THR Need THR and I'm really concerned

skye_56

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I have so many concerns I'm not sure where to start.

First I have a base metal allergy (it includes cobalt). I have an allergy to dental cement and had to have all my crowns, etc removed because my eosinophils skyrocketed (over 2000). We now have them down to 510 but they are going to have to start pulling my implants because they used metal in the posts.

This had been going on for years and all the doctors blew it off saying "it was just allergy season - that's why the numbers were a bit high. Until they were really high. Thank god the problem was figured out and reversed.

They tried a number of different cements made in the US and I was allergic to all of them. I'm not allergic to the ones in Europe, so they must be using a different compound. I have to admit my dentist has been amazing.

So now I have to have a THR, with a base metal allergy and an allergy to some compound found in medical cement used in the US.

If that's not all bad enough - I'm 56, I run, do MMA, weights, ski, hike - yup you name it, I do it. It's who I am. My hip has been getting worse and worse and I've gained a ton of weight as my activity level has decreased due to the pain. It's a bit of a caught 22. I slow down, to avoid pain. Gain weight which causes pain, because it stresses the hip. I'm so very unhappy. I'm going to have to try this and hope that my body likes it because there is no going back, which is what scares me.

Any advice would be wonderful. Any recommendations, including doctors, or cutting edge technics. I'm between Boston, MA and Nashua NH area.
 
@skye_56
Welcome to BoneSmart, Glad you joined us!

You are not alone with your allergies. Many members have found the challenges they have with joint replacement were caused by metal allergies. Cement allergies are rare but do happen.

You will want to start by using our Surgeon Locator at the top of the page. You will want to search for surgeons specializing in Complex Joint Reconstruction. Be sure you take along your allergy testing results.
What lab did you use to determine your allergies?

I am going to tag @Josephine to comment about your cement allergy.

If you are at the stage where you have joint pain but don't know for sure if you are ready to have surgery, these links may help:
Score Chart: How bad is my arthritic hip?
Choosing a surgeon and a prosthesis
BMI Calculator - What to do if your surgeon says you're too heavy for joint replacement surgery
Longevity of implants and revisions: How long will my new joint last?

If you are at the stage where you are planning to have surgery but are looking for information so you can be better prepared for what is to come, take a look at these links:
Recovery Aids: A comprehensive list for hospital and home
Recliner Chairs: Things you need to know if buying one for your recovery
Pre-Op Interviews: What's involved?

And if you want to picture what your life might be like with a replaced hip, take a look at the posts and threads from other BoneSmarties provided in this link:
Stories of amazing hip recoveries
 
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@skye_56 Welcome to BoneSmart! Both my hips are uncemented so that may be a resolution to one of your issues. I agree with Chris - discuss your allergy tests with your surgeon. There are many options available. It's just finding the right surgeon who is will to explore them with you.
 
My testing was done with a patch test by an allergist. It was one of the worse weekends ever - SO ITCHY! I was also allergic to the non-allergic derma-patch they used to keep the patch in place. LOL

That's what I'm hoping to find - a surgeon that will work with me and understand my concerns. The couple that I have already talked to said they have never had a problem with allergies and metal hips. I don't want to be treated like that. I want a say what goes into my body, so I can balance the risk.
 
Do you know if your are allergic to titanium? Most implants are made of this. There are other choices for other parts of the implant. Here's a link to an article on the main BoneSmart site: Hip Replacement Implant Materials. Note that metal on metal (MoM) implants are no longer used.
 
:welome: You've come to the right place and I hope you get some good answers or at least some feedback in regards to surgeons. You have had a difficult time of it with your dental work. But maybe the knowledge gleaned from those ordeals will help you with the THR!
I have a client who has a lot of allergies to metals. She succeeded in finding the right surgeon for her shoulder replacements. They are out there.
 
Wow, I did not know MoM was no longer used. In fact both surgeons I saw were going to use MoM
 
I'd inquire into the brand and model they were going to use. Chances are it's a metal stem and metal part for the pelvis with an insert between them which is what I've got.
If you were tested for a allergies to metal I would bring those results and or a letter from the allergy Dr. and request the OS consult with the allergy Dr.
 
I have put together a complete package including bloodwork (eosinophils) and a letter from the allergist. I've just had such little success with showing / telling the doctors. They all seem to know better.
 
Wow, I did not know MoM was no longer used. In fact both surgeons I saw were going to use MoM
I doubt they were going to use MoM. Not sure if these implants are even available anymore.
I've just had such little success with showing / telling the doctors. They all seem to know better.
Well there are plenty of people with metal allergies and there are solutions. Perhaps try and find someone who is better at listening to your concerns. You need to stress that you are not trying to demand a particular implant. You just want the right implant for someone in your situation.

Have you tried the Surgeon Locator (top of the page on the blue bar)?
 
@skye_56 I sent you a personal message. My surgeon , highly experienced may be able to help you if you are willing to travel a couple of hours.

I think you may benefit from a practice that does thousands of hips a year.. Sometimes its good to be a little piece of meat in a big smooth functioning machine that has seen it all
 
I have an allergy to dental cement and had to have all my crowns, etc removed because my eosinophils skyrocketed
Oh my gosh! That's dreadful for you.
In fact both surgeons I saw were going to use MoM
And even more dreadful! Sadly, while metal on metal hips have been withdrawn in Europe, I believe they are still available in the US which I think is scandalous!

However, all it not lost. You can still find a surgeon who uses uncemented hip replacements. These are secured in the bone by a substance sprayed on the implants during manufacture called hydroxyapatite which is a special material that bonds to the bone. You can read more about this here Cemented and uncemented hips. They are very commonly used in the US and I don't think you should have any difficulty finding a surgeon who uses them. I'll ask my colleague to come and advise you @Jamie
 
yup that is the info I sent @skye_56 about my surgeon who is not far away from her at all. Uncemented and titanium and polyethylene.

There must be other surgeons around Boston too.
 
Oh, good, @Jamie has checked in with some options for you to explore.

I, too, am allergic to nickel. When I asked my surgeon about this, he good-naturedly pointed to an implant on his bookshelf, and encouraged me to have a look. It’s made of titanium, ceramic, and polyethylene, and he said I needn’t worry. He was so comfortable with my question, I had the impression he hears it frequently.

I think Jamie might be hitting the nail on the head when she says you’re talking to the wrong surgeons, because it seems to me, the right surgeon for you would react more like my surgeon did. You have extremely valid concerns, and you will find a doctor who thinks so, too - and one who has the right solutions for your particular problems. It’s unfortunate that you’ve come across some incompatible doctors first. But, I’m sure it’s only a matter of trial and error until you find someone who will help you, and I encourage you to keep trying until you find an OS you have confidence in.
 
Thank you everyone for such wonderful suggestions and I will check out all the Doctors that have been recommended to me.
 
Hopefully this helps you sleep easier, knowing you have some options. :console2:
 
a friend of mine had her surgery about a decade before I did, she was banned from running. I will be running later today. I have no restrictions from the surgeon (other than the fact that I'm 57 still thinking I'm 27).

@Going4fun I'm a runner who needs a THR - may I ask who your surgeon was?
 
My surgeon is Dr. Matthew Austin of the Rothman Institute in Philadelphia.

There are a lot of surgeons OK with running these days. The best move is to really focus on finding an excellent surgeon ... and an excellent surgeon who, when you meet them, you trust.

And tell the surgeon your goals. Dr. Austin isn't some wild outlier.
 
Thank you for the information. I'v seen 4 surgeons so far and I've gotten as far as "you can do everything, but black diamond hills with moguls and running. It seems the moguls are the problem, which I can totally give up, but I am not willing to compromise on the running.

When I started this journey, the first Doc I saw said I would have to change my whole lifestyle. The next one insisted that just because I had a patch test that showed I was allergic to cobalt, didn't mean I would be allergic once it was implanted into my body. I walked out of that one.

The last one was the best, he does a ton of surgeries. They were going to give me a ceramic hip but told me that the titanium base was an alloy, which means it's mixed with something else. I asked what that something else was and he said the manufacturer does not list it and I still could not run. He's ratings and reviews are very, very high (4.2 - 4.8) - but that just scares me not to know what is going into my body especially since I have a proven issue with metal (teeth).

He was going to use the "superior direct approach", which I can't really find any info about. He said that's the method he uses on young active people.

I guess I'm still looking for a doc - although I'm feeling pretty discouraged at this point. I am getting a blood test that's very sensitive in order to find out what I'm allergic to because one of the doctors said the patch test does not really give a good picture for implants.

Personally I think if someone says "I have a base metal allergy" to either a dentist or surgeon they need to insist on more information.
 
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