Revision THR Resurfacing problem I have had

[Poppet]

Norm, I spent five days in ICU, unconscious, having multiple blood transfusions.. amongst other more serious problems...

Fear not

 

[North East Man]

Hi Poppet,
Thanks for your post.
I didn't ask that question out of fear. I was just curious to know was it normal to lose 3 pints/units during a BHR operation. Surely it's not!
Regards,
NORMAN

 

[Josephine]

No it's not. Generally speaking, a primary hip replacement can be done with minimal blood loss - about 500mls at most. Also, blood is rarely used unless the patient is showing signs of anaemia. There are plenty of volume expanders which can be given via the drip to keep up the proper quantity of blood circulating, such as normal saline and other fluids, without having to resort to using fresh blood.

 

[North East Man]

THANKS Josephine,
I appreciate all the expert help you've gave me.
I think this means another possible mistake was made.
Regards,
NORMAN

 

[Josephine]

I think you're right! However, that being said, one of the early criticisms of HR was that the neck might break out and allow the prosthesis to become displaced. For the longest time this was a big issue and much negative was spoken of it as a consequence.

However, then Derek McMinn came on the scene and proposed a protocol of more stringent training for surgeons and set up training programmes all over the UK and the States. I heard him speak at a meeting earlier this year when the big bad news about metal on metal hips was all over the news and he was adamant that in his years of doing HR and running his clinics (the McMinn centres) he'd had ZERO bad outcomes either with MoM or anything else. And I believe him because almost all the complications and bad outcomes from hip replacements are due to inadequate operative techniques. Putting one in mind of the old chestnut about bad workmen blaming their tools!

 

[North East Man]

Hi Josephine,
You certainly know your stuff. Thank you for reading everything I've said so far & agreeing I am probably right. Once I see your recommended surgeon in Sunderland & maybe get a date for an operation I'll not know whether to get the revision done first & then my other hip later.
The X-ray of my other hip says it has almost a complete loss of joint space, subchondral sclerotic changes, subchondral cyst formation and osteophyte formation.

I am now in a position where rather than just needing a second hip done 4 yrs after the first one I need both hips done .


Thanks again Josephine,
NORMAN

 

[Josephine]

My pleasure! If I may advise, I would definitely get this hip done before you do the other one. You don't know if it might collapse (assuming it's doing what we think it is doing). And Nanu might agree to doing them 6-8 weeks apart if you ask him.

 

[North East Man]

Good morning Josephine,
Thanks for your advice which I will certainly take.
Your help has been so invaluable.
Best wishes,
NORMAN

 

[North East Man]

Hello again Josephine,
I'm back again with what I think is a better X-ray of my Hip resurfacing & this is the one that was taken after the operation in 2009.

I thought for the sake of £10 I should get my original Xrays. So I arranged it with the Radiology dept & got the CD today.

What do you think of the X-ray. To me its obvious he's drilled 'cockeyed' into the Femur.
Thanks again Josephine,
NORMAN

 

[Josephine]

I think it's more than that, Norman. As you can see, I've edited your photo a bit and it has to be said that the xray is not really of sufficient resolution for diagnostic purposes. However there might be a ghost shadow beneath the stem (dotted line) which could mean that it's moving and has created a cavity around the stem. This would account for the symptoms you posted in your opening post.

if I cough, sneeze, trip slightly I get a terrific pain in the hip. When sleeping & turn over in bed the pain wakes me up. When walking I can feel the hip & feel the clicking

The danger of this is that the neck might be being broken down as I mentioned in a previous post. I've drawn a red box around the area at risk though again the quality of the xray is too poor to be definite about it.

But in other words, my friend, your implant would appear to be loose!

This xray on found on a previous post is clearer but doesn't show the ghosting. The picture was originally placed diagonally as you can see here.

It would be very helpful to know the dates of these two xrays.

 

[North East Man]

Hi Josephine,
Thank you for your reply .
The lateral X-Ray I posted earlier today was taken at the Gateshead hospital on the 6th of April 2009 just after my operation. I will now attach the full size image for you to look at & I'll not darken it like I did for the one posted this morning.

The first lateral X-Ray you saw just after I first started posting was taken very recently ie July 2013. You say it is clearer & it doesn't show the ghosting seen on the 2009 X-ray. YES it was placed diagonally when I downloaded it from the CD.

Do you right click on the image & send it to your Desktop so you can view the higher definition image?

I've just tried doing it & its much better

Does this now change what you said earlier Josephine?
I fell in lucky getting all this help from you Josephine. Much appreciated.

 

[calikat]

She is a gem isn't she? <3 Josephine

 

[Josephine]

The lateral X-Ray I posted earlier today was taken at the Gateshead hospital on the 6th of April 2009 just after my operation.

I see - that does change things. Hey ho! can't always be right!
I'll be interested to see what Mr Nanu has to say.

But all (xray) evidence to the contrary, I'd still say your symptoms as described appear to be in keeping with a loose implant.

 

[North East Man]

YES Calikat, as you rightly say Josephine is certainly a Gem.

Good Morning Josephine,
Thanks again for checking the X-Rays & it could turn out like you say ie a loose implant.
This would mean it has been loose since just after the operation.
I see my GP on Monday 14th Oct so don't know how long it will take after that to see Mr Nanu but I'll get back on here to let you know the results.
Thanks a million,
NORMAN

 

[calikat]

I am pulling for you Norman. I am so sorry you have been having problems for so long. I hope it gets sorted out.

 

[North East Man]

THANK YOU so much Calikat. I appreciate your kind comment.
It's lovely to know there are real nice people around.
Best wishes,
NORMAN

 

[Jaycey]

North East Man, please update us after your appointment. Lots of your cyber friend here following your journey.

 

[North East Man]

Thanks Jaycey I will certainly update the thread once I know a bit more. After I see the GP next Monday I'll update the thread . Then it will go quiet from the 19th Oct to 4th Nov as we are going abroad with my son & his young family for a holiday. Regards, NORMAN

 

[North East Man]

I've been to see my GP & he didn't know why I was sent for a 2nd opinion to a Surgeon who doesn't do Hip resurfacing ops & who couldn't comment about the hole through the femoral head into the Femur being 'cockeyed' ie drilled on an angle. So he is arranging for me to go & see Mr Nanu who Josephine recommended.
Thanks again to Josephine for that . It will go quiet but I'll update whenever I find out more. Thanks to you all for taking an interest. NORMAN

 

[Josephine]

the hole through the femoral head into the Femur being 'cockeyed' ie drilled on an angle

We tend to call that a 'malalignment'.