Any Other Canadians With the Durom Hip Device? Americans?

[kb134]

I'm a 30 y/o male and had my right hip resurfaced at the UBC Hospital on May 20th 2008.  My surgeon and his colleagues stopped using the Durom Hip Resurfacing Device a couple of months after implanting mine, due to the amount patients that required revisions ...
I need a revision ...
From what I have read, some doctors in the USA have said that the Acetabular Cup has a design flaw, and because of that flaw, when it is implanted, normal bone ingrowth does not occur, and the consequence is a loose acetabular cup.  Ouch.  Zimmer, the designer of the Durom Hip say that it is surgeon error for the instances of the loose acetabular cups.
Anyone out there in this situation with a Durom Hip, in a Class Action Lawsuit, or whatever else we can get involved in - Canadian or American??
Or any opinions?

[woodway2]

Hello KB134
Can you tell us more about your situation... symptoms etc. When are you having a revision? Do you know what kind of THR you will have?
Thanks,
Nancy

[kb134]

Hi Nancy!
My situation:
I had the Hip Resurfacing surgery to my right hip on May 20th 2008 at the University of British Columbia Hospital.  Dr Donald Garbuz was my surgeon.  The surgery was successful, and I had my first post-op appointment on August 12 2008.  During the interim, I had come across some reports that were surfacing in the United States regarding the Durom Hip Acetabular Component, and I became greatly disturbed.  I took those concerns to my surgeon on August 12, and he said he was fully aware of the issues surfacing in the USA and told me not to worry.  Prior to my surgery, I asked my surgeon about the implant that they used, as well as mentioning that I had read a lot about the success of the Birmingham Hip Resurfacing.  He responded and said that he and his colleagues use the Durom Hip for they felt it was a better design and superior to other devices. 
I had my surgery, and began to get active - lots of time in the pool, and then I eventually began to ride my road bike accompanied by stretching to regain some range of motion. 
During the winter months when the temperatures dropped here - yes I live in the Vancouver BC, Canada region - but it was cold enough and my right hip would get so sore, and at one point, I thought that the device had come loose.  The pain subsided and I considered it a bullet dogded.  In the new year I tried to run a little, and after about 2 minutes of running, I had to stop because of the pain radiating from my right hip down my thigh.  I saw Dr Garbuz for my one-year post-op appointment on May 4 2009.  I was also seeing him regarding my left hip, which also needs to be resurfaced.  I was X-rayed and I got to see those X-rays with the surgeon.  I noticed something and asked, "Is that a notch?"  He kind of fumbled a bit and flipped through my file and responded, "Well the notch is not in the Operative Report."  I let it go because of ignorance, and our discussion turned towards my left hip.  I was told that the Durom Hip Resurfacing and the Durom large MOM devices were no longer being used, due to the amount of patients returning with loose Acetabular Cups, and the high metal ion counts in many patients.  I was also told that he and his colleagues began using the Birmingham Hip System and that they started using it about one month after my first post-op appointment. 

[kb134]

I then began to lok into the "notch" issue.  I discovered that it is surgeon error ...
The fact that it was not in the Operative Report also disturbed me.  I lost confidence in my surgeon.  Why would I let him cut me open and do my left hip if this is what goes on?  On May 17, I was running and playing with my little nieces at a family get-together when I experienced a sharp pain in my right hip.  I walked it off, and tried to continue.  But the pain would not subside. 
On May 22 I saw my family doctor to get some X-rays.  I got the films and sent all my info (I had a CD of my Day of Surgery with the implant X-ray, as well as the August 12 X-rays to compare) to Vicky Marlow, the most amazing woman and patient advocate for resurfacing, and she sent that info to 3 prominent surgeons.  Within a day, I had two responses to those X-rays:
Dear Vicky,

 

I do not know for sure, but I have the impression that the cup has changed position.

 

On the first x-rays it was different and you saw a line (not fully seated at the beginning)

 

So it is possible the cup is loose. They should know that by Technetiumscan.

(I have seen already 4 patients like that)

 

There is also an increasing impingement and bone going away on the femur.

 

 

The talk about BHR and pseutomour she is talking about is rubbish form the surgeon

 

GREETZ

 

And:
Hi vicky,
Greetings.
Thanks for sending the images.
He has an impending fracture of the neck of the femur but I think the current problem is that the cup has slipped into excessive anteversion.
He needs a full blown revision of both the acetabular and femoral componenets.

[kb134]

I went that route - to get outside opinions - because I wanted to know and understand  why I had pain, and I couldn't speak to my own surgeon that quickly. 
My surgeon and I had an eventual phone conversation that turned when I brought up the issue about the notch on my femur-neck.  His response shared his thoughts, which I agreed with, that I no longer had any confidence in him.  He said he would refer me to whomever ...
He also spoke down about the Resurfacing Doctors that Vicky had contacted on my behalf.
One thing I forgot to mention earlier: Hip Resurfacing is no longer covered by Medical here in BC.  Some reports had come out of Oxford stating the high incidence of "pseudo-tumours" showing up in resurfacing patients.  And following that news, my surgeon and his colleagues are now advocating THR's.  If one wants a hip resurfacing, which is now a patient elective surgery, then the patient has to pay the $4000 for the device.
At this point, I am ... well, a little stuck with my options.
My quality of life has declined again, and I have to be opened up again.  I'm 30.  I am investigating my options concerned with the Durom Hip, since patients were still being implanted with the device even after the news of the higher that average revision rate in the USA.

Did I get everything out there?

[kb134]

Hi!  Yes, me again.
I also want to say that even with my stretching and rehabilitation routine, I am not able to bend my knee/thigh passed the 90 degree point.  I do not know if that is normal, but from all the pictures and videos I've seen, I should have had more ROM than that. 

[woodway2]

Hi KB134
I am so sorry that you are going through this. I have my own story to tell which you can find on previous posts . I see my new surgeon later this week for an update on my high metal ions.
I am shocked to hear about BC delisting resurfacing. I am in Toronto. I have heard the Oxford group called "fear mongerers" but I do think the long term problem with resurfacing is going to be that it is just too hard to get it right. I hear that computer guidance is being developed but it is going to be a while. Right now computers only guide the femoral side, not the acetabular. This is where my problem is and the cause of my high ions. As I have no pain the surgeons do not want to revise, but this week's news is that my levels are way up again.
I'll report back after I've seen my new surgeon in Ottawa.
Nancy

[kb134]

Hi Nancy,
I saw some of your posts ... wow.
I'm waiting ith the rest to hear some news.
I didn't catch it - what device is in you?  A BHR or a Durom?
Do you know the specifics info about your new surgeon?  Has he ever revised an acetabular cup and so has the experience?
With prayers girl,
Klint   

[woodway2]

Hi Klint
September 2007 BHR
Nancy

[fedup]

I had a Durom hip resurfacing in May 2006 at VGH as well. I had severe pain and swelling from the beginning and many months later exploratory surgery and an iliopsoas tenotomy leaving me with a weak painful leg. Eventually I had a revision to a THR April 2009 and it was found that the Durom acetabular cup had never integrate with the bone. It had been loose all along despite "normal xrays". I think the scientific literature supports device error as opposed to surgeon error as the cause of the acetabular cup failure. Currently I continue to improve post op, but am concerned about what to do with my other hip, also in need of a replacment. I find the whole Durom issue concerning. Have they stopped doing them in Europe as well as Canada? It may be that they did more in BC and that's why they noted the increased failure rate. PS Despite the fact the prosthesis caused inflammation to the iliopsoas tendon (hip flexor) getting the tenotomy was a very bad idea and did not reduce the groin pain. My operated leg with the THR is almost painfree after 3 years post op (and 2 years pre op) constant pain. Now I know why people get joint replacements.

[Pat Walter]

Hi fedup

I am sorry to hear about your revision.  I just wanted to say that the BHR Birmingham Hip Resurfacing Device is the most used device worldwide and has not had the same track record as the Durom.  I did not want you to think that it was the resurfacing that was a bad idea - it was the improperly placed acetabular cup and improperly designed acetabular cup.

The survivorship of the BHR prior to the FDA approval in the US was 99.8% and then dropped to 96% when the inexperinced US surgeons began resurfacing.  That is still an excellent record and as the US surgeons become more skilled in placing the acetabular cups, hopefully the survivorship rate will once again increase.

Again, this points out the importance of using a very experinced surgeon for your hip resurfacing.  I realize you are from Canada and did not have that choice, but wanted to make the point for others.

Again, I am sorry to hear about your revision.  You should have been out of pain right after your resurfacing surgery too - but unfortunately, that did not happen for you.  It does for most people and I want new perspecitive patients to realize that.  I have many hundreds of personal sucessful stories posted on the website.  I also post stories about people with problems so people realize that with any major surgery - there can be problems, but they are normally in the minority.

Thanks for sharing your story and I hope you find a good solution to your other hip.  Please keep in touch.

Pat