Previous Trauma Need Replacement

[Ipock]

Hello, I would like to thank everyone for there input and support on this forum, it makes understanding procedures so much better when you know people that have been through the same thing.

I was injured in a car accident in Apr 08, where i had a complex acetabular fracture, seperated my pubis symphsis, and fx on my femoral neck.  The doctor fixated everything with 2 plates and 20 screws, I was 24 at the time, so the doctor told me that I was to young to replace it, and he expected the joint to last 10 years before I would need a hip replacement.  I also had resulting Drop foot from the accident.  Three months post op i began to develop severe Hetetropic Ossification.  I attended therapy everyday and had pool therapy 3 times a week.  I regained Hip flexion to 110 degrees, but had no internal, and less than 10 degrees external rotation.  I progressed well, and was swimming, rowing both on the water and off, and lifting (ketelbells, deadlift, hang power cleans).  In August, I couldn't complete a rowing stroke with out sever pain, this raised a red flag.  My therapist tested me and my hip flexion had decreased to 50 deg.  I had films taken and the radiologist said it was very concerning for AVN.  After meeting with two free doctors one for a THR (crosspoly cup/ ceramic femoral head) and the other a hip fusion, I was told that i didn't have AVN it was Post Traumatic Osteoarthritis.  I've begun to develop arthritis im my lower spine, and have increased knee pain.  I had Injections in my SI joints and that Has provided releif for the time being.  I've had my xrays looked at by doctors mentioned on this sight and by others also.

My questions are has anyone out there had a HR after previous trauma to the acetabulum?

Has anyone had HO before there surgery and how was that handled.

Are there any other hippy's out there that might have a similar situation or can offer help/advice.

I'm 26 years old and want to be young again with little to no pain, i'm not looking to run.  I just want to hike, play golf, hunt, fly fish,  kiteboard, surf, and row.  And maybe lift weights again.  I think returning to Ju Jitsu is out of the question.   Thanks to everyone for this great resource.

[Pat Walter]

Hi

Welcome to Hip Talk.

My only suggestion to you is to make sure you talk to the top resurfacing surgeons in the US and abroad before making any decisions or letting a less expeirnced surgeon work on your hip.

Where do you live?  Consider only the top surgeons like Dr. Gross of SC, Dr. Su of NY and some of the others at the top of my list.  You need the best if you want to remain active and have a good outcome.  I would suggest Dr. De Smet in Belgium if your insurance would cover it.  Many insurance comanies do.  He is one of the best in the world at very diffiuclt surgeries.

Because we are only patients, we can't tell you what to expect with such problems with your hips.  Listen carefully to the top doctors. Dr. Gross and De Smet will give you free consultations if you email them and attach a copy of your x-rays in a digital format as a jpg.  Get input from the best before making any decisions.

Pat

[Ipock]

Thank you Pat for all you do,

I did send my xrays to Dr. Gross, Dr. De Smet, and Dr. Bose when i first found out about this site, I finally got a little nerve up to post something.  I will talk them to them more once my medical retirement is finalized from my current proffesion.  I live in San Antonio Tx, So the weather is nice for all of this arthritis in my body; 68 degrees on december 21st is hard to beat.  Take care, brian

[Pat Walter]

Hi Brian

You have choosen the best in the world to talk to.  They may all not agree on the choice of treatment, but I would trust any of the three.  It is good you have taken time to try to find out as much as you can from the experts.

Meanwhile, I hope you can find someone with a similar problem to talk with.  I know there are others on this group that are also very kind and supportive.

Good Luck and keep in touch. 

Pat

[Ipock]

Just wanted to post a little note,  I received a call from Dr. Grosses office and my surgery is schedualed for the 21st of May.  They are having to design a custom acetabular componet with a shelf in the front because I am missing the front of my acetabulum and a 10mm? spike to provide additional stabilization.  I am really looking forward to 6 months post op and being able to enjoy life painfree without the unexpected thrashings of hip pain.  I am completely confident in the procedure and Dr. Gross and can not wait to begin this new chapter in my life.  I will post some more information around and after the surgery.  Untill then I wish everyone well and perfect procedures. 

If anyone else has had a custom implant could you let me know how that went for you.   Thanks, Brian

[Pat Walter]

Hi Brian

Thank You for your update.  I am glad Dr. Gross has been able to figure out a solution for you.  I don't think I have ever heard of such a design for the acetabular cup, but I am not a doctor.

I know many people will appreciate you sharing your story to help us learn more.

In return, I think you will find a lot of support from the great group of folks here.

We will continue to follow your story with interest.

Good Luck until May 21.  I know you will have lots of mixed emotions.  HOpefully, you will stay positive and keep looking forward to the 6 month time after your have healed.

Pat

[obxpelican]

You cannot beat Dr. Gross, he's one of the best, arguably one of the best in this country, you will meet Lee and Nancy who are fantastic folks too. 

Don't be afraid to ask Dr. Gross lot's of questions, he's not the type of doctor who will stand there with his hand on the door hoping that you will stop asking questions.

Good luck, please let us know how things work out.

Please let Lee and Doctor Gross that Chuck from Pat's site says hello.


Chuck

Just wanted to post a little note,  I received a call from Dr. Grosses office and my surgery is schedualed for the 21st of May.  They are having to design a custom acetabular componet with a shelf in the front because I am missing the front of my acetabulum and a 10mm? spike to provide additional stabilization.  I am really looking forward to 6 months post op and being able to enjoy life painfree without the unexpected thrashings of hip pain.  I am completely confident in the procedure and Dr. Gross and can not wait to begin this new chapter in my life.  I will post some more information around and after the surgery.  Untill then I wish everyone well and perfect procedures. 

If anyone else has had a custom implant could you let me know how that went for you.   Thanks, Brian

[Bionic]

Ipock,

Your accident sounds hellish.  I'm glad you've been able to recover as well as you have.  Dr. Gross did my right hip last year.  I couldn't have asked for a better experience.

I wouldn't be surprised if your back and knee pain improve once your hip is fixed.  I had all manner of aches and pains before my surgery, which are now gone.

With your prior femoral neck fracture, will Dr. Gross be able to resurface your hip, or are you looking at at THR?

[resurface]

Sorry to hear about the accident.  I few things that you may wish to consider.  Keep in mind that most femoral neck fractures are treated with either a cephlomedullary nail or a compression hip screw.  Both require a larger lag screw into the neck & head.   Some get cannulated screws where they place typically 3 screws into the neck and head. You were most likely treated by an fellowship trained trauma surgeon following the accident.  I would suggest that you also see that person again and discuss your situation.  This information may be quite valuable to future meetings with a surgeon who may do a HR.  I doubt that there is much issue is they performed a THR.  Femoral neck fractures are the most common behind distal radius fractures.  As a young guy, they should have good outcomes.  Best wishes...