Revising my hip revision?
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gimpyD posted:
OK, I need some input. My THR of 12 years needed revision due to osteolysis from the "plastic" cup particles. Lots of bone loss and a cyst. Doc said it was almost too late. The revision was much more painful than I had anticipated. I still have pain walking after 6 months. I have a metal on metal revision. The Dr. says he can do better. He is considering a cross-linked polyethylene liner, and maybe a ceramic ball. I want the pain to go away. I want to be able to walk again. I'm afraid that I may go through all this again and still have the same or worse outcome. I'm just plain afraid. I didn't feel that the pain was managed well after this last revision. I've read that each revision has worse results. Anybody have any experience with this? I'm 50. Should I wait and see if this one heals up, or bust a move and get it over with, hoping that now the surgeon knows what he's dealing with he can make a better fit. And maybe the metal on metal issues will not be a worry. Any suggestions?
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bionic_hip_man responded:
gimpyD, I feel your pain. I too am 50 and have had two total hips and 3 revisions. I was 34 when I had the original replacements and after years of being very active, the plastic cup failed and became dislodged so I had the ball rattling around hitting the metal cup. Had to have a revision that took a while because the metal ball impacting on the metal cup created a lot of metal particles that had to be cleaned out. A first for my surgeon. I had the other revised and it was improperly positioned resulting in 2 dislocations and a trip back to surgery for another revision. I had the cross-linked poly cups put in because the femur stems were compatible. As far as the residual pain it has become part of my life. I have been treated for chronic pain for years. I try to stay as active as my pain will allow, but there some days I hobble around with a cane and I am 7 and 9 years post op. My advice is to be sure your surgeon is well experienced in revision surgey. One thing I found helpful after surgery was pool therapy; warm water and the buoyancy made a big difference. My advice is to let this revision heal completely and try aquatherapy and find a doctor to treat your pain.(NOT your surgeon). I've found that surgeons feel they are less than successful if the patient has ongoing pain. That is my opinion. I wish you the best as I can truly feel your pain because I have been exactly where you.
 
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gimpyD responded:
Thank you Bionic-Hip-Man! I have been under the care of a pain management Dr. for a few years. I think that water exercise will be good. I've been through PT. I have some good days where I can walk around a little. Use the cane most of the time, and crutches on bad days. I don't want to go through even more pain only to have the same outcome. My surgeon is highly rated, and has done many revisions, but the bone loss was worse than expected due to a hidden cyst where the loss area went into the pelvis rather than just around the artificial hip. Luckily the femur implant is holding on well. Sorry to hear it happened to you also. Was the second revision any better or worse?
 
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bionic_hip_man responded:
gimpyD: The second revision happened only nine weeks after the first revision, and they used the same incision line. I too had cysts in the bone and osteolysis. I was fortunate that the femur implants were solid bone ingrown. As I mentioned , I would try everything;water exercise, physical therapy etc., I'm sure you are like me and hope that the femur part never loosens because I have been told there is tremendous bone loss when that is removed. While I am being treated for chronic pain, like you there are those bad days that need more assistance Sometimes I wish my doctor could walk(hobble) a mile in my shoes. I know my revisions cause a lot more pain than the original prosthesis and is being caused by a tremendous amount of scar tissue which my surgeon says my body produces a prolific amount of. Scar tissue has been described to me as gristle like and takes a lot of exercise to loosen it up. I have learned to just take it one day at a time,because chronic pain is unpredictable as you know.
 
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Tessahipgirl responded:
Hi Gimpyd,
I hope you are still out there. If so, let me know, I would love to see how you are doing. I had major osteolysis also, and had a hip revision in dec 2010. It was so bad I was almost not able to have a reivision. My cup is double the size it should be. I had multiple "holes" in my pelvis from the osteolysis, and my entire trochanter bone was gone except for a thin shell. I am 42. I have been able to put full weight on my affected leg as of April, but the muscle weakness is still pretty bad. Also, the trochanter isn't totally healed. The bone graphs take a long time from what I understand. I am frustrated because I just want to walk normally without a cane. I was wondering how you are doing now and when you started feeling back to normal where you could walk without assistance. Thanks