My butt hurts

[B.I.L.L.]

Hi guys,   Got an update and a couple questions for you.  I am now at just over 18 months and was steadily improving until about 5 months ago when it started to become uncomfortable to sit. Since then it has gradually gotten to the point where riding in a car causes swelling in my butt cheek and the back of my thigh, and once it is swollen it hurts and starts to knock. If I'm sitting in the car and reach towards the floor it knocks several times co-inciding with pain. My Dr. (kaiser) says the x-rays look ok (well except for the 65 degree cup but ok as far as bone growth) They tested my blood and said the results were "Very low" : the cobalt was 0.005ppm and the chromium was 0.01ppm. I haven't really found any solid info on whats too high, and it seems like the other tests are not ppm, they're pp-something else. (This info came via phone call but there is nothing about it in my patient history.)  He said the problem is just from the surgery and has nothing to do with the implant itself.  When I wake up in the morning it feels pretty good but by the end of the day it's puffy knocking and sore. Walking is better than just standing, but sitting is the worst, I find myself leaning over on the un-operated hip and sitting completely crooked. I've been taking 1-2 vicodin 4-5 days a week, Some days it's not so bad but other days I give in so I can work and or sleep at night.  I have just started to investigate bursitus and wonder why my doc didn't mention it because it sorta sounds like it may be it. I have been steadily exersizing and can flex all the surrounding muscles nice and tight, but when I relax they just sorta go to jello, like they're puffy, flabby and bigger than the other side.  I see my regular doctor on friday, he wants to know why I and I quote "Still need narcotics"   So what I am wondering is, Does that sound like bursitus or something else ?     Are those ion levels high, low or average ?    How do they test for damaged tissue ?  Can I get an mri and will that show anything ?  or do they have to take a tissue sample ?  Any help appreciated, Thanks, Bill. 

ps.  It's not all doom and gloom, luckily I can swim and bodysurf as long as I want, and riding my dirt bike doesn't hurt at all, I actually feel better after I ride,  Stevel was right haha   Thanks again

[Pat Walter]

Bill

If you are having that much of a problem 18 months post op - it is time to get some of the top resurfaicng surgeons to give you an opinion.  Don't take the cup angle lightly - if it is wrong, it will cause a lot of problems.  The bearing surfaces are not rubbing together properly. Bone growth doesn't make any difference if the angle is not right for your body. We are only patients and can't tell you what is wrong.  Only the top surgeons can.  I would go beyond your surgeon and get some good info from the best in the world.  They are very use to figuring out what is wrong with other surgeon's  resurfacings.  They do a large number of revisions of other surgeon's errors, not that yours has made an error - but having problems 18 months post op is not a good sign.  You need an answer as to what is wrong.

No one should require vidcodin 18 months after surgery. Especially as many as you are taking.  Something is WRONG.  

If I had that many problems, I would be sending my x-rays to Dr. De Smet of Belgium, Dr. Gross of SC and perhaps a few others depending where to live to get an answer.  I don't remember where you live.

You can send an email to the surgeons with a copy of your x-rays attached in a digital format as a .jpg   Dr. De Smet will give you his opinon by email. Dr. Gross will also.  YOu need to get some input from the top doctors that have done thousands of resurfacings.  

Good Luck.

Pat

[fenceman]

Bill, I am sorry to hear you are having pain.  We had ours done around the same time and mine feels great.  I just came back from 7 days at Disney World and we walked 1000 miles a day(felt like it). My hip only felt a little sore after 5 days straight of walking but then again my good hip and feet also hurt. 

I use to drive (and sit) with my wallet in my pocket (same hip) but mine will hurt unless I sit with good posture and no wallet. 

I would definitely get a second opinion.  I would be always worried about my cup alignment.  Pat is right about the pain.

Bill

[stevel]

Pat,

After reviewing Bill's prior posts, I believe Bill lives close to Fontana, CA since he went to a Dr. there to install the hip resurfacing device.  Fontana is on the outskirts of LA.  So he is close to Dr. Amstutz and Dr. Schmalzaried and probably should go to one of them to review his case.

[B.I.L.L.]

Pat,

After reviewing Bill's prior posts, I believe Bill lives close to Fontana, CA since he went to a Dr. there to install the hip resurfacing device.  Fontana is on the outskirts of LA.  So he is close to Dr. Amstutz and Dr. Schmalzaried and probably should go to one of them to review his case.

Hi Steve, I beleive Dr Schmalzaried quoted me $350+ to check it out.
Hate to spend that kind of money since I pay over $1,000.00 a month for Kaiser... but I might have to go that route. I meet with a kaiser Dr on friday with a 1/2 page of questions. Not one kaiser Dr has ever mentioned bursitus, celebrex, pt, or any other suggestions besides it's from the surgery heres some more norcos. I'm requesting a new ortho on friday, I'll keep you guys posted. 

ps. I have looked into other insurance plans, no one else will even sell it to me 

[stevel]

Hi Bill,

As Pat mentioned, several experienced Drs. that do a lot of revisions of failed hip resurfacing devices, will evaluate your x-rays for free.  Dr. Su does this.  But your problem is more than an x-ray evaluation and includes metal ion tests and possibly a MRI.  Another post mentioned an MRI at Hospital for Special Surgery (HSS) to evaluate pain.  HSS has some of the most advanced diagnostic equipment in the US.  I've heard Dr. Klug, Roseville, CA accepts Kaiser Insurance.

"Advanced Topics in Hip Resurfacing" for orthopedic surgeons will be offered on May 7 & 8 at the HSS.  The top worldwide Drs. in hip resurfacing will be participating.  Check out the agenda at Vicky Marlow's website.

Basically, I wonder if your destiny is a revision because of the steep (65 degree) cup angle?  Or, how many 65 degree cups survive beyond a couple of years?

I've been following your story as your surgery was 1 week before mine and your recovery has been protracted with setbacks whereas my recovery was "unremarkable" to coin the term radiologists use.

[B.I.L.L.]

Hey Steve, Dr Klug in roseville saw my x-rays at 6 months and was one of the doctors who advised me to "wait and see" maybe it will be ok. To make it worse I had to fire a kid this morning so I'll be killing myself for awhile while I pick up whatever mess he left, plus find and train a new guy, awesome.....  Oh well I know sooner or later I'll get to where I need to be but god damnit you know, I should be there now    I hope all the newbies are following my story and don't get suckered into an inexperienced Dr.  At least some good may come out of this even if it's for someone else.
If I need a revision Dr. Klug will be the guy. Thanks for the response

[revision]

Hi Bill,

I have been following your story. I had hip resurfacing surgery in June 2008. From the begining I had problems. Like u I had two second opinions at 5 months ( Dr De Smet & Dr Bose) They both agreed on the steep angle of the cup and associated problems but disagreed on a Revision. One said wait and see, the other said immediate revsion.

I went for the revision (in Belgium) advice six months after my resurfacing. Thank God I haven't look back since. I can do practically everythink with no pain.

Bill I agree with your advice to newbies. Please be careful what surgeon you choose. Go for experience, loads of experience. A revision is tough. Get it right first time. Your health is your wealth.

Best wishes,

Revision

[stevel]

Reading the agenda for the course at HSS in May, I notice the target attendees are orthopedic surgeons who have performed at least 10 hip resurfacings.  Dr. Su will be performing a live demonstration hip resurfacing surgery moderated by Mr. McMinn.  This begs a question:  Should a newbie go to a local surgeon who has done 10 hip resurfacing surgeries, has completed this course and be the 11th patient and have insurance coverage or fly overseas to Dr. DeSmet who has done over 3000, but pay out-of-pocket for everything ($23,000 + or -)?  

[B.I.L.L.]

23K ?  Thought it was more than that ?

[stevel]

Bill,

For a current estimate, visit Dr. DeSmet's website and ask for a quote for your type of surgery.  For you, it'll probably be a revision.
Pat's single hip resurfacing operation cost $17, 845 for everything including travel in 2006 and is listed on this website.

[fedup]

BILL, you need an ultrasound, likely folowed by an MRI to clarify what is going on. It is abnormal to be having pain and swelling at this point, esp as it fluctuates during the day and with activity. Hopefully it's a "simple" bursitis and not extensive soft tissue inflammation related to your prosthesis. Have they done a complete blood count (CBC) and looked at your inflammatory markers (ESR & CRP?). Hope things get worked out soon.

[B.I.L.L.]

BILL, you need an ultrasound, likely folowed by an MRI to clarify what is going on. It is abnormal to be having pain and swelling at this point, esp as it fluctuates during the day and with activity. Hopefully it's a "simple" bursitis and not extensive soft tissue inflammation related to your prosthesis. Have they done a complete blood count (CBC) and looked at your inflammatory markers (ESR & CRP?). Hope things get worked out soon.

Fedup, I will be traveling to see Dr. Klug sometime in june or july and will request the tests you mentioned. Funny (or maybe not so funny) but the people in here seem waay more educated than the kaiser docs I've seen lately. I just want an answer, good or bad. Thanks for your input.