Hi, I'm new here.
Went to Doctor's yesterday and he said i will need a new hip shortly. I've been having alot of pain with the hip re-surface- not been able to lift my leg upwards without lot of discomfort. This has been going on for 18 months or so but lately it's got very bad and pain in buttock now as well.
(I know, I know all the pain in bum jokes ;D)
I had the op in Feb 2007. I really thought the re-surface would last longer than this or I would have had the THR done instead.
Doc also asked if I had been told that I would probably need a THR in the end and I said no I hadn't been told.
Was 54 when op. done and was just told it was better for younger patients to have the Birmingham hip.
Is it unusual for a re-surface to fail, for the want of a better word, so soon or am I just unlucky ???
Was this the doctor who did the resurfacing telling you this? If not, did you get your surgeons opinion? How did it fail? Infection? metal allergy? Repairs can be done if something is loose without having to have a THR.
Hi.
I cannot see original surgeon as we have moved quite a way away from where hip re-surfaced.
Doctor didn't say why hip failed just said I'd need a new hip but symptoms not bad enough yet.
Symptoms are getting like when I needed the original surgery.
Just disappointed and worried as I'm full-time carer for my hubby who had a stroke.
Thanks for getting back to me
Quote from: daylily on October 29, 2010, 03:55:52 AM
Doctor didn't say why hip failed just said I'd need a new hip but symptoms not bad enough yet.
For a technology that could last for life, I would definitely push to know why your resurfacing failed, before even considering anything else.
Hi I did have an x-ray about 18 months ago- nothing showed up. I don't think an x-ray gives the full picture. It was a locum doctor I saw so I'll go back to my own. Trouble is I'm new there and it was my first visit so Doc won't be up to speed- he'll just see the x-ray reports.
Can I ask for a more detailed scan or something ??? If so do you think it should be MRI or a Ct scan ???
Thanks for replying
Send your x-rays (email) to hip resurfacing surgeons that do a lot of revisions of failed hip resurfacings, such as Dr. Su, Dr. DeSmet & Dr. Bose.
I believe they all do free x-ray evaluations.
Though you do not live near your surgeon you could call him or her. If the doctor you just saw didn't do a new set of xrays at least, what is he basing the diagnosis for THR? You will need new xrays taken from front and side to get an opinion from any of the experts. Something doesn't sound right here.
I think the Doc is going off the manipulation of my leg and hip at the appointment.
Not great deal of movement and what there is is painful.
At least I suppose that is what he was going off.
You've got me wondering now. Maybe go back and see regular Doc and get a definate answer or at least some new x-rays. I just assume Docs know what they're on about.
I'll get back to you all.
Thanks
update.
I e-mailed one of the Doctors recommended on this site (the nearest one to us) and had reply saying have to get a referral from my own doc.
One thing that has puzzled me- I was not given the option of THR or re-surface, doc just said they were doing re-surface and that was it!
Do people in the UK get a choice or is it only in other countries?
I cannot honestly remember anyone discussing the re-surface/THR with me at all!! ::) ::)
When sending x-rays to one of the pro doctors you should send a new set along with your post op and any you any in between. Even though he isn't close by Dr. DeSmet was wonderful in answering my questions nor was he going to be my surgeon. There was no charge and no referral needed.
If you get the surgeon who did your resurf to email you your xrays they will already be in jpeg form so you can send them right on.
thanks littleb.
If i can get a sitter for hubby i'll talk to my doc to see where to go from here.
It's not helped cos we've moved several times since original op.and different docs say different things.
Don't know who's more confused them or me ::) ::)
I think first step has got to be new x-rays/ mri and i'll go from there.
Thanks for advice. I'm not very computor literate yet so can only do basics-e-mailing some x-rays is way beyond me
I'll get back on forum when I get some answers.
Daylilly
What is wrong with your resurfacing? What do the x-rays tell? Is the acetabular cup at the wrong angle. Have you had your blood testing for high metal ion levels? Do you have an allergy to cobalt/chrome?
YOu should be given a reason for the revision. BHRs just don't wear out - they are metal that is able to last a liftime. Bone growth under the components sometimes becomes weak. There are some reasons for that in that the cemented femur cap was not done with the right amount of cement. The high metal ions occur when the acetabular cup is not placed at the correct angle. Many of the less expiernced surgeons did not place acetabular cups at the proper angle a few years ago. The top surgeons did, but many did not realize the importance.
I would suggest send a copy of your x-rays in a digital formate to Dr. Gross of SC, Dr. De Smet of Belgium and find out just what is wrong. Many of the less expiernced surgeons can look at the x-ray and not realize what is wrong.
I present the information above so you realize that is it most likely not the BHR device, but most often how poorly it was installed. Other than a metal allergy, there are few other causes for a revision.
I would want to make sure you are having problems with the resurfacing and not muscles or soft tissue before I had a revision. I would rely only on the top surgeons to give you their opinons. Then you can make a decision. You also really need to be careful who performs your revision. A poorly done THR will be more diffiuclt to revise in the future. Just because you get a THR, does not mean it won't ever need to be revisied. Again, it is the bone growth into the components that hold it in place. The long stems in the femur bone can become loose.
I don't want to alarm you, but I would get some really good input before I made a decision to get a revision and then use only the top docs to have that revision. You might only need to get the femur portion and keep your acetabular cup if you go to a MOM THR. If you have high metal ions or an allergy, you will need to go to a ceramic on ceramic. So you have many questions to be answered and decisions to make.
Pat
hi Pat.
I can't answer most of the questions because nobody has told me anything. I went to my Doc with groin pain and being unable to lift leg up when standing, a bit of pain on the scar side. I was shocked when he just came out and said I'd need new hip.
No recent x-rays/MRI or anything. I am seriously confused.
It takes months here to get to see a consultant or to even get an MRI, probably looking at 3-6months before i see anyone senior about hip. There is no way of doing it any quicker, so it starts with a visit to Gp Doc and he makes a referral to consultant who you don't see straight away anyway. (you see an underling first who organises x-rays and stuff).
Thanks for replying
Daylily,
I might have missed something-Sorry but I'm unclear from the previous posts of where you are located and who performed your surgery.
You mention the UK-is this where you live? If so please let me know, I might be able to help-my HR surgeon-Prof Cobb from Imperial College London does specialised CT analysis.
Regards
Toby
Hi Toby, Thanks for replying. I live in North Wales, UK. I am going to my own GP next week (cannot make it this week as I need a sitter for my disabled husband) and I am going to ask him for a referral to a Doctor in Oswestry mid-wales. He's mentioned on this site and I have previously heard good things about the hospital he is with. I need answers quickly as I am struggling with caring full time for my husband. I have to sit on the floor of the bathroom to wash his lower half and it is getting increasingly harder to get up!!!!
Trouble is I have osteo-arthritis in most of my joints/bones so the hip is one problem I can do without.
Hi Daylily,
Thanks for replying.
Is it Prof Richardson at Oswestry that you are hoping to be referred to by your GP? I sure hope so-he's very experienced with HR and the diagnosis of post op joint analysis problems. Bearing in mind your circumstances (both hip and domestic) a good GP should really support you and ensure that you obtain an emergency appointment-it is possible on the NHS. If it is Prof R.. maybe phone his secretary to find out the possibilities/timescales procedures of seeking an emergency appointment and with this knowledge be assertive if you are not receiving the support you need your GP.
You deserve some good luck and I'm hoping you'll get it in, all aspects of your dilemma.
BW
Toby
Hi Toby, Yes it is Prof Richardson I'm trying to see. I have already been onto the hospital he is with and have been told to get a referral from my Doctor first. No rushing the National Health Service is there ???
Getting fed up of the pain, not just in hip in the spine as well. I think that's what is confusing GP's, they think hip is all part of general arthritis.
I might try ringing the Professor's secretary personally, it was just a general secretary I contacted before.
Many thanks for the suggestion.
daylily
Hi Daylily,
I'm really pleased that it's Prof R. I know it can be slow but I'm still a great supporter of the NHS, particularly when we have excellent surgeons Like Prof R and my surgeon Prof Cobb working to support it.
Keep at it. Beg if necessary for the earliest referal.
Just off to sort the fireworks and beers-got some friends and our kids, buddies coming over.
BW
Toby
ps who was your original surgeon/which hospital?
Hi Toby. Have good time tonight. We're going on the promenade there's a firework display (only live 200 yds away).
My original surgeon was a Mr Chan at Tameside General Hospital, Greater Manchester. A hospital with a grim reputation locally; I wasn't given any options at the time. I know better now about making enquiries about the competance of Doctors. They didn't even tell me I was having a spinal for the op-first I knew was when I was in the operating room.
Not that I minded being awake when it was done as it was quite interesting.
I'll get it sorted next week and let you know what happens.
Take care
daylily
Daylily,
How are you?
Did you manage to see Prof Richardson?
Any updates?
Toby
Hi Toby.
I wrote to Prof. Richardson and the reply was that I have to go back to GP for a referal to him.
Not had much time lately as struggling with disabled hubby, he's been poorly and it leaves little time for anything else.
He had a stoke nearly 4 years ago and is showing signs of dementia so I've been trying to get him diagnosed.
It's all go isn't it?
I'll get myself sorted soon, either that or my bones will give way and they'll have to do something.
I really appeciate your interest as it is a lonely life with hubby- we tend to live life on the outside of society.
How's the snow and ice where you are?
We're supposed to be going to a Status Quo concert this Wednesday- if I can get the car out!!!!
Take care
daylily
Hi Update.
I have finally got a Doctor to listen!!!!!
Went to see her yesterday re pain in 'good' hip and although there is some osteo arthritis ( had x-rays) it is not very bad yet so she came to the conclusion that the pain in that hip was from limping with the re-surfaced hip.
Result.
She is sending me for x-rays on the re-surfaced hip-usually takes 3-4 weeks.
It is definately getting a lot worse, in fact it is nearly as bad as before the hip operation.
Just hope the x-rays show something. I believe not everything on a BHR does show on a simple x-ray.
Here's hoping things are now getting moving.
take care all
x
Hi, update again.
My new Doctor had another look at the x-ray on my 'good' hip and decided that there was no need for another x-ray so she made an appointment with the ortho consultant straight away.
The appointment is the 16th June so not long to wait- that's a joke really as I've had problems with the BHR for over 3 years. Range of movement not good, pain bad to very bad, so hopefully something will be done now.
Will update after appointment with consultant
Take care all
Hi daylily
I am glad that you at least have an appointment and hopefully a solution soon.
Please keep in touch. Good Luck.
Pat
Update.
I saw the ortho consultant today (a new hospital as we have moved) and he was great, very easy to talk to. He had more x-rays done. Result, he said the hip resurface had been put in at the wrong angle.
He wants an ultrasound done to see what soft tissue damage there has been over the last 4+ years and I had bloods taken to see any metal problems. When the ultrasound is done I'll go on waiting list for a total hip replacement. The usual waiting time is 6 months but he's going to see if he can get me in quicker to minimise the damage to soft tissue.
At last I finally know what is wrong- I was begining to think it was all in my head.
So hopefully by the end of this year I should be on the way to being 'normal', whatever that is.
Take care all
Daylily,
I'm pleased that you are back in touch with the SH group and feel encouraged that you are finally getting answers to the problems. Incidentally, do you know the angles of your HR from the xray? It would be helpful to know.
Daylily, I do feel concerned that you might have to wait six months. My understanding of the new 'NHS Constitution' is that you should expect to receive your operation within 18 weeks of the referral. (Other UK hippies might be able to confirm or correct me here.) Certainly, as you suggest, if your metal ion tests show raised levels your surgery should be classed as urgent.
Take care but please keep us informed.
Toby
Hello toby nice to hear from you again.
The angle of HR, well it's pointing too much to the outside hip area, I'm not sure what sort of angle that is.
On the face of a clock the cup bit is like 10 past the hour and the other side is obviously 20 to the hour. That's the best way to describe it.
Waiting time- well surgeon did say he would try to get me in sooner, I suppose it depends on the blood tests. He might call me in next week (don't really think so with the NHS). I'm not sure if the waiting times are the same in Wales as they are in England.
These metal ions- do they make you feel unwell at all? Reason I ask is that the last few months been getting a lot of headaches and generally feeling ill and it's not like me.
I'm trying to get fitter for the surgery, not easy with looking after my disabled hubby 24/7 but went for a walk today, suffering a bit now though. Going to work at the fitness, build the muscles up then hopefully the surgery will not be too drastic.
Thanks again Toby, I will keep posting and will take computor into hospital, got to have something to do.......
Hi Daylily
Glad you are finally getting proper treatment and will have your metal levels tested. Your description of how you feel would certainly be consistent with metal toxicity. I was found to have exceptionally high metal levels towards the end of last year (2200+ for cobalt) so have some experience with what it feels like. I was getting a lot of headaches, and also migraine auras (though not necessarily at the same time). Also a general sense of not feeling too great, and not being able to work efficiently. The most striking incident was a truly disconcerting Alzheimer's type episode when I went quite blank in the middle of a presentation. So - yes, heavy metal toxicity can include all these things. I'm glad to say that all these symptoms have more or less disappeared since the revision surgery in January, though it took a few months.
Very best of luck to you
regards
JMS
JMS, who did your original resurfacing?
Daylily,
Just keep looking after yourself.
JMS's post highlights that we have some very experienced friends on Hip Talk, so please do keep in touch to tap into knowledge and support.
Best Wishes
Toby
Hello all,
Just an update.
I saw the consultant on 16th June and today I received my appointment for my pre-op assessment.
How quick is that?!!!!!!
The consultant told me 6 months maybe less but this is super swift.
Maybe something came up on the bloods test????
Anyway, I cannot wait for the revision, 3 years of pain and believing it was all in my head.
Surgeon said the op would probably be 4-6 weeks after the pre-op.
Will update when I have more news.
Take care all
Hope all goes well.
Ed
Daylily,
It's good news that things are moving and that your consultant is quite rightly prioritising you surgery to a more realistic timescale than was previously stated.
Take care and keep us informed.
Toby
Hi,
Just been to my Doctors and read the letter from the new ortho consultant.
It says the device is 'at a rather steep angle of 51 degrees'
What exactly does this mean? Is the device very far off what it should be.
I'm afraid it means nothing to me so any help would be appreciated
Thank you
Hi daylily, both my cup angles are at 40 degrees, which I think is more standard now. I know there's other hippies posting that have high cup angles, from when higher cup angles were not thought to be problematic. I hope you can get this adjusted and get the benefits from a good hip procedure. Is there any thought of replacing the cup, or is THR the best procedure?
Hi, my surgeon has just said a THR would be best to get the metal out.
He's going back to ceramic I think. I haven't seen the results of the metal ion blood tests yet, the GP today said it's a more complicated test and takes longer for the results.
To be honest just want it out after 3+ years of getting worse, somedays I cannot even lift my leg to get in the car, have to hand lift it in.
Pre-op next week then it's only 4-6 weeks.
take care
Makes sense and the best of luck.
Daylily, I am sorry for what you are going through. Just glad to see that you are getting it taken care of. Al the best, Keep us posted.
Hi DayLily
The metal ion tests seem to be taking longer and longer to come back - presumably as more people are getting their levels checked. My first test eighteen months ago was back in ten days but now it seems that six weeks is the norm. Hope your levels are not too bad, when you finally get to hear.
My experience is that the ions levels drop very quickly after revision surgery. I hope you find that too, and that the pain issues are also resolved. Let us know how you get on.
;D
Well finally got the date for my hip revision- go in on 20th September and op the following day.
Not before time, pain in re-surfaced hip getting very bad.
Going for a spinal block, it wasn't too bad last time although depends what they find when they're in there!!!!!!!
Keep asking consultant what the metal ion test results were exactly and he's not telling! Is that good or bad??????
Whatever, only 3 weeks to go. not sure how I'll cope with disabled hubby and the wheelchair but I'll cross that bridge when I come to it.
Will update when I've had the op.
Thanks for all your support and take care of yourselves.
We will be thinking of you...please keep us posted.
Daylily,
I'm happy for you that you've got a date for the op.
Three weeks gives you a good amount of time to organise things at home and get yourself as healthy as possible to ensure a speedy recovery.
Please keep us updated and endeavour to obtain the metal ion levels so we can all share the results as they return to normal.
Best
Toby
Daylily
I am glad you finally have your surgery scheduled. The 3 weeks will go by quickly and you will soon be back on the road to recovery. I want to wish you Good Luck and I will keep you in my thoughts and prayers. Please keep us updated when you can.
Pat
Sept 20 is not too far away, best of luck and keep us posted.
Daylily-
Best wishes on your upcoming THR. I hope that this takes care of the problem and you can return to an active life.
Dan
Hi all, well d-day has arrived!!!!!!
Going in hospital for revision of BHR tomorrow, the operation is the day after.
Have not had the results of the metal ion blood tests yet, would you believe the blood was put in the wrong coloured bottle and got sent to the wrong laboratory???!!!!
Anyway had some more bloods taken last week. The surgeon says he is almost certain that there will be above average metal ions going off the angle of BHR cup.
He's putting ceramic in this time just to be on the safe side, do not really care what they put in as long as the pain goes away.
Will post again as soon as I am able. Should be out by Friday I think.
Take care all
Good luck!
I'll be thinking about you. Best wishes!
Good Luck. I will keep you in my thoughts and prayers. Looking forward to your posts during your recovery. I wish you a very quick recovery!
Pat
I hope it all goes well for you.
Ed
Hello all, well I'm back from the hip revision operation. It didn't go according to plan,
Apparently the cup bit of the re-surface was too big for my pelvis!!!! ( Supposedly I have a small one, you wouldn't think so looking at me)
and because of that the outside rim has rubbed the bone off the outside edge of my pelvis which meant a bone graft. The cup was also slightly loose as the consultant said it was extremely easy to get out. (The cup was a Duron???) sorry I'm not up on the tecky stuff, which I believe are prone to loosing
Saw my x-rays post op and it looks like a mechano set in there with all the screws!!!!!!
So only partial weight bearing on operated leg for 6 weeks (20%) then in 3 weeks it physio for range of movement exercises.
Feeling pretty good all considering, pain under control with pills, I was on liquid morphine for a couple of hours post op, but that deep bone pain is gone so it's only the normal healing now.
All onwards and upwards now, just glad the DXXN thing is out
Got back home yesterday afternoon 1 and half days afer surgery
thank you all for your help and support, it has been much appreciated and I will continue to post when I've any significant news.
xx
Great to hear that you are out and on your way to recovery. Aim sorry everything didn't go as planned but now you know the reason for the problems. It sounds like they solved it and you will be fine.
Best wishes as you recover.
Dan
I'm glad the surgery is over for you, Daylily. Although it didn't go as planned, at least now you can get on with your life. That was quite a long ordeal for you. I'm sure you will be much happier now. Let us know how it goes.
Hi Daylily,
I'm thinking of you, too. So glad all will be uphill for you for now on. What a time you have been through! Please do let us know how you are doing now and then. Lu
That's great daylily, sounds like you're on the way back. So the cup was too large for you? Sorry to hear about the issues, but really good luck and thoughts for you.
Daylily,
I'm really pleased that it's all over, it's good they found the answers to your problems and now you can be pain free and make a great recovery.
Best
tOBY
PS I've had a NIGHTMARE myself-my achilles trendon repair surgery got DEEP INFECTION been in Hospital for 3 weeks fighting to save my leg and resurface-just got home to switch on computer and check on you. I'll post my horror story later.
Toby
I am very sorry to hear about your infection. I hope you will continue to recover OK. I will keep you in my thoughts and prayers. Infections are terrible. I know many people will be thinking of you.
Pat
Oh Toby how horrible for you. You must have worried sick about it.
Lets hope it's all ok now.
Very painful achilles tendon stuff, my physio said mine were like old ropes, that was years ago, he said I'd never walk properly, wrong thing to say to me, of course I had to prove him wrong.
Glad you're back home and OK ish?
toby,
Is everything O.K.? Did the infection go away? I assume you would not have been sent home if it wasn't. I hope you are alright.
Hi Daylily
Glad the revision surgery is safely behind you, though sorry to hear that it didn't go as planned. My revision has some pretty impressive hardware holding it in place too, but am glad to say that it doesn't bother me at all, and I doubt yours will either.
I found recovery from the revision went quite smoothly - I knew what to expect and how to get around the problems, so there were some advantages to doing it twice. Hope you find the same
best wishes
JMS
Hi Toby
Very sorry to hear about your infection. Hope you are feeling better soon.
Toby, how are you? hoping it's all done with.
Thanks Guys for all your kind words.
I will try to tomorrow to post full story of saga for others to learn from.
After a 3 week nightmare-I'm now at home having had 3 surgeries to debride/remove infection etc in addition intravenus antibiotics through picc line and vac pump. Luckily, last week I had 2 sets of clear swabs/cultures and normal blood markers which showed both systemmic and wound infections were controlled. I' currently have a Vac Pump on thewound to assist healing and will require future surgeries to close wound(2 weeks) and then in about 6-8 weeks have a tendon transfer. Hence, a long road ahead- still many battles but my surgeon is confident that in 8 months to a year I should make a close to full recovery and return to biking, running and swimming (hope he's right!). Thank goodness my beautiful HR hip was saved- I have been terrified!
Best
Toby
Toby
Thanks for your update. I am gald to hear things are looking better. It sounds like a long road to recovery, but hopefully it will be a full one allowing you to return to all the things your love. Meanwhile, we will all keep you in our thoughts and keep our fingers crossed for you!
God Bless
Pat
Good news on the HR, Toby! good luck going forward, keep us posted.
Thanks Pat, Hernan and my other Hippy Buddies.
I've been a little busy since returning home(mother seriously ill to add to the problem) but I will endeavour to post my full story/ordeal over the week-end.
Thanks Again
Toby
Hi all, Hope you are all keeping well,
Update on my hip revision operation at 7 weeks post op with bone graft.
Just seen the consultants side-kick and finally got the ok to come off the crutches.
It's been hell looking after my disabled hubby on one leg!!!!!!
I can drive again now so we can at least get out again.
I asked about my metal ion results ( have asked several times but never had an answer) and the registrar
didn't really know what the figures meant.
So, these are the figures he tossed at me, I have no idea what any of it means so would be grateful if someone could translate for me.
He gave me 2 figures for cobalt and chromium
Cobalt +1.1 and +18.9
Chromium +5.3 and +102.0
That's all he gave me. Any help with the figures would be appreciated.
Thanks
Not exactly sure what they mean or why you have two numbers for each, unless they were taken at different time periods? All I know is that the levels should be below 4.
Seems like anything under 4 ppm is ok, the other ones are high, but I guess it also should be compared with what you had before; if you are currently at 18.9 Cobalt and were much higher before, then your body is eliminating it well.
I wonder if the larger were your figures before? so that the 18.9 has gone to 1.1? You need more clarification what they mean from them.
Thanks for the replies, to be honest the registrar could not even get the results up on the computer a nurse had to do it for him and he had no idea what they meant either, he just gave me those numbers.
I was not sure if the lower numbers were the maximum they should be and the higher ones were what mine were a week before surgery.
I think the metal ion bloods have only been tested that once. I really wanted to see the consultant today but he was not in.
Ah well, I have to go back in 6 weeks, hopefully I can see the consultant then
Thanks again.
I believe that they have expressed the figures in both ppb and in nanomoles per Litre. According to Iverson C, Christiansen S, Flanagin A, et al. AMA Manual of Style: A Guide for Authors and Editors. 10th ed. New York, NY: Oxford University Press; 2007,
the conversion factor for cobalt is is 16.968 and for chromium it is 19.232.
If you divide your figures by these numbers you get a good match.
Excellent JMS, I was sort of wondering about the units and that possibility. I think when folks get their numbers, they should ask for the whole lab report and then that should all be explained.
Yup, JMS and Tin have it right - once the conversion is applied, Cobalt 1.1 and Chromium 5.3 are your readings. So most likely, your Cobalt levels are down to good levels and the Chromium is hovering above the 4.0 mark. Sounds like good news.
Hello all,
Hope you all had a great Xmas and wishing you all the best for the New Year.
Just a final update on my revision operation.
Just been for my 3 month check-up and everything is GREAT ;D.
No pain, full range of movement, walking a couple of miles every day and back to pushing my 18 stone hubby in the wheelchair. Feel fantastic.
Recovery was extremely difficult being non weight bearing for 7 weeks, very hard cooking, cleaning and looking after disabled hubby as well but we got there in the end.
I sincerely thank you all for the advice and help I have received over the months. will be popping back now and again to see how you are all doing.
Many thanks
anne
xx
Great news anne, no pain and feeling good; nice to hear of a good outcome for you.
Daylily, That's wonderful. Have a Happy New Year! ;D