another loose cup question

[doublerocket]

Had my hip resurfaced may of 2013. Cobalt metal by Dr. Desmet. Everything was text book and was recovering well. after about 6 -8  months i started feeling more pain more often than less. x-rays reviewed by Koen and he said the cup had not yet fully grown in. pain persisted and I sent Dr.Kohn more x-rays in July of 2014 at which point he said that the bone growth into the acetebular cup had failed and the cup was now indeed moving. He indicated that the procedure was properly performed, but that sometimes this does occur by nature. His prognosis is that he wants to try and revise to a thicker cup of the same material. He said he will check for any low grade inflamation in the fluid and if this is the case, suggested to go to a large surface ceramic on ceramic THR also in the case that there is excessive bone wear he would like to revise to THR as well.
A little freaked out right now because I am very active and physical and am afraid to loose my abilities. Just curious about any suggestions or similar experiences or if anyone has had to go the route of large surface ceramic on ceramic THR and what I could expect to be able to do exercise wise after the fact. I still fully trust in Dr. Desmet but want to bounce it off our group as well. experience is worth more than gold!
Rob petrin    5/14/13 LBHR  DeSmet

[Dannywayoflife]

Really sorry to hear that mate! Unfortunately sometime that does happen. Fingers crossed for you that Koen can remedy it for you!

[Tim Bratten]

Hi doublerocket
Sorry to hear about your problems. I had a botched HR by an Argentine surgeon that was revised by De Smet to his ceramic on ceramic THR almost three years ago. It's working quite well: I regularly hike, jog a bit and am an active (in fact, sort of a fanatic) rock climber. I don't know if you know anything about rock climbing, but yesterday I redpointed a 5.11d (French 7a) and today I will probably boulder. I also have a nine month old HR from De Smet and my hip is working, well, like new. That's some real bad luck  about your problems, but I would personally continue to trust De Smet (anyways, he has done wonders for my problems) and I can testify that his THR system can work quite well (at least it has, so far, for me). In my case, my surgeries with him have given me the opportunity to return to the sport that was (and is again) my passion.
If you want to see some pictures about my climbing with the THR,  check out my blog link in the mountaineering and climbing thread.     


PS: When I got my hip revised, there was another American, a younger guy, who lived in Spain, who was also having surgery with De Smet. As I recall, he had damaged his hip in a car accident, and was not a candidate for HR. At any rate, he also received De Smet's THR system. The guy sent me a few e-mails after the surgery to see how I was doing and to tell me how he was doing (a mail at six months, one year and two years). He was very happy with how his hip turned out. He was not a big sports enthusiast or anything like that, but he was a healthy young guy (maybe ten years younger than me) who had limped ever since his accident. At six months post-op he told me that the limp and pain from the accident were completely gone. At one year post-op he told me he could touch his knee to his forehead and he felt like he was back to normal. At two years post-op he told me ha had started to play recreational tennis and that he was real happy with how the surgery worked out for him.

[Pat Walter]

I am sorry to hear about your lose cup.  I would believe Dr. De Smet when he said that everything was done properly.  I have read hundreds of stories of his patients and I was his BHR patient in 2006.  Sometimes our bodies just don't react as they should.  I am sure he will get to the bottom of it for you.  If he says you require a revision, I would believe him.

If you want other opinions, you can send your x-rays to several of the top US surgeons like Dr. Rogerson, Dr. Gross, Dr. Brooks and others - there are quite a few giving free consultations.  You can see them on my list.

http://www.surfacehippy.info/listofdoctors.php

There are some people here that have had their cups replaced instead of a revision.  It really depends on your bone structure.  Others have had to have full revisions.  Fortunately, that doesn't happen too often.

Good Luck and keep us updated.

Pat

[doublerocket]

Hi Tim. Thank you so so much for your feedback. Your personal experience and the experiences of others is the most valuable information out there. I am not a Rock climber, but it sounds like you are slaying it! Congrats on staying so physical and pain free!!  I personally try to kill myself through Jogging, Motocross and Ice Hockey. I also trust Koen very much and it seems to me he would be one of the number one choices for me to have the best chance at recovering my hip properly.

HI Pat, your feedback means a lot to me and gives me confidence. Great idea to consult a 2nd surgeon...it's really due diligence for what has to happen next.

Does anyone know what the longer term history is of these ceramic on ceramic THR's?

  Rob           5/14/13 LBHR DeSmet

[Dannywayoflife]

Ceramic Ceramic is fairly new. The early Ceramics were prone to shattering, the new delta ceramics are far far more durable but are fairly new so we have speculate a little based on lab results as to their long term lifespan. However i would wager that as with resurfacing a well designed and implanted CoC device will last a long long time. It is not possible to wear out the bearing couple of most modern devices i personally believe the longevity of modern devices is more to do with how well they stay fixed to the bone rather than wear. The alloy the BHR is made from has been shown in retreval studies to wear at less than a micron per year after 30+ year invitro.

[doublerocket]

Thanks Danny. excellent information. That was what I was thinking. I had heard past horror stories of Ceramic exploding and couldnt imagine that this prosthetic had not yet been corrected. I wonder what the word on the street is about these new ceramic prosthetics. Is it the best alternative to resurfacing?
( at least with what we know about them).

[Dannywayoflife]

If a candidate I would always advocate a resurfacing as opposed to a thr. However a hr isn't a perfect thing that suits all, I think many surgeons over here in the uk are now using the ceramic on high cross linked Polly bearing couple. Although I'm sure I've read that Koen de smet really rates CoC

[Mike D]

Hi Rob,
I have a large ball Oxinium (ceramic)/ cross poly THR. I wanted HR but wasn't a candidate due to past teenage problems.
It was a huge blow to find this out but at just over 2 years on I'm completely happy with the way it works- I'm fully pain free, range of movement is really good-I've just about got my knee to my head with ease and I've done lots of long walks and some jogging with no issues at all.
I played a lot of squash before my THR and I have to admit I miss it badly- I've thought about having another go and resisted the urge so far.
I think I'll do it next year and see how it goes-it won't be at the same level but at least I'll be on court thrashing around again!
If you do need a THR, it will have an effect on your jogging. Just rein it in a bit and not hammer it ,I'd say.
The Ice hockey? I'm not sure, -I haven't played it but it looks pretty much all or nothing and I'd be cautious on that.
The motocrossing shouldn't change ,though. There's a few guys here, me included, who have carried on biking on either road or track and enjoy it all the more now that it's pain free.
I even bought a bigger bike cos it's so much easier to do!
Fingers crossed you get your cup sorted out and can carry on everything where you left off but if not, don't despair at all.
The devices you mention are excellent and if someone like De Smet does it, it will last a long time.
If it has to be the THR, I wouldn't worry-just make a few adjustments to your activities so you're not punishing it and enjoy it!
Mike.

[doublerocket]

That's exactly the stuff Mike....your feedback is precious to me, thanks so much. You are all making it easier to make this choice to move fwd. I am crossing my fingers we can stick with the resurfacing and change the cup.....but I need to be prepared to wake up with something else. Either way...I feel confident that Koen Desmet is the right guy to help me out.
Rob

[Dannywayoflife]

Rob what ever Koen gives you will be dam good. I think you've just been very unlucky with your initial resurfacing cup. Unfortunately sometimes these things happen no surgery is 100% perfect.

[doublerocket]

So back from Gent and the caring hands of Dr. Desmet. As it turns out the bone was pretty seriously infected which caused the bone never to grow correctly into the cup. Koen had no choice but to go THR using the Delta big head Ceramic on Ceramic to get it right. I am 6 weeks post op now and recovering well with the infection gone, I am on a hefty antibiotic program, 12 pills a day for 3 months to eradicate the infection.
Now that I am no longer a BHR a THR...sounds wierd, does anyone know of a site that might offer similar support for me and  my new Prosthesis?
Thanks everyone for your help! Rob Desmet LT BHR

[Pat Walter]

Glad you are back and everything worked out for you. 

You are welcome to stay here and post in the THR section.  That way others that have had revisions or THRs can still talk with you.  Everyone else will still offer support.  I have a THR Discussion Group, but it is very small.  It has never grown.

http://www.hipsforyou.com/totalhiptalk/


 I am sure if you search Yahoo Health Groups, you can find a THR group.

I will watch for more updates in the future so I can post your revision story.  They are also important for perspective patients to read.  They know things sometimes don't work out, but there is still hope even with a THR.  Especially when they get a large ball THR from a top surgeon.

Good Luck.

Pat

[doublerocket]

Didnt think to look that you had aTHR section. I am relieved! This place feels like home and I didnt really want to go anywhere else. Thanks Pat. LBHR DEsmet 5/13 and LTHR Desmet 3/15

[Pat Walter]

Sure - stay around.  I don't mind even if you don't post in the THR section, but it does help new people sort things out.

Hip replacements whether BHR, THR or revision are all major surgery to the hip.  They all have to heal and are very similar involving the same joint, muscles and ligaments.

Good Luck and looking forward to hearing about your progress.

Pat