scheduled for THR revision Oct 8th

[mcgaughy]

anyone on here had a revision? I'd be interested to know what to expect. thanks for any help you can provide.

 

[Josephine]

Hi, mcgaughy - some info about yourself would help as cases vary so very very much. Like age, how long you had the present THR, why you're having to have a revision, that sort of thing.

 

[mcgaughy]

sorry about that, I posted a couple of months ago and should have added to that thread instead of a new one. I have had the original THR for 25 years. It has loosened so I am having to have the revision. I am 53, broke the hip at 25 and had the THR at 28. I have had virtually no pain for 25 years until this last spring when it started bothering me and feeling as if something was not quite right. First doctor I saw said they would have to "cut" the bone to get all the old cement out but the doctor I have now (at UAB in Birmingham) says they will just add new cement on top of the old cement and my recovery time will be much shorter.

 

[Josephine]

You know, just last night I was reveiwing a book on hip surgery and the author described that, complete with sketches and I was like WHAT?

I have never, ever seen such a thing!

In the UK we use an OSCAR (Orthosonics System for Cemented Arthroplasty Revision) with which the old cement can be removed from inside the femoral canal. But this really only needs to be done in cases of infection so if the situation is loosening, then simply trimming out what cement you can to make room and then infilling with more cement is perfectly acceptable.

And 25 years is a pretty good run for a THR, especially considering it was implanted in 1983! Things weren't too bad then but nothing like as advanced as they are now.

So basically, I'd anticipate it to be pretty much like a primary in terms of recovery.

 

[mcgaughy]

doctor says I'll be off work about 4 weeks and I should be better than before. I forgot to mention, I had an Epidural before with the hip surgery and he was amazed at that, said he will not do it without general anesthesia. I actually had 3 hip surgeries and didn't have general anesthesia either time because I requested the epidural. I was "awake" through part of the surgeries but asked them to give me more drugs when I heard them "crank up the saw" when they were doing the THR

 

[Josephine]

That's odd about the GA vs spinal issue. Most surgeons and anaesthetists think that a spinal is much safer than a GA. Still, whatever he's comfortable and YOU are comfortable with. We tend to use each about equally in the UK.

 

[Reconstructed_Linda]

Hey there!

I am 49 and had a first HR in 1988. All cemented, vacuum packed. In 2000, I had the acetabular cup revised, but they did not touch the femur component. Last year I started having thigh pain, when sitting on the floor, having kids on my lap, moving certain ways etc. Nothing showed up on X-rays for awhile. In January of this year I went in for a check-up and the x-rays showed that the titanium rod had broken in two and separated. The bottom portion of the rod was still tightly cemented but the top had gotten loose. I had a THR a few weeks after that (as soon as they could schedule it to lessen chances of a bone break). They cut the femur to remove all of the old cement and metal pieces. Everything was replaced, and I have lots of screws and wires to hold everything together.
The surgery was long (~ 6 hours), but turned out well. I had a great surgeon, a young guy (in his thirties) that I was referred to, by a well respected established older surgeon (not too old - in his mid-late fifties). While trying to figure out my thigh pain problem I tried making appointments with a few different surgeons, and the first established older guy I was referred to refused to see patients needing revisions of work he did not initiate. He referred me to someone younger who totally misdiagnosed the problem. I went to another surgeon for a second opinion, and he was the guy who referred me to the surgeon who finally did the revision. Apparently the surgery is a lot of work - for the younger guys. My surgeon seemed to specialize in revisions and I had the surgery done at a University medical center. I am glad I had the second opinion. I went back to work in six weeks, and everything is fine so far. No pain. I hope this one lasts for awhile! I would be happy to answer any questions. Good luck with your THR and let us know how it goes!

All the best!
Linda

 

[mcgaughy]

Thanks Linda for your response. I also had the "ball" replaced in 1990 but they did not touch the femoral part because it was very solid then. I am hoping that they don't have to cut the bone and can do as the doctor is hoping and just put new cement over the old and put in the new part. I know you must have some pain as a result of all the screws, etc. and the bone healing. I had a bone graft before the original THR and that had a pin and screws and was very painful during the healing process, much more so than the THR. Good luck to you in your recovery.

 

[mcgaughy]

Sorry I haven't posted in a while - I've been really busy getting ready for the surgery trying to catch up at work and get my house ready. I'm doing my preadmission stuff today so it's making me realize how close it is - less than a week away. I've been really dreading it but now I'm ready to just get it over

 

[Tommy Utah]

Good luck McGaughy

 

[Josephine]

Amen! Hope it all goes well without any hitches.

 

[GaliceGal]

doctor says I'll be off work about 4 weeks and I should be better than before. I forgot to mention, I had an Epidural before with the hip surgery and he was amazed at that, said he will not do it without general anesthesia. I actually had 3 hip surgeries and didn't have general anesthesia either time because I requested the epidural. I was "awake" through part of the surgeries but asked them to give me more drugs when I heard them "crank up the saw" when they were doing the THR

Hi mcgaughy,

I just wanted to wish you the best. I had my first THR 3 weeks ago today and had the epidural. I had my choice of epidural and general and thought being awake would be safer and also very cool! (it was! lol) I, too, asked the anesthesiologist to knock me out when it was time for the bone saw. I decided it wasn't something I needed to remember.

Anyway, I'm here in the U.S. -- West Coast-- and when discussing anesthesia options, I was told that 99% of THR cases are done with an epidural. There must be a particular reason your doctor wants you under general anesthesia. I would ask him specifically why he wishes you to be completely under. And, most importantly, if you're not comfortable with general anesthesia, maybe you need to think about a different surgeon. You need to be 100% on board and comfortable with every single aspect of this before you go through with it.

Wishing you the very best--

GaliceGal

 

[Josephine]

I'd imagine it's probably more a case of his prefered procedure than anything, GG. Some 'gas-men' just don't like doing spinals/epidurals.

 

[AOC]

Rather timely reqest! I just returned home last Thursday after my reviison surgery on Sept 22. I had my original in 1986 (age 36)and was told that I needed to have it revised due to wear even though it was not giving me any trouble. The surgery was what I expected and after initial pain subsided it was time to get moving. Due to the previous revision, my doctor prescribed a brace to decrease the chance of dislocation. It jams itself into the incision and is not very comfortable but it does provide some needed support. I find its becoming more tolearable as the days go by and the surgical site begins to heal. I had the staples out yesterday an I was able to walk several hundred yards down the steet this moring. The leg is extreamly weak and I'm going to have a lot of work to get my strength back. My original had no glue and they left everthing intact since all the matal was rock solid. Since Josephine and I both looked for a new replacemet liner for the old model, I suspect the doctor glued a new high density polyethylene liner into the old cup. He made himself extremely scarce after the surgery so I'm going to have to wait to get all the details. He repaired some of the osteolysis and added a new piece to decrease the impact of the poly wear on the bone He also added a new ball to fit the new liner. I'm a little short of details but the surgery went quick with no real problems. As I'm finding out, every revision is unique but most come out well. I wish you the best of luck and I'll let you know how it goes.

I spoke to the anesthiologist before surgery because I wanted a general. I tolerate it well and I wanted to use lovenox rather than coumadin after surgery. That way I didn't have to bother with the twice weekly blood draws. He told me he always uses a general unless its specifically requested. He said its easier to maintain a patent airway with the general so he prefers it, especially if they will be moving you around. A solidly placed ET tube is easier to maintain and safer in the long run. I had no problem with it and came to screaming for pain medicine as they moved me onto a strecher but with no other side effects.

 

[Josephine]

Glad it went okay, AOC. Good to hear from you.

 

[mcgaughy]

came home Sunday and this is the first time I've gotten to the computer. I can tell you I don't remember this much pain from the last time but they say you forget the pain so I guess that's true. The surgery took a good bit longer than predicted (about 2 to 3 hours rather than 1 1/2) because they had to do more than predicted. From what I understand right now I had a good bit of cement broken up in there that they had to dig out and they had to replace both parts because mine was so old they couldn't match up with the old part. Better today and will post more tomorrow or as I feel better

 

[Josephine]

Well, at least it's over and done with now. I'm pleased you are well enough to check in and say hi!

 

[mcgaughy]

so much better today. Getting stronger every day. Got staples out and can get my first shower tomorow (good for everyone Hope to start posting more within a couple of days.

 

[jaz]

Great to hear you are feeling stronger. It must be nice to have those staples out.

 

[Josephine]

Great news, mcgaughy!