resulting pain and irritation from it. I was going to try to tough it out a little while longer but everyone thinks that I should just get it done and over with now so that I will be ready to roll by time summer comes around. I am scheduled for revision on March 4th. Not quite a year out of this one. Maybe the second one will get me 20??!!!
 
So he set the femoral prosthesis in too low! Sadly, that does happen although it shouldn't. I really hope you get a better result this time.
 
Status
Not open for further replies.
Back
Top Bottom