Revision of 7½ year old hip

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Scott

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Hello. I'm back after a long hiatus from the board. I had a THR of my right hip in May, 2009, and this board was a tremendous resource for preparation and recovery. I got quite busy with life and regretfully eventually stopped reading and posting.

I feel like I had great success with my new hip, though I pushed it too much and now need a revision.

A little background. Within a few months of my replacement I was riding and racing a road bicycle. Two years after the replacement I did my first triathlon and fell in love with the sport. Over the next four years I raced two full Ironman triathlons and four half-distance Ironman tris, countless other shorter distance tris and a bunch of 5/10/15/25K/half marathons and century bike rides.

My OS never "liked" that I was working the hip so hard but always told me to use pain as a guide, so I did.

At times I would have setbacks with pain and have to ease up or lay off for a few weeks and then recover again but for the most part I competed pain-free. I really learned to get a feeling for how hard I could push myself and what was pain versus soreness. Summer 2015 I was on a run and suddenly felt a pain that radiated down my thigh. It was excruciating and stopped me in my tracks. It was very poor timing as I was in the heavy part of training for my second full Ironman.

After a few weeks I went to see my OS and his advice was to rest the hip, so I unfortunately had to stop running entirely all the way up to my race and ended up run/limp/walking the race. I then took a few months off of no running at all. After that I tried to get back into it slowly but the pain kept coming back. This was different than anything I'd experienced before.

Fast forward to now after x-rays, MRI, blood tests and hip aspiration (that was fun), and I'm now scheduled for a revision. My OS believed from the beginning that I was suffering from wear but I had to go through a lot of tests to ensure there wasn't an infection or some other abnormality causing the pain.

Unfortunately, my OS doesn't know exactly which components are going to have to be replaced until he gets in but he suspects the liner and head (mine is large cobalt) if I understood him correctly. Something is definitely causing a lot of fluid build-up. I actually felt better just after they aspirated 20cc of fluid for testing. BTW, if you ever have this done, be prepared because "just a pinch" is a lie. LOL.

My surgery is scheduled for November 17th so I thought I'd come back and get caught up on all I've missed over the years. Looks like it's still an active and helpful group.

I've resigned myself to the fact that my running career is either over or severely shortened but hopefully I can still bike as much as I want and go on hikes with my wife and dog and generally enjoy outdoor activities.
 
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@Scott Looks like you really got a lot of mileage out of that hip! At least got your money out of it! Amazing the things you did after replacement. Best wishes on the revision. How is your other hip? I had both of my hips replaced over the last couple of years. They are doing wonderful and I am so thank-full!. I had both knees replaced in 2013. I walk about an hour everyday... just walk. I have no pain now but I baby these replacements so hopefully they will last me the rest of my life. Please keep us up to date on your recovery. Joan :SUNsmile:
 
Welcome back, @Scott, although I wish it didn't have to be for a revision! Wow, you really did push that new hip, and it is helpful for others to hear what happened to you. I had a THR July 2015, and have had pain/limping since then. Will have a revision/exploratory surgery soon. Also a repair for a gluteus medius that has been torn since the surgery or shortly afterwards. I had a hip aspiration, but mine didn't hurt much, except for when they added fluid to see if they could get a sample taken out to check for infection. They couldn't.

Sounds like you are in a good frame of mind for how to handle the rest of you life regarding exercise. All I have dreamed of is being able to walk unaided without pain, and will be ecstatic if I can go back to just hiking in natural areas. Best of luck with the upcoming surgery!
 
@Scott, wishing you best of luck with your surgery and recovery. Wondering if you are aware of hiprunner.com? It is another site with runners that have had THR and gone back to running. Might be another good spot to share experiences. I have congenital hip dysplasia and waiting on getting my right hip replaced. Ironically enough it seems to be getting better but no running. So I am in a quandary, my discomfort is tolerable right now as long as I don't run or over do it. I could get the hip replaced but as we know it will not be recommended to run after.
 
Hey Scott - seems like you tested it out good and proper! Can't say more than that. But just think - your new hip will have 7+ years of advanced technology on it so should be much more wear resistant!
 
Hi Scott,
Welcome back, wish it was under better circumstance.
In an earlier thread you mentioned this about your implant.
The ortho is going to use a Wright prosthetic that is metal on metal and a larger head and socket to allow me to get back to hard activity.
If in fact this is what you have, Metal on Metal implants are no longer being done to a high failure rate, and ions leaking into the soft tissues.

More information:
http://bonesmart.org/forum/threads/metal-on-metal-warning-old-but-ongoing-news.13043/

:fingersx: you have a different implant.
 
Scott - a question if you don't mind - is your hip replacement metal on metal? If not, do you know what it is?
 
@Scott Looks like you really got a lot of mileage out of that hip! At least got your money out of it! Amazing the things you did after replacement. Best wishes on the revision. How is your other hip? I had both of my hips replaced over the last couple of years. They are doing wonderful and I am so thank-full!. I had both knees replaced in 2013. I walk about an hour everyday... just walk. I have no pain now but I baby these replacements so hopefully they will last me the rest of my life. Please keep us up to date on your recovery. Joan :SUNsmile:

Thanks! I'm very pleased with what I've been able to do. I won't stress the new parts as much but still want to be active. My other hip is fine. This replacement was due to breaking it in an accident when I was 14. When I had it replaced I had apparently been bone on bone for a while. Hopefully the other one stays good and healthy.

Welcome back, @Scott, although I wish it didn't have to be for a revision! Wow, you really did push that new hip, and it is helpful for others to hear what happened to you. I had a THR July 2015, and have had pain/limping since then. Will have a revision/exploratory surgery soon. Also a repair for a gluteus medius that has been torn since the surgery or shortly afterwards. I had a hip aspiration, but mine didn't hurt much, except for when they added fluid to see if they could get a sample taken out to check for infection. They couldn't.

Sounds like you are in a good frame of mind for how to handle the rest of you life regarding exercise. All I have dreamed of is being able to walk unaided without pain, and will be ecstatic if I can go back to just hiking in natural areas. Best of luck with the upcoming surgery!

Thanks for the comments! Hiking is something my wife, dog and I have taken up. We all love it and it's something we can do together unlike my triathlon activities. I love nature.

@Scott, wishing you best of luck with your surgery and recovery. Wondering if you are aware of hiprunner.com? It is another site with runners that have had THR and gone back to running. Might be another good spot to share experiences. I have congenital hip dysplasia and waiting on getting my right hip replaced. Ironically enough it seems to be getting better but no running. So I am in a quandary, my discomfort is tolerable right now as long as I don't run or over do it. I could get the hip replaced but as we know it will not be recommended to run after.

I wasn't aware of the site. Thanks for that! I put a lot of long and hard miles on this hip; otherwise, I believe it would still be in great shape. I always knew it was a risk but there just hasn't been enough data for what I put it through. I say get the replacement, let it heal and try it out :yay:

Hi Scott,
Welcome back, wish it was under better circumstance.
In an earlier thread you mentioned this about your implant.

If in fact this is what you have, Metal on Metal implants are no longer being done to a high failure rate, and ions leaking into the soft tissues.

More information:
http://bonesmart.org/forum/threads/metal-on-metal-warning-old-but-ongoing-news.13043/

:fingersx: you have a different implant.

Scott - a question if you don't mind - is your hip replacement metal on metal? If not, do you know what it is?

Apparently I didn't listen properly 8 years ago, or at least didn't know what I was hearing. My OS told me recently that the cup and head are both metal but he used a polyethylene liner. I had blood tests done to look for indication of metal wear but the doc said the levels he was concerned about were good, whatever that means. There were four things he was looking for and I don't remember what they were.

It's funny to me because I've been aware of the DePuy failures for many years due to those cheesy lawsuit ads on TV and people forwarding articles to me. I was never concerned because I had a different manufacturer's equipment and never experienced the symptoms that the failed hips exhibited (until the last year or so). I understand now that the manufacturer probably doesn't matter, at least too much, so I'm glad to know that I have a liner even if it is worn now.

After doing more research lately I wonder if I should talk to my OS about a ceramic head. Back in 2009 he felt the configuration he used was the best for my activity level but I'm not sure if he would say the same now.

Thanks for all the replies, everyone!
 
I wonder if I should talk to my OS about a ceramic head.
You definitely do not want metal on metal again. I would clarify this with your surgeon. If he is talking about MOM again then please do find another surgeon. There are plenty of implants out there for active people and MOM is no longer considered safe.
 
You definitely do not want metal on metal again. I would clarify this with your surgeon. If he is talking about MOM again then please do find another surgeon. There are plenty of implants out there for active people and MOM is no longer considered safe.

Is a metal head/ball and a metal cup with a polyethylene liner considered MoM? I assumed, maybe mistakenly, that the liner between the two metal pieces negated MoM designation? I'm not being facetious - asking seriously.
 
Is a metal head/ball and a metal cup with a polyethylene liner considered MoM?
Sorry, I miss-read your post and assume you had metal on metal. No, MoM is all metal. If you have a poly liner that's fine. Sounds like you wore it out!
 
Hi @Scott, I really appreciate you posting your story. I am very interested in hearing from people who were very active who have had their hips replaced. I was a professional dancer, and I have really backed off of my training after having both hips replaced. I would like these to last me the rest of my life, but putting my body through what I used to do seems dangerous. Reading about what happened to you has made me feel very glad that I made this decision. Many dancers try to get back to the level they were before the surgery. It seemed unsafe to me.

I have a ceramic hip with the poly liner. My stem is titanium. I have been researching professional dancers, and the ones that went back into intense training have had to have revisions. Many of them have also caused damage to their knees.

It's a tricky balance, finding out what you can do, but still respecting the new limitations. I am now able to do light weights at the gym, yoga, swimming, biking, and hiking. I think you will find the right activities for your new joints. I look forward to reading your threads.
 
I'm 8 days out from surgery. Can't believe it's almost time. Pre-op work is done. Found my crutches and cane. Guess I need to get everything else together :yikes:
 
I ran a report on my training/exercise log system to see how much usage I've put on this hip since 2009. Almost 28,000 miles cycling and 4,200+ miles running.
 
You have certainly given that hip some miles! Can't imagine the cycling caused much wear but certainly the running. I look forward to following your recovery soon.
 
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