7 Years Post HR with Depuy ASR

[jessytlc]

I'm 38 years old. Female.

I've found mostly newbies on this site, but I hope I can find a few seasoned veterans. I've had the implant for 7 years without pain--except after excessive physical activity. But recently, during my third pregnancy, I've had occasional thigh pain. Nothing big, just a little ache, once in a while. But of course, with all the ASR press, I'm terrified that it's begun to fail.

I have an appointment scheduled with Dr. Schmalzried in a month.

Until then, does anyone have any information on this:

Is this normal? Does anyone else experience the occasional mild ache?
I have a good amount of clunking. It decreases when my exercise levels increase. Anyone else?
Does anyone have a site with good information not influenced by ambulance-chasing law firms?
Anyone else with a Depuy ASR?

A nervous pregnant Mom could use a little insight.

Thanks.

[phillwad]

Jessytic - sorry I can not help.  I am just over a year since my second.  I have a little bit of noise/feeling - sometimes it is like a tendon lifting over something. - Good luck - Phill

[Tin Soldier]

Wayne-o here on the forum has an ASR and there have been a few others, but for someone with an ASR, he is probably the most active here.  He's had it since 2006? and he's going strong.  His avatar is inspiring, snowboarding and looking agro.  He comes and goes here so you might PM him and see if he has some insight.

Clunking is very common and generally folks report that it goes away with daily activity with the legs, like walking, focused PT, cycling, running, things that tighten up the muscles around the hip.  I don't know if ASR hippies get more clunking simply because of the slightly unhemispherical cup of the ASR, or not.  That was detetrmined to be the problem with it.  I have 2 BHRs and I get clunking, lots of folks still get it after several years and I sort of expect that it will never go away, but it certainly diminishes with increased daily activity.  I'm not sure if you can correlate extra clunking to the ASR's shape or not. 

Keep in mind the ASR has a 15% failure rate or something in that area.  That's not as bad as the press and the lawsuit makes it out to be.  I don't recall the reference to that info, but Pat probably does.  It may have been an FDA summary on the whole lawsuit blowout.  Regardless, I'm pretty sure Pat more info about the ASR on this site.

What do you think about the possibility of slight mods to the pelivs from pregnancy or temporarilly during pregnancy that might make soft tissue around the hip adjust and cause some discomfort or mild pain?  Seems possible to me, but I think you should ask the doc about that.

Lots of folks mention discomfort or mild pain in there hips or upper leg from excessive activity or even the occasional pain but it goes away, so I wouldn't worry too much about it unless it continues to get worse and you don't have an obvious source, like excercise,...  I think the failure symptons of the ASR are generally the same in all MoM HRs having to do with reactions to elevated metal ions from excessive wear, which is the basis of the ASR failure.  Those symptons are pain in the hip, x-rays with signs of degradation, fluid around the prosthesis, elevated Co and Cr in blood. 

I think your best approach is to do a little more research here and see what more you find out about the ASR, organize your questions for the doc, and try not to worry.  Schmalzired is a very experienced surgeon, so you should get a lot of these questions answered. 

Also, this site has a ton of info, and a lot of good folks willing to help you out with info and especially support.   Hang in there.

[imgetinold]

I'm with Tin.  Do some research and talk to the surgeon.

Certainly, pregnancy loosens up a lot of things, shifts your center of gravity, makes you walk different (my wife was waddling at 8 months).  I imagine any of those things can mess with the loads on your hip, and therefore cause a temporary pain.

I'm guessing that the clunking is the result of decreased activity levels, which is a result of pregnancy.

Of course, my medical opinion - plus $5 - might just buy a cup of Starbucks (decaf, of course!).  I'd bet your fine, and will wait for your post to confirm as much.....

[hernanu]

I'll re-post this here...

Hi Jessy, I'm not a seasoned vet, but am aspiring to be 

There is a decrease in synovial fluid during pregnancy, whether you are a hippy or not. Clunking is probably more pronounced when you have less synovial fluid available, since the fluid is what gives us our smoothness. For us, keeping a good layer of synovial fluid is probably critical. Maybe once you start moving, some more gets involved and the clunking lessens.

Quoting from this:  http://www.netplaces.com/pregnancy-fitness/your-first-trimester/improving-your-posture.htm

"During pregnancy, you actually have a decrease in the synovial fluid in your joints. This makes them more prone to injury. Be sure to avoid bouncy and jerking motions while exercising."

One possible thing to do is to make sure you're hydrated more than usual, helping produce more of that synovial fluid.

And from this site about pregnancy exercise: http://www.bosu.com/scripts/cgiip.exe/WService=BOSU/story.html?article=4714

"A decrease in Synovial fluid, or lubrication of the joints, is evident during pregnancy (ACOG 2003). Because of this physiological change, a longer more gradual warm-up is recommended prior to more vigorous exercise.
"

Hope that helps.

[Dan L]

Jessy,

Tin, 'getinold, Hern really, really know their stuff, (along with many other Hippy's here), so you've got some great input here to mull over.

I seem to have had the clunking only very early on each side, maybe 3 months, now 14+ months and almost 10 on the other have not had for many months.  I do seem to notice that activity of all types versus inactivity does really help decrease pain and stiffness, and may explain the decrease in clunking as well.  Prolonged sItting is probably the one activity that brings out a bit mire stiffness and low level soreness at times, worse in certain chairs. 

Hope it helps,

Dan

[wayne-0]

Hi Jessy, Yeah I have two ASR implants that were put in Nov. 7th 2008 about 4 yrs 1 and 1/2 months ago. As far as the failure rate, it is close to 13% that leaves an 87% success rate. I am thinking that 87% is better odds than 13% so I am not gonna dwell on the negatives. In my particular case I never had any pain after surgery nor do I to this day. I know it is hard to believe but that is the truth. I am one of the lucky ones. The weird part of my recovery as I have read that many people clunked right away. I did not clunk at all but I did have a clicking sound but not until 3 months after surgery, and that lasted on and off for a few months. And let me tell you some times it was really loud. I mean if you were upstairs and I was downstairs you would have heard it. The only thing I experience is a slight shifting sensation but it is very rare and I have to stand in a certain position and move my hips in a back and forth motion to experience it. So if you are worried have your doc order an MRI and metal ion tests. I will continue to have these tests so as to stay on top of any problem that may arise. I think if you have these tests done and all shows well it will alleviate most of your fears. I think Tin Soldier and Hernanu are right on with their responses. Keep us posted.

Wayne-0

[Tin Soldier]

Thanks Wayne on the stats.  I wasn't quite sure.  I totally agree with the point about negative vs positive side of the precentages.  I even thought about that when I was writing it.  The ASR and MoM implants get such a bad rap that it's good to really understand the stats and presnet the success as opposed to the failures.  I agree, I like 87% succes better than the negative version of that number. 

[jessytlc]

Thanks everyone for the insights and advice. Helps me not to worry until my appointment in January.

Wayne-o, what you described is IT exactly. I said clunking because I simply did not how to describe it. But you did. It is a shifting sensation. As if for a moment something just...shifts. And it is always a certain position and involves bending forward for me. It doesn't really "shift" at any other time. But mine feels pretty pronounced. But, also, I'm not as active as I was before. And I can say with certainty, more activity means less shifting.

I felt better after hearing that other people had the occasional twinge and so on. Mine has been associated with pregnancy. But I don't have any stiffness, and I haven't had pain for a few days now. So...

Getting my ions done in a week so that Schmalzried can look that over beforehand. I'll keep everyone posted on what I hear.

Oh, again, thanks for the assurances on the stats. I was reading some stuff that was talking about 70-80% failure rate. Flipped out a little at that.

[Gav]

Hi All

Not been on here for a while now.

Had ASR in Sept 2009. Ion levels are good, surgeon says the implant is fine and still in place. I don't need to go back for any checks now for another couple of years or so.

I was having problems with bursitis when I did some running, but this has improved recently. I have recently gone back to my spinning classes, which has helped me to lose a few pounds.

So all in all, I'm not as worried about the implant as I was.

Compliments of the season to all Surface Hippy members, and a Happy New Year as well.

Gavin

[hernanu]

You too, Gavin, thanks for checking in.

[Gav]

I've recently had a letter back from the hospital telling me that I now have to go back for regular testing as the BMC in the UK have had some sort of revue on metal hip implants.

http://www.dailymail.co.uk/health/article-2271699/DePuy-sold-toxic-hip-implants-despite-knowing-dangerous-THREE-YEARS.html

[hernanu]

I've recently had a letter back from the hospital telling me that I now have to go back for regular testing as the BMC in the UK have had some sort of revue on metal hip implants.

http://www.dailymail.co.uk/health/article-2271699/DePuy-sold-toxic-hip-implants-despite-knowing-dangerous-THREE-YEARS.html

Hi Gavin, I also did testing for metal ions as a precaution at two years. The results, as I hoped and expected, fell within an acceptable range.

I think many people are having this done either because they want to be reassured, because their surgeons are now systematically doing it now due to the issues that arose, or simply to have a good baseline for the future.

All good reasons, in my view. There is absolutely nothing wrong with being as informed as you can be about implants, especially where there has been a recall. The failure rate, while higher than other devices is still about 13% if I recall correctly, so the success rate is in the upper 80's.

So the large majority of people with the device, though recalled are not having problems with it.

So to me, the test is a positive thing. It can relax your mind about this, then you just go on and enjoy your life.

[Gav]

Hello folks.

Nearly 8 years on and I'm pleased to say that it's all still good.

I've been discharged from the care of the consultant, and only have to go back if any problems arise.

Have given up on the running and have started to take regular trips on my hybrid bike.

At 50 years of age, I'm still able to carry my golfbag round my local course!!

Gav