THR MoM resurfacing converted to ceramic dual mobility.

[ljpviper]

Hello all,

I had a metal on metal hip resurfacing done on 04/16/16. It lasted about 11 months, from one day to another my hip swelled up and started to have chronic pain. Went back to the HR surgeon and X-rays were clear and my cobalt and chromium levels were ok in 2017 and 2018.

I went back and forth, with PT, Art massages, etc for the last three years. In the end nothing helped. HSS opened a new facility in March of this year in Palm I decided to consult with them on the ongoing pain/issues. Had blood work this past June as well as an hip aspiration all clear still. Finally in July I had another MRI. The doctor who reads the images was able to see some loosening on the femoral cap pin. The beauty of HSS is the NY office has such great talent and the staff share information with the Palm beach location.

I decided to bite the bullet and yesterday, the revision surgeon cut my femoral HR devise and put in a dual mobility smith and nephew femoral stem. He was able to save my metal acetabular cup and just place the ceramic shell in it. I basically had half a hip replacement. The surgery lasted 45 minutes started at 10:30 am. I was in PT/instructional class at 3:30 and then discharged at 4pm. I had a rough night but the pain is not too bad.

I discussed the surgery with the OS and there was some necrosis under the metal cap. He noted some dark almost brown blood as well. This was the beginning off metallosis. There was no damage to any tissue. I guess my body was very sensitive to metal, even if my tests came out low.

I can allready walk on it without much pain, but I am going to take it real easy. The reason I got the resurfacing was I was 45 at the time wanted to stay active and scared of the dislocation possibility with a conventional hip replacement.

After 2 failed scopes and one failed resurfacing I hope this will be it. It has been a rough ten years. My left hip has mild arthritis but I think I can get a few years out of it. Only certain movements make it hurt

Also, HSS is like a well oil machine, can't say enough good stuff about them.

Thanks,

Larry

 

[Jaycey]

@ljpviper Welcome to the other side of surgery. Well done on getting that MoM device replaced. Sounds like you were just in time before any major damage was done.

HSS has many happy customers! I'm glad you could connect with an expert.

Do take it very easy. Although your op was short - it is still very major surgery.

Here are your recovery guidelines:
Hip Recovery: The Guidelines
1. Don’t worry: Your body will heal all by itself. Relax, let it, don't try and hurry it, don’t worry about any symptoms now, they are almost certainly temporary
2. Control discomfort:

rest​

elevate​

ice​

take your pain meds by prescription schedule (not when pain starts!)​

3. Do what you want to do BUT

a. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you​

b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.​

4. PT or exercise can be useful BUT take note of this BoneSmart philosophy for sensible post op therapy
5. Here is a week-by-week guide for Activity progression for THRs
6. Access these pages on the website

Oral And Intravenous Pain Medications​

Wound Closure​

Pain management and the pain chart
Healing: how long does it take?
Chart representation of THR recovery

Dislocation risk and 90 degree rule
Energy drain for THRs
Pain and swelling control: elevation is the key
Post op blues is a reality - be prepared for it
Myth busting: on getting addicted to pain meds
Sleep deprivation is pretty much inevitable - but what causes it?

BIG TIP: Hips actually don't need any exercise to get better. They do a pretty good job of it all on their own if given half a chance. Trouble is, people don't give them a chance and end up with all sorts of aches and pains and sore spots. All they need is the best therapy which is walking and even then not to excess.

We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery.

While members may create as many threads as they like in a majority of BoneSmart's forums, we ask that each member have only one recovery thread. This policy makes it easier to go back and review history before providing advice.

 

[golfer67]

Sounds like you are on your way to a great recovery and years of pain free hip motion. I also have a dual mobility hip replacement my replacement is the Zimmer G7. Good luck and let us know how well you do. I would like to know if after you recover if you can tell if a dual mobility hip works as well as a resurfacing.

 

[ljpviper]

I sure will, the resurfacing hip lasted 9 months before having issue, it felt normal at month six. This anterior recovery has been way easier. It could be because he did not have to mess with the acetabular side. The recovery from resurfacing was brutal, it was done with a posterior incision.

I just walked to the bathroom an back without a walking aid. I am going to take it slow no need push anything.

Thanks,

Larry

 

[Layla]

HSS is like a well oil machine, can't say enough good stuff about them.

Yes, I’ve heard. HHS has a good reputation.
Wow, you walked to the bathroom and back without an assistive device. Amazing. Please do take it slow....you’re right, no need to hurry things.
I hope you have a good night.

 

[ljpviper]

Yeah I am feeling the surgical pain tonight. I guess the cocktail of pain drugs wore off they inject in you before closing you up. The good news is my adductor which would swell upon weight bearing is normal in appearance. Also, the constant glute pain is gone as well. I feel more stable standing as well. I believe the femoral cap from the hip resurfacing shifted, and it started all these issues.

Scary how he found the beginning stage of metallosis, yet my cobalt and chromium are very low.

 

[FCBayern]

It sucks when that numbing agent wears off. They actually sent me home with a pump that kept putting a numbing agent in my knee for three days, I thought during those 3 days, "this isn't so bad", and then the pump ran dry so I kind of expected it with my hip. The good news is as you probably remember from your first op is that after the first couple of weeks things will begin to look a whole lot better.

 

[Layla]

Scary how he found the beginning stage of metallosis, yet my cobalt and chromium are very low.

Scary, but a blessing it was discovered. Good to hear your chromium and cobalt aren’t elevated. Get the ice going and hopefully it will ease the pain. Hope you rest comfortably overnight.

 

[ljpviper]

Yeah, you definitely do not want to fight the pain. Trying to stay ahead of it with oxy every 4 hours.

The pain just woke me up.out of my sleep. I recall from my hip resurfacing surgery the first 7 days are the worst. At least I got 6 hours of sleep.Those zingers down your quad are no joke. Posterior you deal with the monkey fist pain in your glute. The anterior pain is all in the front. I dont have to work till the 28th, so i am taking my recovery one day at a time. We have been working from home since March, we dont expect to go back to office till maybe 2nd quarter 2021 I chose this surgery date as i do not have to move around much when i get to work on the 28th. Yes, Layla glad he discovered the metalosis now, it truly was a blessing. I am still upset with the OS that did the resurfacing. He just brushed me off when the xray did not show anything. Sorry for the long post.



Regards

Larry

 

[ljpviper]

Wow, I just got the surgeons report. I caught the metal on metal just in time. He wrote we encountered bloody synovial fluid, that should be clear.

Also the kicker, dark metallic tinged fluid was found all around the joint.

Thanks

Larry

 

[Mojo333]

Larry.
Sure am glad they got that initial replacement out before more it caused more harm.

The zings and zaps from awakening nerves and sore quads were part of my recovery journey too.
Hope you are icing like a fiend when resting...it was a great help to me.

Early days and all temporary, my hippy friend.
Healing vibes coming your way.

 

[ljpviper]

Thanks, great to hear. I slept a solid 7 hours. Definitely getting better mobility in the newly operated hip.

Thanks

Larry

 

[Mojo333]

ooh...I'm jealous. I didn't manage that for weeks
Best thing for a healing body.
You are going to love that new hip.
I have never regretted my replacements...back to healthy and happy.

 

[ljpviper]

The surgical pain in the anterior method is quite different than the posterior method I had in my resurfacing.

I won't sugar coat it, the first few days for both are awful. Let's see how I progress this week.


Thanks for all the support

Larry

 

[Going4fun]

@ljpviper, I think I remember your case. I remember because I thought long and hard about resurfacing and was really thinking before I just grew uncomfortable with the whole metal thing.

Good job to get to HSS and to stay with pursuing a diagnosis. Glad this round of surgery feels so much better than the earlier round. I don't know if this is right, but I heard an interview with a surgeon who said resurfacing cuts less bone but hip replacement cuts less tissue. (Don't hold me on that comparison).

Anyway, yeah I felt for you. Because I knew that people going for resurfacing were almost always folks who were athletic and raring to get back to activity.

Thanks for reporting this update.

 

[Mojo333]

Yes, my first post op appt was 10 days after surgery, and I accused my lovely OS that the timeline was based on the hope I wouldn't still be ready to hurt him
We had our hips REPLACED, that is no small feat
It isn't a tonsillectomy or a minor procedure.
Hang in there Larry, I know it is disconcerting and actually scary these first three or four weeks ..but bad hips don't fix it themselves so really no choices, right?
Hope you are taking it easy and telling with the punches...
Healing mojo coming your way.

 

[ljpviper]

Yeah, the first 2 weeks are no fun. I had a decent 7 hour sleep. Not bad since this is day 5. I am mainly laying down all day, and just walking to the bathroom and around the house when needed.w

My hip is definitely getting its strength back. My main source of pain is on the front. I cant tell too much as the bandage is hiding most of it. I imagine this is where the femur is cut and the femoral component is inserted. Also, the muscles being separated as well.

I plan to take my recovery very slow. I am off work next week and will just add a little more walking each day. I wont push coming off the crutches either. The pandemic was a blessing for doing this surgery as I have been working from home since March. I go back to HSS for the follow up in 2 weeks.

I feel blessed I caught this metalosis on time. It can cause some real damage throughout your body.

I appreciate everyone's ones support.

Thanks,

Larry

 

[Mojo333]

My quads felt as if I was hung up and they were used as punching bags....Super Tender!!
Thankfully our amazing bodies heal!
Hope today is a good day.

 

[ljpviper]

Got a new pain out of the blue yesterday. I have been using the Walker or crutches. Maybe you all that had anterior surgery can advise.

The pain seems lower more deadcenter on the hip under the bandage. Hip swelled up a little more than usual. I had to elevate more and ice all night.

My hip flexor area and glutes feel great. Maybe just expecting too much as anterior surgery was supposed to be easier.

Thanks

Larry

 

[Jaycey]

Maybe just expecting too much as anterior surgery was supposed to be easier.

Larry, please don't fall for this - it's marketing hype. Anterior is no easier than any other approach. It's THR just like posterior or lateral.

You are still very early days out. There are lots of aches and pains as you begin to move around more. Ice and elevate and listen to that hip. It will be very quick to tell you when you have gone too far.