Watch 2019 JRAD Videos

Protrusio acetabuli

Status
Not open for further replies.

Kimcol

new member
Joined
Oct 26, 2009
Messages
6
Location
United Kingdom
Hi! I'm so pleased to have found this site after painstakingly seraching the internet for info on protrusio acetabuli. I have only just been diagnosed with this and although I understand what it is I still want to know what to expect and how it will progress. Any info would be gratefully received. Thanks! :pzld:
 

tom67

post-grad
Joined
Sep 18, 2009
Messages
1,283
Age
52
Location
Mass. United States
Hi Kimcol, and welcome to Bonesmart, I've never heard of " Protrusio Acetabuli "
But I am sure someone will be along as soon as possible to try and help!
(maybe a little more background on the affliction or on your conditon would
be helpful!!) Thanks,
 
Joined
Jan 8, 2009
Messages
5,014
Age
72
Location
Iowa
Country
United States United States
I am a knee person. But there are lots of hip people here too. I am sure they will be able to help you.
 

Jamie

ADMINISTRATOR
Senior Administrator
Joined
Mar 24, 2008
Messages
59,348
Age
71
Location
Kansas
Gender
Female
Country
United States United States
Hi, Kimcol....welcome to BoneSmart. We're glad you found us. Our forum nurse, Josephine, will be online shortly and can talk to you more about your diagnosis. In the meantime, I wanted to welcome you and let you know that we will be here to provide whatever support you need.
 
OP
OP
K

Kimcol

new member
Joined
Oct 26, 2009
Messages
6
Location
United Kingdom
Thank you for making me welcome! I have seen one thread on here about Protrusio Acetabuli, which is why I joined, but it is an old thread and closed now.

Basically I have been suffering from hip pain on and off for probably 2 years, but in the past 6 months it has become more and more. Now I feel uncomfortable most of the time. I went to see my GP a couple of weeks ago because I thought I should get it checked out. I thought it could be due to a Mirena Coil I had fitted in Jan 09 - there are a lot of women with the Mirena who complain of joint pain. (I think I have aways put ANY pelvic pain down to my menstrual problems - which have been ongoing for years - so maybe I have had this for longer than I think?) My GP did a quick examination and thought it was my hip, not pelvic pain, so arranged an X-Ray.

The X Ray showed bilateral protruso acetabuli, although I get more pain in the left than the right. The other major symptom that I have is loss of movement. I used to do Yoga and could do the Lotus postion easily, now I can't even cross my legs properly!

Anyway, my GP has told me to take painkillers and try and go as long as I can before having THR surgery because modern replacements don't last long and as I am only 40 I should wait as long as I can stand it.

I have called my GP since and asked for a private referral to a hip specialist as I would like some more answers. I really want to get my head around how long before I would need surgery, how bad it will get, how long the recovery is etc, etc, etc! I could go on and on!

Anyway, that's the story so far, if anyone could answer some of my questions I would be very grateful. :D
 

Josephine

NURSE DIRECTOR EMERITUS
Nurse Director
Joined
Jun 8, 2007
Messages
84,940
Age
78
Location
The North
Gender
Female
Country
United Kingdom United Kingdom
Well, for starters that 'expert' opinion you received tells me that your GP is ill-informed and very much behind the times! People much, much younger than you are having hip replacements. Even as young as 20. And the notion that 'modern' replacements don't last long is equally invalid. Read this thread implant longevity and get the specs on that.

What you need to do is to go back to your GP and politely but firmly tell him that you would like a referral to an orthopaedic surgeon for a second opinion. It's your right to do that. And if he waffles about it, just stand your ground and say "never the less, I'd like to hear what a hip surgeon has to say about it." It's okay for him to say live with it as long as you can - he doesn't have to do that!

If you tell me in which county you live, I can recommend a hospital or surgeon. You need to make sure you go to a surgeon who is expert at hip replacements and does upwards of 500 a year, the more the better.
 

SheriALS

junior member
Joined
Oct 1, 2009
Messages
79
Location
United States
I am 41 and just got my new hip. I was diagnosed 8 months ago with severe OA in my right hip. I have hip dysplasia which led to my early onset of OA. I also used to do yoga and could no longer do most of the poses. I couldn't get my GP to refer me for the x-ray so I called a neurosurgeon I had seen previously (he originally suggested my hip may be the cause of my back problems) and he wrote the referral for me. Then after obtaining a copy of my x-rays I made my own appts- first with one surgeon and then with a 2nd- without a referral. So, you may not need a referral from your GP....Call a couple of surgeons and see if they require that. Tell them your situation. Or hopefully your GP will come through with that.
Do search around as Josephine said though for a surgeon who is very experienced with hips
I am sorry that you are going through this struggle & I hope you get the answers/solutions you are looking for soon.
Blessings,
Sheri
 
OP
OP
K

Kimcol

new member
Joined
Oct 26, 2009
Messages
6
Location
United Kingdom
Thanks for your replies. I have already called my GP and asked for a private referral to a hip specialist - my Mum wants to pay to get answers to my long list of questions! I live in near Norwich, England so any advice on good surgeons would be appreciated. Is THR the only option with this problem or does resurfacing work?

I'm so glad I found this site, I don't feel quite so alone now! :D
 

Josephine

NURSE DIRECTOR EMERITUS
Nurse Director
Joined
Jun 8, 2007
Messages
84,940
Age
78
Location
The North
Gender
Female
Country
United Kingdom United Kingdom
Ah Norwich - the place of my birth! I also trained at the N&N but the old one on St Stephens Street!

You know,
a private consultation cost about £150-250 (guesstimate!) and you'll likely have to wait some weeks for an appointment. Plus you'll see exactly the same surgeons privately as you would at the N&N so why waste the money?

I can also tell you that unfortunately the N&N has a policy that if you are referred there by your GP, you cannot choose the surgeon, you are allocated to one. That's a bummer but I wouldn't let it put you off pushing to see Mr Calder, Mr Nolan or Mr Wimhurst. They are the hip surgeons at the N&N.

Mr Tucker is a hip surgeon too, but I would recommend you avoid him if you can as from what I've heard, he doesn't much care for patients who want to ask questions!

As an even cheaper version, why don't you post your questions here - I'm sure I could answer a lot of them!
 
OP
OP
K

Kimcol

new member
Joined
Oct 26, 2009
Messages
6
Location
United Kingdom
Gosh it's a small world. I also did a year of training at the N & N, and the West Norwich where I lived, but unfortunately I had to pack up because of a car accident.

Yes, I figured Mr Nolan may be the man for me in this area and I have heard good things about him - he replaced my grandmothers hip many moons ago.

OK so here are my questions:

How does this thing progress? Currently I am uncomfortable every day and at night I turn constantly. The movement has lessened and I am beginning to really notice little things like getting in and out of the car, but is is all still manageable and I don't need to take painkillers all the time - yet!

Is it herditary? I have three nieces who all complain of hip pain. I also have two sons.

Once you have a THR for this condition is that the end of the protrusio or does it happen with the new joint?

I read your thread on implant longevity and I understand that they last much longer now. I noticed in a thread you had with another lady with this condition that you said although she could have a THR but she would have to have 2 -3 revisions. What is a revision?

What happens when it is bilateral? Do you just get the worst one done first then the other one when it has deteriorated also?

I guess the long and short of it I just need to know what to expect!

Thanks for all your help, I am very grateful.
 

Josephine

NURSE DIRECTOR EMERITUS
Nurse Director
Joined
Jun 8, 2007
Messages
84,940
Age
78
Location
The North
Gender
Female
Country
United Kingdom United Kingdom
How does this thing progress? Currently I am uncomfortable every day and at night I turn constantly. The movement has lessened and I am beginning to really notice little things like getting in and out of the car, but is is all still manageable and I don't need to take painkillers all the time - yet!
Progress - as in the surgery or the condition? Please clarify.
Is it hereditary? I have three nieces who all complain of hip pain. I also have two sons.
All the term 'protrusio' means is that the floor of the acetabulum or socket has worn to such a degree that the femoral head is about to break through into the pelvic cavity.

Is it hereditary? Not really though rather depends upon the cause. Some people get protrusios from ordinary osteo-arthritis which is neither hereditary or familial. However, another cause of it is from things like congenital hip dysplasia (or dislocation) and that can run in families but is not hereditary or genetic. Those cases are usually picked up at birth and should be treated so they don't go on to develop into this condition.
Once you have a THR for this condition is that the end of the protrusio or does it happen with the new joint?
That's the end of it. If the acetabular floor is very thin, it will be reinforced with bone graft, steel mesh, bone cement or a special titanium shell which should be sufficient to see it though as long as you need it.
I read your thread on implant longevity and I understand that they last much longer now. I noticed in a thread you had with another lady with this condition that you said although she could have a THR but she would have to have 2 -3 revisions. What is a revision?
A revision is where the whole implant needs to be replaced. This can be because the cup has worn or the cup or stem has become loose through wear. If the former, the liner of the cup can be replaced but if the latter, then the entire thing has to be removed and a new one put in. In cases of severe protrusio this can present some problems when it comes to replacing the cup but these things are constantly under review and being developed and improved all the time.
What happens when it is bilateral? Do you just get the worst one done first then the other one when it has deteriorated also?
Well, there are two approaches to this and it depends upon how bad your hips are. If one is a lot worse than the other, then you can have that done and anything from 6 weeks to 6 months later, do the other one. However, if both are equally bad, some surgeons will do both hips at once - one surgery, one anaesthetic, one recovery, one rehab. If you look around, you'll see lots of threads by people who've had bilateral hips done - in this context 'bilateral' usually means getting both done at once.
I guess the long and short of it I just need to know what to expect!
Of course you do! The best I can advise here is that you read around the threads in this forum and the After Surgery forum. Also the Information Centre > Recurring Information forum.
 
OP
OP
K

Kimcol

new member
Joined
Oct 26, 2009
Messages
6
Location
United Kingdom
Thank you for your prompt reply to my questions, I think you just saved me £150!

By progress, I mean in this condition. If my symptoms are mild at present how long before I would require surgery?

Is it better to have surgery before the floor of the acetablum is worn out?

I am working my way through previous threads which are very informative and looking at the information centre too. I must say you are doing a marvellous job here and I'm so glad I found BoneSmart!
 

Josephine

NURSE DIRECTOR EMERITUS
Nurse Director
Joined
Jun 8, 2007
Messages
84,940
Age
78
Location
The North
Gender
Female
Country
United Kingdom United Kingdom
Oh you must have it done before the floor wears out! It makes for complications if it reaches that point. Much better to start off with some bone for the cup to rest in/on and it will last longer too.

As to how the condition will progress that's awfully difficult to say. It rather depends upon how advanced it is now. But if your surgeon has already defined it as P
A then I would say the sooner the better.
 

Jamie

ADMINISTRATOR
Senior Administrator
Joined
Mar 24, 2008
Messages
59,348
Age
71
Location
Kansas
Gender
Female
Country
United States United States
Kimcol, I'm so glad that you have found some help and comfort here on BoneSmart. It makes so much difference when you have information at hand....you can make better decisions and the fear factor is greatly reduced.

I wish you luck as you work through all of this. Jo has given you superb advice and you have plenty of threads here to read through. Also, if you have any other questions or concerns, please don't hesitate to post them. You are part of the BoneSmart family now and we'll be here for you!
 
OP
OP
K

Kimcol

new member
Joined
Oct 26, 2009
Messages
6
Location
United Kingdom
Thank you for all your help and advice. I've discovered so much from this site.

I see a surgeon on Thursday so will know a lot more then and will probably need to come back with another list of questions!

Thanks again, I've been made to feel very welcome - it really helps.
 
Status
Not open for further replies.

BoneSmart #1 Best Blog

Members online

Forum statistics

Threads
50,659
Messages
1,369,581
BoneSmarties
31,786
Latest member
Cissa
Recent bookmarks
0

Top Bottom