I'm having issues with my 3 years BHR and I'm starting my research in case I need to have it revised. I'm having really high metal ions and it will be retested in January.
Anyways, can a BHR be revised to a Mini Hip? How does the Acetabulum cup come out since it's obviously fused to the bone as well as the cap on the BHR?
Hi PistolPete,
Hopefully you may not need to go down the revision road, but here are some thoughts related to your questions in case you do.
If the problems you are having relate to just one side of your resurfacing (either the femoral cap or the acetabular cup), you might explore the option of looking to revise just the problem side and retain the other side if it is not part of the problem. For example, I think that Dr Gross keeps a well positioned cup whenever possible, and revises just the femoral side if that is the problem. I think that I have also heard of him repositioning cups using a dysplasia cup that allows for additional screw fixation when the cup was the problem and had to be replaced.
Your question about getting the cup out is one reason to maybe explore these options. They do have tools to cut the cup out of the bone, but of course that means some bone loss, which might be worth trying to avoid.
I am sure that in some cases it is better to just get rid of the old prosthesis and get a fresh start, but since you are being smart and doing some early research, the idea of preserving a non-problematic side might be worth adding to your homework. From what I have read, it seems like Gross, Pritchett, and DeSmet do some of the most interesting work at trying to preserve the parts of a failed resurfacing if they were not part of the problem.
Another option to consider is that I read on this site recently that Dr Pritchett said he could revise a BHR to his new ceramic on poly resurfacing option, much to my surprise since I did not think that it was possible.
Good luck with your research.