Muscle problems 3 years post op

[PDJ]

Hi everyone. I had a resurfacing at the Royal Orthopaedic in Birmingham 3 years ago. In January this year I was referred for Physio as I wasn't able to walk. My physio said it was the muscles in my leg shrinking and pulling on my joints so she worked with me but it didn't work so I am back to the hospital to see my consultant in 2 weeks. Has anyone experienced anything like this? And if so, did it resolve itself?

[B.I.L.L.]

Did they check your ion levels ?

[hernanu]

BILL is right - get the levels checked to make sure there's no issue.

[John C]

Yes, get a metal ion check. Also, since your problem seems to be soft tissue oriented, it is possible that x-rays may not tell you much other than checking for the acetabular cup angle. There was a report recently from the HSS in New York saying that an MRI was the best way to explore and diagnose these soft tissue concerns.
A last thought is about your activity level. Is there any chance that a low activity level might be why the muscles are shrinking? I would think that the physio would have covered that possibility.

[evant]

I'll be interested to hear the outcome of the consult with your surgeon.

I naturally hope your situation can be remedied.

[B.I.L.L.]

[PDJ]

Thanks for the replies. I cycle every day so I don't think it is inactivity. Is there a way to check my own iron levels? If not I will ask them to do it at the hospital. I have been using a foam roller on my ITB but I have stopped as it was hurting. It's really frustrating.

[GBLarry]

Hey PDJ - I too had tightening muscles and did mostly cycling as cardio workout, but found that the best method of improvement for me was/is a combination of yoga and working with a 6" hard foam roller.  If you are not familiar with what the rollers do and how they work, get your physical thapist to explain them to you, but they are supposed to hurt at least a little.  Mine said he used one himself all the time to treat sore muscles from overwork or lack of work.  I found that the cycling, even though I would work up a sweat, didn't give me the stretching and flexibility needed to keep this old body tuned.
Larry

[John C]

PDJ,  Its actually not your iron levels that you would want to check, but cobalt and chromium since that is what the prostheses are made from, and is what you are looking for to check for any excessive wear ions. Your hospital could do the blood draw, but it usually needs to be sent to a special lab in order to get accurate and meaningful results. It would probably be best if your surgeon ordered the correct tests.

[PDJ]

I have been today and had blood taken. They are testing cobalt and chromium levels and have booked me in for an ultrasound in 4-6 weeks. The surgeon is pretty sure that it is going to have to come out and a full ceramic hip replacement put in instead. It's pretty bloody depressing really. 

[Dannywayoflife]

Really sorry to hear that! What is the reason given for a revision? Who is your surgeon?

Danny

[PDJ]

The pain and lack of movement I have seemed to demonstrate that the resurfacing is failing. My surgeon is Mr O'Hara.

[B.I.L.L.]

Sorry to hear that PDJ. Your symptoms sound similar to what I had. Pain, swelling, and loss of rom. Good luck and could you post your test results when you get them thanks.

[whyme]

Hi PJD, that sucks.
Thanks for posting -in spite that it adds a little worry to some of us new hippies- and I hope the revision brings you back some good quality of life.
Let us know how it goes.

[Dannywayoflife]

Mr O'Hara is a dam fine surgeon. Did you receive the Finsbury adept device? As I know he generally uses that.

Danny

[Granton]

Very sorry to hear your news, PJD.

I am sure you will end up with a good solution, but it's a real downer to have to go through surgery again.

All the very best of luck!

[happyhopper]

Hi - sorry to hear of your problems.
I have had similar problems and have spent a long time trying to find out what is wrong.  I can honestly say that orthopaedic surgeons do not understand muscles imbalances and weakness and most physios treat the symptoms not the cause.  If a revision is suggested for muscle issues, please beware.
Eventually my new surgeon suggested  a nerve conduction study when the neurologist also tested a number of muscles.  5 major muscles showed weaknesses and I therefore still have a number of muscle imbalances.  I am now working with a therapist from the CHEK institute who is taking a whole body view and has also identified issues with my feet.  My therapist has recently been on a Dynamic Neuromuscular Stabilisation course run by the Prague School of Rehabilitation and their way of thinking is much advanced than UK physios.  They really understand how muscles work with the Central Nervous System. 
If you wish to contact me directly I will try and see if I can give you some further information on muscle imbalances.
Best wishes
 

[PDJ]

So I have now gone through all the hoops required and I need a full replacement. Metal ion levels were fine but after they took an x-ray in October, which apparently nobody looked at, and another one in December along with an ultrasound, finally last week I was told by Mr O'Hara that the implant has moved and it needs to come out. Two of his registrars missed this and sent me for physio instead. Total incompetence on their part really. I am seeking legal advice on this as I do feel than by the time my op comes round, I will have waited 18 months from the initial pain to get the correct treatment which I feel is negligent. Anybody think I have a case?

[hernanu]

I am sorry to hear that. If you had symptoms a while ago, it seems like the XRay would be the first thing to look at.

I don't know enough about the law on the device failing like this; despite the uproar about metal ions, the largest cause of failure is the loosening of the device, according to the national registries.

I feel for you, but in an undesirable situation, at least the treatment, a good THR is a good one. Once you have the revision, I hope you are pain free and back to activity, as you should have been with the HR.

[patm]

Did your surgeon show the x-rays and point out how they knew the implant had moved? I can't believe that you would have 2 x-rays for that purpose and no one read, or caught it. Incompetence at best.  I have worked in the medical field my whole life, and there are many wonderful, competent people in it, who really do try to do what is best for the patient, but I would have the surgeon SHOW ME what they are seeing - I guess I don't trust anyone completely anymore. I would think that you would have more pain than muscle wasting and weakness if the implant moved. Good luck and let us know how it goes