Loose Acetabular cup causes revision to THR

[Gary]

Hi,
I am new to this web site, so I'm just jumping in here.  My story is that I recieved a bhr hip last may.  I am experiencing pain on the out side of my hip after sitting.  It takes several minutes (10-15 ) to walk off.  given the time and space to walk around the pain will subside and I will feel great.  Able to do most anything.  Run, jump whatever.  After getting up from the sitting position the pain has gotten to the point where I need a cane to manuver.  I am schdueled for a thr revision surgery next monday Feb 28.  My doctor feels the acetabular cup is moving, that the bone did not grow onto the surface to stabilize it, but won't know for sure until he can open me up and look again.  I have read in a report on bhr on the internet that there is a acetabular cup with rim screws for displacia patients. My question is has anybody heard of revising the bhr by replacing the cup with the displacia cup with rim screws.  Why do a full hip replacement if the bhr can be repaired??  This thought has been haunting me since the doctor said I need the thr any thoughts would be greatly appreciated.

[Pat Walter]

Hi Gary

Welcome to Hip Talk. I started a new topic for you because this is very important.

One thing I can tell you is I know of a lady from the Yahoo Surface Hippy Group that had a loose acetabular cup.  The surgeon did make a second surgery to replace the cup only - he did not make the revision to a THR.

I will tell you something that the experienced doctors have told me and that I have posted  http://www.surfacehippy.info/loosecups.php about loose acetabular cups -  they are surgeon error.  Nothing less.  I will try to find the info I have from several other doctors.

You can see from this page that slipped cups are a problem with the less experineced surgeons. There had been 7 that we knew of when this page was posted.
http://www.surfacehippy.info/pcselectingsurgeon.php  There are probably more, but these are just from people on the large Yahoo Surface Hippy Discusison Group.

Before I had a revision, I would want to talk to some really expeineced hip resurfacing surgeons to find out what is going on and what could be done.

I would write to Dr. Bose of India and Dr. De Smet of Belgium and get some input from really experienced hip resurfacing surgeons. They are normally quite willing to talk with people and let them know about any unusual situation.  I would attach my x-rays in a digital format.  People with problems often write to them. They are very gracious and helpful. Their emails are on this page.
http://www.surfacehippy.info/listofdoctors.php 

I am very sorry that you have a problem, but I sure would find out more about what has happened and why.  Hip surgery is very major - as you well know and you deserve an answer.

Who is your surgeon?  Are you sure that the cup has moved. Many people have some serious problems with muscle issues after hip resurfacing.

I hope you can get some extra input from Dr. Bose and De Smet.  I think it will give you some peace of mind before you go back into surgery.

I would not be shy about finding out what is going on - you paid for the surgery and you had to go thru the pain of an unsuccesful surgery. 

Please keep in touch.  I hope that you can get some answers before you go in for THR surgery.

Pat

[Vicky]

Gary,

Postpone your surgery!  Get other opinions.  There is no way that it is a given that you get a THR if you have a slipped acetebular cup.  That is the easy way out for a doctor.  That is the one area where a BHR can easily be revised to another BHR.  As long as the femoral component is still stable, there should be no reason to replace that with a THR.  Who was your doctor and where do you live?  Can you email your x-rays for a free consult with some other doctors?  If the cup was not seated properly, it will slip.  Any experienced resurfacing surgeon should be able to go in there and seat that component correctly and if needed add the dyplasia cup with the screws.  POSTPONE your surgery, do not let your doctor just give you a THR now until you find out your options from some of the more experienced surgeons out there.  Tell us where you live and we can recommend a doctor for you.

Vicky

[chfwlrs]

Thank you for the advice

[Gary]

Hi Pat,

My Doctor is Dr. Rodrick he practices out of Southern Ocean County Hospital in Manahawkin NJ.

Hi Gary

Welcome to Hip Talk. I started a new topic for you because this is very important.

One thing I can tell you is I know of a lady from the Yahoo Surface Hippy Group that had a loose acetabular cup.  The surgeon did make a second surgery to replace the cup only - he did not make the revision to a THR.

I will tell you something that the experienced doctors have told me and that I have posted  http://www.surfacehippy.info/loosecups.php about loose acetabular cups -  they are surgeon error.  Nothing less.  I will try to find the info I have from several other doctors.

You can see from this page that slipped cups are a problem with the less experineced surgeons. There had been 7 that we knew of when this page was posted.
http://www.surfacehippy.info/pcselectingsurgeon.php  There are probably more, but these are just from people on the large Yahoo Surface Hippy Discusison Group.

Before I had a revision, I would want to talk to some really expeineced hip resurfacing surgeons to find out what is going on and what could be done.

I would write to Dr. Bose of India and Dr. De Smet of Belgium and get some input from really experienced hip resurfacing surgeons. They are normally quite willing to talk with people and let them know about any unusual situation.  I would attach my x-rays in a digital format.  People with problems often write to them. They are very gracious and helpful. Their emails are on this page.
http://www.surfacehippy.info/listofdoctors.php 

I am very sorry that you have a problem, but I sure would find out more about what has happened and why.  Hip surgery is very major - as you well know and you deserve an answer.

Who is your surgeon?  Are you sure that the cup has moved. Many people have some serious problems with muscle issues after hip resurfacing.

I hope you can get some extra input from Dr. Bose and De Smet.  I think it will give you some peace of mind before you go back into surgery.

I would not be shy about finding out what is going on - you paid for the surgery and you had to go thru the pain of an unsuccesful surgery. 

Please keep in touch.  I hope that you can get some answers before you go in for THR surgery.

Pat

[Vicky]

Gary,

See about getting a consult with Dr. Su, he is at HSS in NY and is one of the top resurfacing surgeons in the U.S.

Vicky

[Gary]

How do I get in touch with these doctors to get a second opinion?

[Vicky]

Here is Dr. Su's info, he is great and local to you

Dr. Edwin Su
300 Hip Resurfacings to date
Hospital for Special Surgery
535 East 70th Street
7th Floor, Room 704 West
New York, NY 10021
212-606-1128
877-606-1555 (toll-free)
Hospital for Special Surgery

Dr. Bose
Dr. Vijay C. Bose
1000 Hip Resurfacings to date ***
BHR Regional centre - India
Apollo Speciality Hospital, 320, Mount Road, Chennai - 600035. INDIA
E-Mail: bose5vijay@hotmail.com
Telephone: 0091-44-(0) 98400 - 32251
Hip Resurfacing India Website

Dr. DeSmet
Dr. Koen De Smet
3000 Hip Resurfacings to date ***
ANCA-Clinic
Kalverbosstraat 31A
9070 Heusden
BELGIUM
Phone: +(1)32 9 2525903
Fax: +(1)32 9 2526457
+1 for USA & Canada:
E-mail: helpdesk@heup.be
ANCA Clinic Website

Feel free to email me too any time.

Vicky

[Pat Walter]

Hi

Use my doctors list:

Dr. Su at bottom of this page  http://www.surfacehippy.info/listofdoctors.php#New_York

Dr. De Smet Belgium

http://www.surfacehippy.info/listofdoctors.php#Belgium

Dr. Bose

http://www.surfacehippy.info/listofdoctors.php#India

List of all the doctors info - phone, address and emails

http://www.surfacehippy.info/listofdoctors.php


Good Luck.

Pat

[Gary]

Hi all,

Just wanted to let you know that I postponed my surgery and have made an appointment with Dr. Su on March 11.  Now I just have to survive that long/

Gary

[Gary]

Hi,

I have been reading about acetabular cup slipping and what the symptoms are.  I pretty much fit the bill.  My only question did anyone feel pain free after walking with the aid of a cane or crutch?  After 10 minutes fo walking or standing with my cane, the pain subsides and I can walk just fine, not even a limp and can do must anything while the leg feels good.  Anybody else experience this??
Gary

[Pat Walter]

Hi Gary

I am glad to hear you are going to visit Dr. Su.  If you still need to be revised - you will probably hate us, but at least you will have another really experienced doctors input.

I am not medically trained in any way, shape or form - but it seems very strange that you can walk the pain away.  Most of the people I know that have had the slipped cups and other serious problems, never could get rid of the pain.

I have read about some people having muscle problems and this sounds somthing like that.  Again, I know nothing about medicine, only the hundreds of stories I have read.

Please keep in touch.  I will keep you in my thoughts and prayers and hope that you will find a good solution to your problem and it doesn't include major surgery to a thr.

If you are in such pain, can your family doctor give you some medicine?  I wonder if taking some muscle relaxers might help the muscles around the hip?  Just a thought.

I had the same type of problem about 6-8 weeks out - it is very common.  After sitting for awhile, the first few steps really hurt.  I went to the pool and did some water walking, exercises and stretches.  My doctor friend has a 92 degree therapy pool and it help a lot.  Other people have said the same thing.  It might be worth trying to find a pool and try that.  Here are the exercises I did http://www.surfacehippy.info/poolexercises.php

You might also want to read this page about people with pretty bad muscle problems
http://www.surfacehippy.info/groinpain.php

I hope you can make it to March 11.

Stay in touch and good luck.

Pat

[Gary]

Hi Pat,

The reason I think I have a loose acetabular is due to the fact that I have been in touch with another patient of my doctor who had a bhr about one month before my surgery. We have experienced the same symptons , and our time line is almost Identical. This patient has had the revision surgery to thr, and is doing very well.  The cause for his revision was a loose acetabular cup.  Our cases are so similiar that my doctor and I have assumed I have the same problem.  This patient could also walk of the pain, and I'm some what surprised to hear that you know of no one else who experienced this.

I teach and am on my feet most of the day, as long as I don't sit down, I have no problem getting thru the day, unless I sit down to have lunch!!!  Even at home if I go out for a walk, then I can do whatever chore I chose, but I have to walk it off first.  The pain is very sharp, but will pass with enough walking. 

Gary 

[Pat Walter]

Hi

Again, I am not medically trained in any way, so I don't know more than I read from other people.

I do hope you are able to get thru to March OK.  If you do have a loose cup, I hope you will let me post your story for others to read.  All of the loose cups I have read about cause terrible pain no matter what they were doing.  Some even hurt just laying down. 

I do hope that Dr. Su can help you.  I know in some of the other cases, they sent their x-rays to other doctors and they could see the slipped cup.  So that part of your situation is different.  If you have current x-rays, you can send them to Dr. De Smet and Dr. Bose for a consultation. They often help people with problems even though they were not their patients.  They may be able to tell from the x-rays becasue they have in the past. 

We will all keep our fingers crossed for you and hope you get the problem solved so you won't have any pain.  We all have known pain and are grateful for new hips that have removed the source of the pain.

We don't want you to keep walking for years without sitting!!!!

Good luck.

Pat

[Gary]

Hi all,

Well march 11 has come and gone.  I did meet with Dr. Su.  He could not tell by the x-rays if my acetabular cup was moving or not.  He said the hardware and the alignment all looked good.  He felt that trying to repair the hip might be risky it all depended on the amount and quanity of bone of my pelvis.  It may be possible, but only when they could look and see what is going on inside my hip.  His conclusion was I may just need a THR, but only going in would determine that.  He recommended a bone scan.  He said that this would be a good way to determine if there was any movement of the acetabular cup.  The second opion he offered coinsided with my surgeon, so I felt good about that.  On top of it all, my hip is starting to feel better.  I have not used my cane in 2 or 3 days.  the sharp excruciating pain is gone.  I still have some discomfort, but for shorter distances until I feel (for lack of a better word) normal.  Dr. Su also said if I am having these peaks and valleys that the best course of action may be to wait to do anything.  The way I feel right now I agree with him.  I have made and appointment to see my surgeon next week to discuss a bone scan, but if I keep feeling this way, I might just wait on that also.  The only thing I can say right now is I'm glad I put off the revision surgery since I feel about as I did right after my rehab this past summer.  Maybe, just maybe something good is going on in this hip of mine.  I at least hope so.  That's the latest.

Gary

[Pat Walter]

Hi Gary

The good news is that you have gotten some relief for a couple days.  Maybe, possibly, it is some kind of muscle issue.

I am not medically trained at all, but some people have had very difficult problems with certain muslces.

You could hope that this is the issue. 

Sounds like a wait and see attitude would be best at this point. 

We all wish you the very best.  PLease keep in touch.  I hope your pain stays away. 

Pat