Revision Surgery?

[Kevin H]

I had a LBHR done in 12/06 and have been experiencing pain in the joint since shortly after surgery.  After looking at my X-Rays Dr. DeSmet felt I would need a revision to a stem with a modular head.  Is anyone familiar/had this procedure.  Im not in a hurry for another surgery.  Thanks.

[obxpelican]

Kevin,

My question to the doctor would be, why must you have a revision, what is the cause of that?  Is it a slipped cup?  If that was me I would be asking him LOTS of questions. 


Chuck

[Kevin H]

This is Dr DeSmets answer to me after viewing my X-Rays:

Dr.Su has done a perfect job to stay conservative with your bones!

Unfortunately this has resulted in a to narrow ratio with the femoral
neck and this means that your own femoral neck touches the prosthesis to
soon and gives problems, pain, feeling of dislocation (subluxation) and
whatever you feel.
If this is a problem, you need to have again surgery after you get a
metalionsample in the blood!
If this is OK you need a revision to a stem with modular head.
If the metalion sample/level is too high you need a total revision,

[obxpelican]

I would send your x-rays to another doctor for a second opinion that can never hurt to see what another set of eyes can tell you.  From what I hear Dr Su is a great surgeon but you never know what another surgeon may say, even something as simple as some excercises to help with your situation.

I take it that you had some issues with the need for conserving bone pre-op?

Just my opinion.


Chuck

This is Dr DeSmets answer to me after viewing my X-Rays:

Dr.Su has done a perfect job to stay conservative with your bones!

Unfortunately this has resulted in a to narrow ratio with the femoral
neck and this means that your own femoral neck touches the prosthesis to
soon and gives problems, pain, feeling of dislocation (subluxation) and
whatever you feel.
If this is a problem, you need to have again surgery after you get a
metalionsample in the blood!
If this is OK you need a revision to a stem with modular head.
If the metalion sample/level is too high you need a total revision,

[Kevin H]

I knew nothing of bone conservation...

The last time I saw Dr Su he offered to remove my device and do a THR.....that was in April 08 and I left that appointment depressed....I had been complaining of the same pain since a few weeks after surgery and he had no other solution and made me feel as if i was imagining any problems. 

I agree to seek another opinion...just not sure who.....

[obxpelican]

Kevin,

Pat on this site has a list of doctors that have a lot of experience http://www.surfacehippy.info/listofdoctors.php.

I would by all means hold on to what you have and NEVER let a doctor cut into you again until you have 2nd and 3rd opinions.

I hope this all works out for you Kevin, I know how this is probably bothering you but in the end this will work out well it just might take some footwork on your end.

Dr. Gross was my surgeon and he's an awesome man, but I am sure there are plenty with his abilities.

I wish you well my friend.


Chuck

[sroberts]

Hi Kevin,

I'm sorry you have not achieved your desired result.I agree with Chuck. Get as many opinions as possible. Both Su and DeSmet are great. Never hurts to try more and ask as many questions as you need to in order to get satisfaction. Try Bose, Gross, Mont, Rogerson. They'll all be glad to try and help. Hang in there.


spencer

[Pat Walter]

Hi Kevin

I just wanted to say I am sorry to hear you are still having problems with your BHR. 

I guess only you can decide if you want another surgery. 

Is your pain so bad that it stops you from being active.  Can you take meds to help control the pain.

I guess you could get another opinion like from Dr. Bose about your current BHR.  Maybe a little more input would give you more information to make a decision on.

I wish I could tell you more, but I am not a doctor.  I can understand that you don't want another major surgery at this point. 

Dr. De Smet is an excellent surgeon and usually can figure out what is causing problems.

I hope you can find a good solution to your pain.

Pat

[stevel]

Hi Kevin,

Is Dr. Desmet proposing to install a Birmingham Mid Head Resection (BMHR)?  What does he mean when he says Dr. Su was being conservative with your bones?  It appears he ground down your femoral head so the cap extends into the neck, causing problems according to Dr. Desmet.  Please clarify.

[Kevin H]

I sent your questions to Dr DeSmet....I didnt understand the bone conservation statement and Im not sure what device he is recommending......

[Kevin H]

here are Dr DeSmet's answers

I wish i could afford to visit him....

Is Dr. Desmet proposing to install a Birmingham Mid Head Resection (BMHR)?

[Koen De Smet] WHEN i DO A REVISION i GO FOR SECURITY! AND I USE AN IMPLANT I KNOW THAT IS THERE FOR 30 YEARS WITH 99.99% SUCCESRATE. I WOULD DO A KORAILSTEM WITH EXCHANGEABLE NECK

  What does he mean when he says Dr. Su was being conservative with your bones?

[Koen De Smet] THAT HE DID NOT LUCKILY REMOVE TO MUCH BONE OUT OF THE PELVIS


  It appears he ground down your femoral head so the cap extends into the neck, causing problems according to Dr. Desmet.  Please clarify.

[Koen De Smet] THAT IS NOT A PROBLEM LOOKING TO THE BONE, BECAUSE IF YOU NEED A REVISION THE HEAD NEEDS TO BE TAKEN AWAY.

YOU SHOULD HAVE METALIONS TAKEN TO SEE IF YOU CAN KEEP THE CUP OR YOU NEED A TOTAL REVISION (THEN CHANGE ALSO THE CUP AND GO TO CERAMIC_ON_CERAMIC)

[graza]

Hi Keven,
Sorry to hear you've had problems.
I have recently undergone a BMHR (20/09/08) with Mr McMinn in Brimingham and after meeting him and undergoing the operation i have the upmost respect and for him and his team and the work that they do. My right hip was completely worn out due to congenital dysplasia and too much high impact sports. Every specialist i spoke to other than Mr. De Smet and Mr. McMinn said i would need a THR. Mr. McMinn was the only person i spoke to who said he'd preform a BMHR. His confidence in what he was willing to take on assured me upon going under that i would wake up with the best possible outcome for my condition.
I urge you to forward your x-rays and notes to him for his opinion. He is an amazing man!
Chin up mate everything will turn out ok.
Graza