Author Topic: Revision Information from Dr. Ball  (Read 3245 times)

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Revision Information from Dr. Ball
« on: September 30, 2011, 08:45:18 AM »
Hi Everyone:

Below is a summary of my meeting with Dr Ball.  He is an extremely compassionate and caring physician and has done many revisions of patients from other physicians.  He spent as must time as I needed going over everything to do with my condition, reviewing x-rays, the revision surgery, and post-op rehap, expectations and recovery. He feels just awful that I have to go through this procedure so soon after the original resurfacing four years ago, but is confident that I will be have 20 or more years on my new hip.

·       Post HR outcomes are now showing that smaller framed patients are not good candidates for resurfacing – I’m 5’5” 110 lbs.

·       The best results are being seen with a ball size of 50+mm – mine was 42mm

·       At time of my resurfacing the depth of the acetabular was prepared too deep which left a space above the cup – evident on the x-ray

·       At some point, possibly around year two, the cup shifted into the space and the back of the cup slipped downward.  The alignment was now off, creating edge loading, and the metal-on-metal wear began.

·       He also feels that the cup is no longer attached, which on the plus side should allow for easy removal during the revision

·       Metallosis has caused degeneration of the femoral neck but the extent of soft tissue involvement will be unknown until surgery

·       While the metal levels are high, he’s seen much higher, and I should expect the levels to decrease approximately 1% per day – I believe that was the math J

·       The BHR will be replaced with a DuPuy titanium device that has a ceramic ball and the cup will have a polyethylene liner.  With this type of liner, there is a good possibility that when the liner has worn out, 20 or so years down the road, only the liner will need to be replaced.  He said my femur looked good.

·       The revision should be less traumatic since there is no need to dislocate the joint with the femoral neck will be removed

·       While he is currently booked 2-3 months out, my condition requires immediate surgery to avoid a break of the femoral neck; who knows where I may be if that were to occur

·       Hospital stay is 2-3 days and he recommends 2-3 weeks of home therapy immediately following.  Recovery should be much quicker this time around.

·       ROM will be close to my post HR and I will be able to continue with all my current activities that I love – well, I think I will give up skiing the Whistler Blackcomb Glacier next time and stick with the grandkids J

He did appreciate the input emails from Drs Bose and Nargol - thank you Vicky!  Without Vicky's help I could not of completed this diagnosis within the 30 days I did.  Over the past two weeks my symptoms have begun to increase at an alarming rate, but now I will receive the care I need.

Thanks to all of you for your support and input.  We must continue to share information, through avenues like Vicky and Pat's Web sites, so that resurfacing can continue to be perfected.  Let me know if you have any questions and I'll keep you posted on my progress...here we go again :-)


P.S.  at this writing I have yet to hear back from Dr Ure after sending him my recent x-rays; twice.  This is very disappointing.




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Re: Revision Information from Dr. Ball
« Reply #1 on: September 30, 2011, 09:47:32 AM »
Thanks for the post, Melissa - sorry to hear the cup was set poorly, but glad that you've got a good alternative with Dr. Ball; good luck!
Hernan, LHR 8/24/2010, RHR 11/29/2010 - Cormet, Dr. Snyder


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Re: Revision Information from Dr. Ball
« Reply #2 on: September 30, 2011, 10:50:23 AM »
Mellisa, after seeing your x-rays I had posted that it would be interesting and important for all hippies to know the reasons for your condition, so thank you for posting.

When I had my hips done, there were two patients that received ceramic THRs and have done well. One was a woman who got bilateral. She has recovered fully, and has returned to sports.So I am sure that you can do well too.


Proud To Be Dr. De Smet's First Uncemented Conserve Plus, Left, August 2010


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Re: Revision Information from Dr. Ball
« Reply #3 on: September 30, 2011, 12:13:02 PM »
Hi Melisa,
Best wishes to you. It looks like Dr. Ball gave you lots of excellent information. I'm also a small female and I'm expecting a really good outcome from my resurfacing. I'm even smaller than you 40mm. We didn't go with metal on metal for just the reasons you talk about in your post.

The ceramic ball and polyethelyene cup sounds like a great combination.

Fingers and toes crossed for you and your surgery.

RHR 8/30/2011 - Dr. Pritchett - Stryker Trident Shell /X3 Poly liner acetabular cup. BHR head.


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Re: Revision Information from Dr. Ball
« Reply #4 on: September 30, 2011, 03:59:35 PM »
Thanks for the detailed post.  It is great information for all of us hippies.

This once again points to the need for EXPERIENCED surgeons who know when to use what prostheses and how to properly install them.

Best wishes on your revision.  Please check in from time to time.

LBHR, Dr. Pritchett, 8/1/2011


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Re: Revision Information from Dr. Ball
« Reply #5 on: October 01, 2011, 12:03:01 PM »
Hi Melissa
I am sorry to hear of your impending revision and wish you well with the surgery. Having been through a revision myself, I can assure you that the THR feels just as good as the BHR did, with all the freedom of movement I had before.  It is also very good to be free of the various side effects of the elevated ion levels.   None of us want to lose our resurfs or go through a revision, but the reality on the other side isn't half as bad as you might fear.  Best of luck with the surgery and let us know how you get on.


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Re: Revision Information from Dr. Ball
« Reply #6 on: November 08, 2011, 03:32:48 PM »
Thank you for your very informative post Melissa.  I am so sorry to hear about your problems and the re-do. You sound really tiny, I was worried that I was too small for the resurfacing 5'7" 142 lb.  I'm thinking that may not be the case now.  All I have read so far states no one with a small frame, you certainly have a very small frame?!!  So sorry, wil be praying for you to find success this time about :))


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