Loose Cup

[willsie01]

If there were a loosening of the device (cup or femoral head) would this be noticeable to me?
I've had a consultant express the opinion that my leg pain is due to a loose cup but I would have thought that I would be aware of any looseness in the joint.

[Dannywayoflife]

From what I've read you would probably be having sharp pain in your groin area. What do your xrays show? Loosening usually shows as dark areas on the film.

Danny

[Tim Bratten]

I could not "feel" that my cup was loose (yet it was), although I did have various kinds of pain due to the various problems connected with my botched resurfacing. If you are interested I can post my last x-ray before the revision that shows the dark areas mentioned by Dannywayoflife. These dark areas were readily identified (correctly) by a surgeon in Buenos Aires and Koen De Smet as indications that the cup was coming loose.
Cheers
Tim Bratten

[willsie01]

My xrays don't show any dark areas.
They suggest everything is fine.
I would be interested to see xrays that show these dark areas for comparison.
Unfortunately I haven't asked for copies of mine yet.

[chuckm]

Hey Tim, just so we are not confused, when you explained that you could not "feel" that your cup was loose, does that mean there was no pain? Or does that mean it was painful but you couldn't feel a loose feeling - like falling apart? It's been a common thread here that loose or slipped cup is associated with sharp pain. But recently someone posted here and said they knew someone who had a loose cup but only transient pain - not constant pain. 

Chuckm

[Tim Bratten]

Here is the x-ray:

[Tim Bratten]

Hi guys
I had to reduce the file size of the photo considerably because of limitations for posting here, so the quality is not great. The "dark" area that shows loosening is the band that marks the upper fringe between the cup and the bone.

chuckm: I had considerable pain that came and went with activity. As you can see the cup was way too steep and the femoral component was levering against the bone (the white area on the bone above the implant). While this occasionally caused considerable pain after activity, it also apparently saved me from high ion levels: my metal ion levels checked out completly normal throughout the year and a half that I had this resurfacing. I also had staph infection in the bone caused by the original surgery (this is what caused loosening of both the cup and the femoral component). I occasionaly had intense pain after activity, but nothing I could directly attribute to the cup being loose. There were so many problems with my my resurfacing straight from the start that identifying a specific pain from the cup being loose was impossible. 

[willsie01]

Was the consultant able to diagnose the loose cup solely on the basis of the xray showing a band above the cup or were there other indications? Pain excepted
It's a while since I saw my xrays but from memory I don't think I have the cup angled so steeply.

[obxpelican]

I can see the space your doctor is seeing, the cup looks like it's rotating about 6-8 degrees.



Chuck

[Tim Bratten]

Was the consultant able to diagnose the loose cup solely on the basis of the xray showing a band above the cup or were there other indications? Pain excepted
It's a while since I saw my xrays but from memory I don't think I have the cup angled so steeply.

I had recurring (and sometimes intense) "set back" pain occasionaly after physical activity (occurring approximately every three months or so) throughout the year and a half I had this implant. I don't believe these pains were so much associated with the cup being loose (the loosening problem became apparent at the end and was due to infection). I never had constant pain (e.g. pain every time I stood up after sitting). I was already pretty much resigned to the idea I needed a revision before I learned that my cup was loose (diagnosed by the x-ray from two surgeons: one from Buenos Aires and Koen De Smet). De Smet told me it was possible to do a bone scan to confirm the loosening but I was so convinced I needed a revision I didn't bother.

PS: I am two years post revision and rock climbing, hiking with a backback, etc. about as well as I ever could.


 

[willsie01]

PS: I am two years post revision and rock climbing, hiking with a backback, etc. about as well as I ever could.

Fantastic