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[THR] one year later ...

Discussion in 'Hip Replacement Recovery Area' started by Peaches, May 16, 2014.

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  1. Peaches

    Peaches
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    Hi, @Josephine ... I went back to my OS a couple of weeks ago for my routine one-year checkup and X-rays. He said the X-rays looked just like they should, he saw no problems. But today, when the
    radiologist's report that I requested arrived in the mail, I got concerned when I read THIS:

    "There is no significant interval change compared with the X-rays taken six months ago, other than
    slight cortical thickening in the medial aspect of the right femur near the distal stem of the femoral component consistent with a stress transmission
    ."

    Can you interpret this for me in layman's language? It's hard not to be worried.

    Thank you, by the way, for bonesmart. I can't imagine going through this surgery without the information and support on this site. This site has been so amazing and helpful. I will always be so grateful.
     
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  2. tashia

    tashia Sr Bonesmartie

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    Welcome back and Happy Birthday. Glad all is well. I will be interested in what is said about the comment made on the X-ray. Take care. Tashia
     
  3. Jaycey

    Jaycey SUPER MODERATOR Moderator

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    Welcome back @Peaches ! Can't believe it's year already. Jo should be along soon to comment on your x-ray results. Please don't worry!
     
  4. Peaches

    Peaches
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    Hi, @Jaycey & @tashia! Thanks so much for responding to my post. I appreciate it. I hope you both are doing well. In tasia's case, recovering nicely from latest replacement, I hope!
    I will revisit soon to check up on how your threads and will also post a little update.

    I have decided to go for broke and post the rest of what the radiologist's report said. Both hips were Xrayed since I'd had some pain with "the other hip." @Josephine, here's the full report. Can you
    please interpret what it means? Thank you so much. I'm kind of worried about "cortical thickening" and "stress transmission." THANK YOU!

    AP OF THE PELVIS AND FROG LATERAL BOTH HIPS:
    FINDINGS:


    On the right total hip prosthesis is present in anatomic position with noncemented femoral and acetabular components. There are no abnormal periprosthetic lucencies.

    On the left [hip] there is minimal osteophyte formation in the femoral head neck junction and minimal buttressing in the medial aspect of the femoral neck. The hip joint space is well maintained.

    Remainder of the pelvic bones and the sacroiliac joints are normal.

    There is no significant interval change compared with
    10/14/2013 other than slight cortical thickening in the
    medial aspect of the right femur near the distal stem of
    the femoral component consistent with a stress
    transmission.


    IMPRESSION:
    Right total hip prosthesis in anatomic position without radiographic abnormality. Mild degenerative disease of the left hip.
     
  5. Jaycey

    Jaycey SUPER MODERATOR Moderator

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    @Peaches from the summary the result doesn't look bad to me. But lets see what Jo says - she's the expert!
     
  6. Josephine

    Josephine FORUM ADMIN, DIRECTOR Administrator

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    Interpretation: everything's fine!
    Interpretation: osteophytes are small bony outgrowths and a normal product of arthritis. If they get big enough, they can impinge on adjacent bone and may be responsible for much of the pain we experience.
    Buttressing is when one area of bone is thickened, maybe because of uneven loading. The "medial aspect of the femoral neck" (also known as the calcar) is the arch of the femur and bears an enormous amount of loading. As a result, this part of the femur is normally thickened, as you can see in the first image. But it would appear that in your case, this is more thickened than usual, as shown in the second image.

    calcar.jpg butttressing of the femoral neck.JPG

    Interpretation: The dynamics of the femur are quite complex. The loading (weight plus walking) is transmitted through the top of the femur and down the shaft to the knee. When part of the bone is replaced with a metal implant, the implant assumes this loading in the upper part of the femur. But where the implant ends, the stress is transferred back into the bone. This results in a thickening of the bone at that point. In other words, quite normal and nothing to worry about.
     
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  7. Peaches

    Peaches
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    @Josephine ... THANK YOU THANK YOU! You have really calmed me down. My OS also emailed me and said it’s normal. But your detailed response was (always is) SO helpful. I’m just a gal who often does need to know how the sausage is made (that’s a U.S. figure of speech). I really appreciate you more than I can ever say.

    The Xrays of “the other hip” seem to say it’s not in bad shape. But starting six months after the RTHR, I started having pain on that side (for the first time ever): groin pain, and sometimes in the trochanter area. The pain was much much worse after attempting PT exercises for my back (spondylolithesis and impinged nerve). When I stopped those exercises, the other hip’s pain lessened a lot, especially in the groin area. Could the pain I
    now experience sometimes in the other hip be because of the osteophytes (aka bone spurs?)? Though the report doesn’t mention it, I do have mild hip dysplasia (shallow sockets), according to another OS I consulted with a few years ago. Could that contribute to the come-and-go pain in the other hip?
     
  8. Peaches

    Peaches
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    Hi, again. I wanted to just give an update. The operated hip is doing really great, I think. I had really no pain (after the post-op pain went away) until around 11 months and then a weird inner-thigh throb occurred, down to the knee. The OS thinks that was just weak adductor muscles. That pain is now gone. The mobility and strength in the op side seems to have gotten even better in month 12 ... so I do believe that for me, the recovery process continues. Unfortunately I have chronic back pain that seems to be much worse since the surgery. Maybe because I'm moving so much more. But it prevents me from doing all the things i'd hoped to do. So in a way I haven't fully "tested" my new hip the way I might have. The other hip started acting up around month 6 and I was worried it was soon going to go downhill. But it has behaved itself a little better in recent months. I suspect the roller coaster ride on that side has begun. I am truly grateful for the surgery, though. Having one good hip has made all the difference and I encourage all the pre-ops to do it den if you too have bad back problems. I have no regrets. All the wonderful folks, patients and moderators and Josephine, on bonesmart made all the difference in the world for me. I love you all and wish you all the best with your recoveries.
     
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  9. Jaycey

    Jaycey SUPER MODERATOR Moderator

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    @Peaches , so sorry you are in the back pain club! Me too! Just keep moving is my moto!
     
  10. Josephine

    Josephine FORUM ADMIN, DIRECTOR Administrator

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    Glad I could help!
     
  11. randy62

    randy62

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    @Peaches wow a year already, rather hard to believe. Glad to hear all is well. I have scheduled my RTTHR for sept 17th. My LTTHR went so well, that I wanted to knock my right out also.
    PLH,
    Randy
     
  12. Peaches

    Peaches
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    Hi, @randy62! So glad to hear your new hip is doing well, but sorry you have to replace the other one. I hope the wait this summer till surgery day isn't too painful for you. I suspect I will be replacing my other one someday soon. At least we have one good hip. I am SO grateful! Take care and let us know how you're doing.

    Hi, @Jaycey ... How are YOU doing? And your back? I
     
  13. bottomshollow

    bottomshollow ADMINISTRATOR Administrator

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    dropping by 14.jpg Great update, @Peaches! Good to know that you're doing well. You know we'll be here when that other hip decides its ready to retire.

    Take care, we care.
     
  14. Peaches

    Peaches
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    Thank you, @bottomshollow ... and how are you???
    You betcha I'll be back with bonspurs--make that bells--on when it's time to replace hip number two.
    I never cease to be amazed at this site. Thank you for all of your support. I hope to hear you are doing well these days.
     
  15. zauberflöte

    zauberflöte

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    @Peaches hey girl! I don' know how I missed this update. I am sorry about your back, I agree that it's likely the result of being more active. Like a giant game of whack-a-mole, isn't it. My "now it's the bad hip" left hip is complaining just like yours, holding me back in my rehab. I still feel improvements from time to time, like you.

    We have recently moved house, but as the time spent doing housework has now overgrown time spent unpacking, it's time to get back to the gym!!!! What happened with your projected move? And, you know, I am still totally in awe of your steps-climbing abilities. Could that be contributing to back pain? A lot of stress on those joints as one steps up...not that you can actually do anything about the subway...:shrug:
     
  16. TeeEm

    TeeEm

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    @Peaches Sorry I missed your one year update too as I have been back on here from time since mine looking out for it. Im glad everything is going well and sorry your other hip is playing up. My knee has had it and im on the WL for a knee replacement. I hope that's IT then !
     
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  17. zauberflöte

    zauberflöte

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    @TeeEm wow, I also hope that's IT for you forever! Somebody, @westsea maybe? who was with us doing a hip, and moved immediately over to do her knee, could coach you through it! How long is the waiting list...?
     
  18. TeeEm

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    @zauberflöte WL not that long, but I don't want it done until the end of September. It doesn't hurt as much as my hip did, but it's getting a bit unstable, I cant bend my knee fully and it's starting to bow, so I don't think Id better leave it much later. Are you planning to get your other hip done, or are you managing to hold it off for now?
     
  19. zauberflöte

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    @TeeEm well, when I went in for my 12-month (and last ever unless I need it!!) checkup, the OS PA said there was "a little" arthritis there in the other hip, and he would talk to the OS about it and call me back. That was May 8 and I haven't heard from him not one peep.... I want to do it before our current nice health plan runs out in October, and at least 8 weeks before the Christmas season-- and this OS books 3 months out! So I think I'm :censored:-ed LOL. I keep saying, I just do NOT want to go down the pain-and-disability road I know I am going to go down, now that I know how much better it can be. Same as you with your knee, I expect :)
     
  20. TeeEm

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    Exactly @zauberflöte . I know exactly what you mean. I don't want to get to that stage either. Can you get in touch with his office and find out what's going on?
     
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