THR Loose Hardware?

[Euxpat]

Hello, new to this forum. Some history....
-total left hip replacement Nov '23, at age of 70
-uncemented Styker components, ceramic head, polyliner
-6 months of very little activity-walking, biking, light gym workouts
-after that, some light to medium yard work
-lifted over 50#'s a few times doing light construction stuff
-jarred hip numerous times, some minor discomfort that never lasted long
-most recently, started doing aggressive gym machine workouts (i know stupid, but hip was feeling great!)
-current x-ays show no change to joint
-I am too far away to go back to original surgeon for opinion at the moment

Now having inconsistent/intermittent dull to sharp pains that move around my joint where the stem goes into the femur. Sometimes groin area, sometimes front of femur going down toward knee, sometimes trochanter discomfort, sometimes deep pain in femur, sometimes butt muscles in a knot when sitting.

So my question is what is available to fix loosening components, assuming that is what is happening? It seems after going through all of the time/pain involved with replacements, and somewhere around 450,000 annual hip replacements and 20% revisions in the US, isn't there some other less invasive way to fix loose hardware?

I've been reading about Prolia injections, anyone have experience with those?
sheffield.ac.uk/news/osteoporosis-drug-could-half-number-redo-hip-replacement-operations

Or what about stem cell injections?

Can the joint repair itself to some degree?

Anything else out there?

Knowing what i've experienced i would not have had this surgery but would have continued with PRP/stem cell injections, gone to cortisone next and finally had a resurfacing instead of THR. Too much mechanical stress with a metal rod inserted into your femur, in my humble opinion.

Sorry if these questions have been asked before. Thanks for any input!

 

[myglasshalffull]

Welcome.
If your surgery was in November & you have been reading guidelines & other posts here you will see you are still very early in a recovery that takes some of us close to one year.
And lifting 50 lbs probably a "no-no." I am not supposed to lift anything over 40 lbs.
How do you know it is a loose hardware? Have you had an XRay? Or MRI?
You need to be re-assessed to determine what the issue actually is. If you cannot see original surgeon at least see primary physician.
With the activities you are doing it's probably just tissues/muscles that aren't very happy. Are you icing when in discomfort?
Keep us posted.

 

[2nd Hippy]

I think @Euxpat wrote surgery was NOV. 2023. (NOT 2024)

 

[benne68]

Welcome to BoneSmart, @Euxpat.

It is possible that your pain is coming from soft tissue trauma rather than from the implant itself -- especially if your X-rays show no change to the joint (how long ago were the X-rays?) and the site of the discomfort moves.

I encourage you to see a hip specialist to have the problem diagnosed. You need to find out what is wrong before you start pursuing alternative treatments. You don't need to go back to your original surgeon for this -- in fact, since you are more than a year post-op, you should have no problem getting a second opinion.

If you would like us to provide suggestions of specialists in your area, let us know where you live and how far you would be willing to travel.

 

[Euxpat]

Original surgery was Nov '23, so I'm 14 months post op. Currently living in Asia so no way to see original US Dr. I did see very young ortho Dr. here on 1-23-25 and got x-rays. He also mentioned possible soft tissue strain. Will be back in the states in 2 months so I will take it easy will see how it goes. Thanks.

 

[Eman85]

Sounds like you're doing too much Dr Google! Take a minute and relax, take it from someone that was in the same boat and I thought I really damaged the implant. Go back to the first days of early recovery, sit and ice and then sit and ice some more. Go have the hip x-rayed and get an OS to read it. I can tell you it would really take a serious fall or something similar to damage the implant, or at least in my case, I've done the fall and the lifting weight and still haven't damaged them. Mine isn't cemented, cup has 2 screws.

 

[mendogal]

@Euxpat

There are many quite sketchy clinics offering injectable "stem cell" therapy (without specifying if its skeletal or bone marrow) for fixing everything from orthopedics to cancer to autism.

Medical uses in orthopedics involve surgery in order to implant the cells where needed, generally for small fractures otherwise difficult to treat. I am unable to locate a single study addressing the implantation of stem cells to increase bone growth around a loose implant. (I don't know why there's no research; given how widespread heterotopic ossification (HO) is following THR, my guess is that uncontrolled bone growth is a legitimate concern).

The research literature on Prolio is positive, but the research protocols involve very specific starting and ending dates. The key period of bone resorption secondary to stress shielding happens 3 months after surgery, so the Prolio needs to be on board before then, and therapy lasts 6 - 12 months, allowing the bone to respond to stem migration.

There are no published studies after 2021, and the FDA has never approved Prolia for this use. This is understandable as it's a quite high-risk drug.

I do recommend you get a second opinion from a hip revision specialist, which will include a set of new x-rays, and also seek a referral to a non-orthopedist skilled in diagnosing soft tissue disorders (which often bother post THR folks). Such a specialist might be a physical medicine doctor (physiatrist), a sports medicine doctor, or a doctorate-prepared PT.

 

[Euxpat]

Dr Google, that's good and I'm guilty at times! I keep looking online and hoping to see breakthroughs/human trials given AI, super computing, and CRISPR genetics, which are all surging forward.

The hip replacement is a miracle indeed but when i asked an ortho recently what happened to growing your own joint replacements he said that the present methods are too easy and too profitable so things are kind of flat lined. So I think better options are coming for our kids/grandkids but i'll age out before it happens. There is also a method of welding bone to metal for a much faster recovery.

Here is some information that I found.

Grow your own joints, starting around the 29:00 minute mark

The Foundation for Barnes-Jewish Hospital > Your Impact > Growing Human Joint Replacements in the Lab

There is also information on the web about bone welding for pets which sounded interesting.

 

[myglasshalffull]

Sorry, I misread surgery date.

 

[Eman85]

While your doing the google searches look at what a hip displacement does to our muscles, it ain't natural, to say the least. I don't think my hip muscles will ever be what they were pre-op which is why in my opinion it's very easy to do damage to the muscles. I hurt my left 2 years ago, I lifted and carried a very heavy round of green oak, 2 steps in I knew I screwed up but continued and finished the rest of the work. I immediately thought the implant was damaged. Saw my OS right away and the x-rays showed the implant was fine. It's been a while and I still get random thigh/groin pain.
I waited a long time before having my hips replaced. Kept hoping for the pill or shot instead of the replacement. Joint replacement is such a huge industry and money maker I'd say the money spent on new technology is going to make it faster and more profitable. Plenty of us that wore out the original equipment and have insurance that will pay.