Become an Insider

Revision THR Looks like maybe a revision will be needed...

@zinnia Well that is really helpful, thank you so much. I figure that eating a lot of protein in many forms is the one thing I can actively accomplish, not that I didn't the first time around, but I didn't measure and count the way I will now. It just gives me (and my husband who will be feeding me) something to focus on, always a good thing for me at least! I have surgery in 5 days, my mental countdown has begun. All should be in place by then. I am holding tight onto my badge of courage.
 
@chalcedonian1 , I'm following your thread closely. You are on the journey I expect to begin shortly. I'm learning so much from your advice and guidance and that of all the contributors to your thread. I know your revision surgery is now just days away and you are focused on that milestone. I wish you success and quick healing.
 
@TerryB_TX Thank you for the wishes for success and quick healing. @Jaycey Thank you for being in the cheering section!

@Josephine I noticed you wrote on @TerryB_TX 's thread that use of NSAIDs during the post-op period can inhibit new bone growth. Do you have any particular studies you can cite/point me to? I have found a number of studies but they conflict with one another, or are inconclusive. My revision surgeon has prescribed Celebrex for a two week period following surgery. I plan to call his office tomorrow to ask why this particular regimen--perhaps it is to do with ectopic bone formation? I would like to understand this better. In my brief research (read with a non-medical brain), I see some agreement in studies that NSAIDS inhibit heterotopic bone formation, some studies that state they had no effect on long-term pain or disability, studies where a short course of celecoxib was associated with a lower incidence of HO after THR (interestingly, that study indicated men had both greater incidence and severity of HO than women). Animal studies show delayed healing and nonunion with NSAID use. Some of the studies I've quickly reviewed go back to 2006, perhaps earlier. I don't see any current studies reflecting more recent research, however. I also tend to be skeptical about results if scientific research is sponsored by pharma companies, etc.

I was NEVER told by my OS (or any other physician) to avoid NSAIDs; I do not believe the OS prescribed Celebrex or related meds to me either. In fact I never researched it until I saw some references on this site the other day, and your comments today as I mentioned, coupled with intending to get the scrip filled tomorrow for the two week period. I do not know if I will be advised to NOT take Alleve/Advil etc. thereafter, most especially during the 12 weeks or so for the new bone growth, but so far, there has been absolutely no mention of this. I know you prefer tylenol/aceptaminophen because of side effects of NSAIDs. What negative effects would a two week Celebrex dose have vs. benefits? Am I guinea pig here, and why would I go near even one tablet of an NSAID when I have proven to have difficulty with bone growth around my implant already?? And if the bone has finished growing around the implant, would taking NSAIDs, say, a year later, have any impact on the stability of the implant in the bone??? I would very much appreciate your full opinion if you have the time. I don't think I could be more confused, and of course I am concerned. Thank you.
 
I was not able to connect with the Nurse Practitioner today at my revision surgeon's office. However, I do have a hand and shoulder surgeon who is the best thinker I know, and I called his office just to get his opinion on this issue, and not to get medical advice. Before I even finished my question, his assistant said that he warns all of his fracture patients to not take ANY NSAIDs for three months after a bone break, or after the bone is reset, etc. His opinion is that Tylenol is ok so long as the dose is properly calculated, because meds like percocet contain amounts of acetaminophen.

He understands other doctors have other opinions but he has been in practice over 30 years, and this is his belief and observation in his practice. I will call the revision surgeon's office again on Monday. If I don't reach him, or someone knowledgeable, I am not comfortable with "arguing with him" the day of my surgery, but as of this moment I do not intend to take any Celebrex/other NSAIDs while in the hospital or at home, unless there is some huge chunk of research that I am missing they can point me to that proves all this wrong.

Just the mere possibility that I could ingest something that might impair bone growth, after I have already proven I have a problem with this issue and now need a revision as a result, is enough to make me run in the opposite direction. So @Josephine unless you know of new research that exonerates NSAIDs in bone growth, that is my current plan.
 
@chalcedonian1 I don't blame you for being concerned. I queried this issue with my surgeon pre-op my RTHR. I had been taking a NSAID for lower back pain for years. It was also prescribed for my hip pain. I asked about not taking this medication for a period of time before my op and then during recovery - twice. Both times the answer was the same - take your meds before and after your op. They sent me home with only a NSAID for pain relief.

So what to do. I think given your situation I would also opt for not using a NSAID. You already have a history of impaired bone growth. You certainly don't need anything more to aggravate that situation. Go with your gut feeling.
 
@Jaycey Thank you. I am going to say I have a problem with NSAIDs and just hadn't focussed on this before--it is true, I do have a problem, I am just not saying what that problem is. If the conversation goes further than that, I'll have to then state my concern. But it is my body, my decision.

I really would like @Josephine to weigh in with her suggestions too.
 
:wave:Thinking of you and wishing I could come up with some reassuring words as you ready for round two for this hip.
I feel your determination to try and make sure everything goes Right this time.
As Jaycey says, go with your gut.
Your body.
I do hope you will be at peace as you go into this surgery. We are rooting for you, in a big way!
Sending you all the best!:angel:
 
Last edited:
chalcedonian1 said:
use of NSAIDs during the post-op period can inhibit new bone growth. Do you have any particular studies you can cite/point me to? I have found a number of studies but they conflict with one another, or are inconclusive.
Click to expand...
Actually no. Wish I did but I do know that it is one part of the treatment criteria for Heterotopic ossification so logic tells me this is not something to be easily dismissed.
chalcedonian1 said:
I would like to understand this better.
Click to expand...
Me too!
chalcedonian1 said:
I see ... some studies that state they had no effect on long-term pain or disability
Click to expand...
I fully agree with this. In fact, I complained to the Trading Standards (UK) last year about a television advert that stated unequivocally that ibuprofen was a better pain reliever than paracetamol (acetaminophen). And the TS agreed and required the manufacturers to remove that statement from their advertising. I understand this has also been done in Australia.
chalcedonian1 said:
I was NEVER told by my OS (or any other physician) to avoid NSAIDs;
Click to expand...
It shocks me how many members here are given scripts for NSAIDs by their surgeons without any advice or warnings. And people really don't read the leaflets they get with their pills!
chalcedonian1 said:
why would I go near even one tablet of an NSAID when I have proven to have difficulty with bone growth around my implant already??
Click to expand...
Well that's the most concrete reason for avoiding them I ever heard of!
chalcedonian1 said:
And if the bone has finished growing around the implant, would taking NSAIDs, say, a year later, have any impact on the stability of the implant in the bone?
Click to expand...
No, of course not! Once osseus integration has taken place, it is done and secure.

However, another thing I don't like about NSAIDs is their scandalous lack of advice to users of the very common side effects. In the UK a couple if years ago, there were many reports of the increase of serious gastric bleeds in patients who took them even infrequently. So I wrote this article Medications: acetaminophen (Tylenol, paracetamol) and NSAIDs, differences and dangers about those side effects. I believe @Celle also has access to an article about cardiac problems initiated by NSAIDs as well.

FWIW, I know many GPs who will not even suggest using NSAIDs for aches and pains much less prescribe them! I wouldn't take them if they paid me. I have had reflux now for about 40 years caused (I believe) by taking ibuprofen for a few weeks.
 
Hi @chalcedonian1 I've been down the path you're going down. I had my original hip replacement in August last year and had it revised in February because of a loose stem. Like you, I think the surgeon originally used too small a stem.
My revision was cemented, whereas I think yours will be uncemented, but things have gone well for me with the revision. I still have issues with my iliotibial band and tight quads but it's soft tissue problems, and it's definitely getting better. I'm walking more and I'm swimming now, I've just been on a great holiday which definitely improved my mental well being, and I feel like I'm finally getting my life back.
So hang in there, keep calm, and hopefully you will soon feel the same! Thinking of you and all the best.
 
Yes @Jaycey it is my body, my recovery. I am going with my gut. I'm not saying that NSAIDs are the cause of my problem, there can be no way of knowing, I have no memory of whether I did or did not take them during that first 3 month period after surgery.

@Margie10 Thank you for your words of encouragement and your advice, each message I get on this site makes me calmer, at least for a bit! And I am always sorry to hear when someone else has had a failure with their implant.

@Josephine THANK YOU SO MUCH for your careful response. I will find out if the surgeon is giving me an NSAID to avoid Heterotopic Ossification, but when I called his office, I was told it was because "it is an anti-inflammatory", which really didn't tell me much, did it? Maybe I will learn more on Monday.

And how amazing is it that you got that information removed from that advert! Yes, I saw this was absolutely done in Australia when I was researching NSAIDs the other day.

I did understand some of the side effects and possible complications from NSAIDs, and I do get my blood tested every two months if/when I am on them every day (e.g., recently I have suffered with a torn rotator cuff and bursitis in my shoulder, which can't be addressed by surgery now, so was given a steroid shot and prescribed Meloxicam for just two months). But because I have never suffered any serious or other side effects of which I am aware from NSAIDs, I have not researched much about them re: inhibiting bone growth until now, until I read your comment on
@TerryB_TX 's thread!!!!!

So far as reading the label on the bottle, I went on the Alleve website; regarding surgery, its FAQs only state "Do not use right before or after heart surgery. For other surgeries, discuss with your doctor to get the answer that's right for your needs. Only he or she is best qualified to answer this question." Well if one's surgeon thinks the research on NSAIDs is inconclusive but ends up on the positive side more than the negative, and therefore prescribes one, as mine has, then I just feel like I am a guinea pig because every article I have read so far on this topic conflicts with another, and is simply inconclusive. On balance, considering everything, I will take my own route after I find out WHY I have been prescribed Celebrex. If there is some brilliant reason none of us has thought of I will report here. Otherwise, I will remind everyone just how much they have to be their own advocate, at least in the US health care system, most especially on this topic and with respect to Physical Therapy, which seems to be viewed here as just about the first step for any physical musculo-skeletal problem, even for people who are bone on bone, and often with a no- pain no-gain philosophy.:banghead:

So aside from this NSAID issue, I feel as ready for Tuesday as I ever will, and appreciate all the good thoughts and wishes, please keep them coming, they are very helpful and it does reassure me to hear from others who have walked before me.

#heterotopicossification
 
Hi there, Hope you're having a nice morning on the East Coast.
We're here for you. Watching and waiting to encourage and cheer you on.
Wishing you peace and comfort as you await Tuesday.
@chalcedonian1
 
Doing a great job going in; you'll do a great job on the other side. Follow that intuition and don't take the NSAIDS; I didn't take any because my kidneys are a bit fragile and I stay away from them. I have bone ingrowth which I did not have before with the acetabular cup; with the stem but none with the cup. Now I do and it feels different; whatever is giving me that feeling, I'll take it! I am even, after two years, beginning to walk unassisted. And this is just about 3 months post op the last revision. At my age and with so much trauma behind me I have to take heart with that.

Now it's your time to keep on the path you've set for yourself, staying calm but directed. Being your own advocate with deliberation. Can't promise you any thing other than I will be waiting for your first post from the other side. But I am thinking you will do famously. Good luck; good cheer. @calcedondian1, your long wait is almost over. :yes!:
 
Josephine said:
I believe @Celle also has access to an article about cardiac problems initiated by NSAIDs as well.
Click to expand...
I was going to mention this earlier but couldn't sight any studies. I took NSAIDs for lower back pain for years. Two years ago I started experiencing chest pain and several other alarming symptoms. Turns out I had a major heart issue. Granted, some of this was family history. But who is to say the NSAIDs didn't contribute? You are very wise to question all this @chalcedonian1 .
 
My doc had me go off nsaids prior to both surgeries. I wasn’t taking many of them before second hip, I was following advice on here of Tylenol for pain and I was surprised how much more effective it was. Also, with second surgery doc had added Tylenol to assist with pain control, so something changed his thinking.

Good luck with the upcoming revision @chalcedonian1. You have received some great advice. As dear zinnia said, keep on the path and be your own advocate.
 
Thank you every one for weighing in, all of you continue to be very supportive and it means a lot.
@MammaT Yes, mine too, for at least a week, I believe this is to reduce possibilities of bleeding during surgery (except for the Celebrex I am supposed to take on Monday, and then 1 before surgery).
Thanks @Celle for giving the link.
@Jaycey Sorry to hear about the major heart issue, and scary to think whether or not NSAIDs contributed to it. My family has some history of heart disease as well, it is something I monitor pretty closely but sometimes these conditions are out of our control when genetics takes over. I hope you are doing OK. You provide invaluable help on this site for sure!
@Layla I do look for those messages, they are much appreciated!
@zinnia You are really amazing--I am happy to hear you can sometimes walk unassisted. You have been through a lot of trauma and remain so gracious and seemingly unflappable. Thank you so much for all you have written me, I appreciate the time you have taken to do so and I drink in the good thoughts and encouragement. I am doing OK, sometimes even better than that. The morning of surgery I will shrink into my own cocoon for sure, letting as many good thoughts as I can crowd out the negative ones that lurk in the deep...
 
Happy Sunday @chalcedonian1
We know those thoughts too. The ones that lurk in the deep.
You have a lot of support here. Comes in many forms, but nonetheless support.
You're in my prayers for comfort and peace of mind as you await your big day.
Sending a warm hug your way. I hope today is a good one!
 
Fiery determined Chalcedonian. :wink:You have a built in fan club and you will do brilliantly.
Hope you let some peace seep in today so your immune system can kick in and not spend all its mojo on stress.
You have done what you can do, and now you are going in informed as possible and with a wealth of wellwishers at your back.
Hope you have a Good Day today :loveshwr:
 
You must log in or register to reply here.
Active Antimicrobial Hydrogel
Corganics CBD

Staff online

Members online

Total: 589 (members: 1, guests: 588)

Latest posts

Back
Top Bottom