Kathryn’s Revision to THR by Dr. Su 2009

April 19, 2009

I had two hip resurfacings – one on each side – within 5 months of each other in 2007. Surgery was at Columbia in NYC with Dr. Macaulay. Used Birmingham device in both.

From the beginning, I had the impression when I walked that the device implanted on my left side (the later surgery) might be “larger” than the one used on the right side . X-rays looked good so doctor had no concern there. At 10 months, my left hip started clicking when I shifted my weight (no matter how slight). The clicking felt uncomfortable, but not painful. My gait worsened, I noticed, and became painful on my left side when I tried to walk with a full stride. By 12 months, I had pain on and off in the left hip area and stretching across my lower back and down the front of my leg to just below my kneecap. Over time, it has continued to worsen and now I feel pain stretching down the inside of my hip joint along the groin as well.

I returned to Dr. Macaulay 15 months after the surgery and had xrays, then ultrasound. Dr. thinks that I may have a pseudotumor that is pushing the device out of position and allowing fluid into the joint, but tests so far have not proven the existence of a pseudotumor. Dr. Macaulay did tell me that while the angle of the device on the right side is at a perfect 45 degree angle, the angle of the device on the left side is off by 10%.

Dr. Macaulay says I will need another surgery to correct the problem with the left hip device and that this second procedure is a bit trickier than the original surgery. I will be getting a CT scan shortly to obtain more info (to detect the presence of pseudotumor if one exists).

Further complicating this situation is the fact that I lost my job two months ago and have limited means for medical treatment.

I have an appt with Dr. Su for a consult (he is very pricey, though) and absent real information concerning these two physicians and my medical options, I fear my choice may be dictated by my dwindling finances.
 

May 13, 2009

I had my appointment with Dr. Su, followed by an MRI and blood work to detect metal ion levels. Dr. Su confirmed that the position of the acetabular cup is off by 10% (should be 45 degrees; mine is angled at 55 degrees). The blood work showed that my chromium level is 7 or 8 times what it should be as a result of the malpositioned cup scraping against the femoral head component. MRI showed swelling in the joint. As the problem is mechanical, another surgery will be required. This will be my third surgery as I had bilateral resurfacings prior.

Dr. Su will try to save the resurfacing but that will depend on the condition of the femoral head; if it is too damaged, then he will do a revision to a THR using a ceramic device. I’m not a happy camper about this but I am looking forward to the prospect of walking, bending, sitting and living without pain. FYI, I’m 52 years old.

Surgery is scheduled for tomorrow. Keeping fingers crossed that all goes well.

August 28, 2009

I am now 3.5 months post-op following a revision to a THR and am still recovering. My femur fractured during the surgery and recovery has been a more complicated process than originally expected. Dr. Su, the surgeon who did the revision surgery, had told me before the surgery that healing process following revision surgery takes a bit longer — it would be approx 8 weeks or so before I would be back on my feet, so to speak. I certainly had not expected such a lengthy and difficult process. Because of the fracture, I enjoyed 9 days in an orthopedic rehab facility following my four-day hospital stay. I would be partial weight-bearing for the first 6 weeks or more following the surgery and had precautions up the ying yang because of the fracture. (Partial weight bearing means toes only; heal is raised). My stay in rehab was absolutely necessary in order to learn how (given all my precautions) to move around my apartment safely, to take a shower, to get in and out of bed or on and off the sofa, etc. Following the surgery, I used a walker, then graduated to crutches. Fortunately, I had the help of a wonderful neighbor and family who regularly came by because I was unable to do much of anything during this period. I continued with crutches into my 7th and 8th weeks. Now, I am walking with a cane (often still with sharp pain), have a pronounced limp and significant muscle weakness. My energy is still quite low and I continue to have trouble sleeping at night because of pain in my hip, buttocks and lower back. I’m working with Dr. Su and a talented physical therapist to become stronger and regain function.