need thr shortly

[daylily]

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 )
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

[littleb]

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.

[daylily]

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

[Lopsided]

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.

[daylily]

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

[stevel]

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.

[littleb]

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.

[daylily]

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

[daylily]

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!!

[littleb]

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.

[daylily]

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.

[Pat Walter]

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

[daylily]

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

[toby]

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

[daylily]

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.

[toby]

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

[daylily]

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

[toby]

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?

[daylily]

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

[toby]

Daylily,
How are you?
Did you manage to see Prof Richardson?
Any updates?
Toby