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Author Topic: Canadian with a Conserve Plus requires a revision. Any others out there?  (Read 4489 times)

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Roboclimber

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I am getting a revision to my right hip January 12th, and I am getting it done in Seattle by Dr. Pritchett. Cost: $25,000 USD. Ouch. Only the acetabular cup is being replaced, and it is being replaced with Synovo unit. Dr. Pritchett feels this is the best choice

Apparently the year I had my surgeries it was discovered that the Conserve Plus was experiencing higher than previously documented revision rates. I am not sure why my implants aren't working (left hip hurts, too), but I am determined to try to get my life back. It has been a brutal last 5 years.

My GP wouldn't even listen to me about any of my decisions over the last few years, so I finally got rid of him and I now have a new GP who seems keen to help me. Surgeons in BC are convinced THR is the only way to go, so my only choice here for a revision would be a THR, and I would have to wait a very long time.

Any other Canadians dealing with something similar?
Rock-Climber with L1 to S1 Spinal Fusion (w. S1 to S4 nerve Damage); R Conserve+ Dr. Antoniou Feb 17,'12. L Conserve+ August 17, 2012 with Antoniou. Revisions to Synovo Cups in 2015 by Dr. Pritchett: R On January 12, L on June 9th, with femoral unit revised, too (TARA prosthesis from Biopro)

Gazza2

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Re: Canadian with a Conserve Plus requires a revision. Any others out there?
« Reply #1 on: December 11, 2014, 07:15:23 PM »
I am getting a revision to my right hip January 12th, and I am getting it done in Seattle by Dr. Pritchett. Cost: $25,000 USD. Ouch. Only the acetabular cup is being replaced, and it is being replaced with Synovo unit. Dr. Pritchett feels this is the best choice

Apparently the year I had my surgeries it was discovered that the Conserve Plus was experiencing higher than previously documented revision rates. I am not sure why my implants aren't working (left hip hurts, too), but I am determined to try to get my life back. It has been a brutal last 5 years.

My GP wouldn't even listen to me about any of my decisions over the last few years, so I finally got rid of him and I now have a new GP who seems keen to help me. Surgeons in BC are convinced THR is the only way to go, so my only choice here for a revision would be a THR, and I would have to wait a very long time.

Any other Canadians dealing with something similar?
Sorry to hear your having problems.  I had a Conserve+ fitted here in Ottawa almost to the day you had yours Feb 2012.  I do not think there are any problems with the Conserve+ they are still using them here, and I believe are a favored device by one of the top HR surgeons (DeSmet.)  Was your implant angle good?  What is the reason for revision is it due to metal ions?   I dd here that there are no surgeons performing HR in BC today (I recall reading that a few tried but got poor results and did not succeed in getting up the learning curve.)   As others have said here many times it is down to the surgeon skill in correct placement more than the implant type.
Dr Kim Ottawa LHR Cementless C+ Feb 2013

Tim Bratten

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Re: Canadian with a Conserve Plus requires a revision. Any others out there?
« Reply #2 on: December 12, 2014, 11:05:51 AM »
Sorry to hear about your problems, Roboclimber. Good luck with Dr. Pritchett! I think De Smet has put in something like 1,800 or so Conserve+  devices and is having very good results with them (around a 1% revision rate). The results are on his web page. I believe it is his preferred device, even though he has also had very good results putting in about 2,000 BHRs. He put the Conserve+ in me and at 10 months post-op I am doing very, very well. I'm also a climber and post sugery I've been able to climb a bunch, including some 11d sport routes and V4 boulders, which is a level I haven't obtained for some years because of my hip problems. I can honestly say my hip feels like new.
« Last Edit: December 12, 2014, 01:58:12 PM by Tim Bratten »
Botched LHR by Dr. Vilicich 06-17-2010 revised by Koen De Smet 02-14-2012
RHR Koen De Smet 02-05-2014

Roboclimber

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Re: Canadian with a Conserve Plus requires a revision. Any others out there?
« Reply #3 on: December 12, 2014, 09:05:29 PM »
Hi Guys:
Some answers to your questions:
  • I am still waiting for the results of my bloodwork done October 27th. They had to redo analysis..long story, but it doesn't appear like a metallosis issue.
  • If I look at any of the reasons why any hip surgery fails, it could be anything - including a bunch of cortisone I had shot into the hip bursa and S-I joints. Who knows? As Dr. Pritchett said: "sometimes they just don't work. They don't know why".
  • Dr. Antoniou is a great surgeon who has implanted a lot of these (over 800), and I personally know some of his patients. However, the right implant never felt good. Terrible ROM: it's a bitch to do up my shoes, and it's not just my spinal fusion. Pritchett says sometimes this happens. Maybe because I'm a short male (5'4")?...
  • Pritchett didn't say anything about the angle being wrong. He just jumped on the gapping and said he didn't think I could wait 6 months - which is what Antoniou wanted me to do (as did my GP). Antoniou made it clear that if he had to do a revision, it would be a THR.
  • I have this from a Canadian source: In it's ninth annual report released in 2011, the National Joint Registry in England and Wales reported an increase  from it's previous year for the Conserve Plus. 2 percent after 1 year, 5.16 after 3 years, 8.52 after 5 years. If these numbers are true, that's kind of high. However, some of my friends were implanted with DePuy, and they're doing fine. Like I say, who knows?
Rock-Climber with L1 to S1 Spinal Fusion (w. S1 to S4 nerve Damage); R Conserve+ Dr. Antoniou Feb 17,'12. L Conserve+ August 17, 2012 with Antoniou. Revisions to Synovo Cups in 2015 by Dr. Pritchett: R On January 12, L on June 9th, with femoral unit revised, too (TARA prosthesis from Biopro)

Gazza2

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Re: Canadian with a Conserve Plus requires a revision. Any others out there?
« Reply #4 on: December 12, 2014, 10:22:54 PM »
That must be incredibly frustrating to not know what is wrong. I hope Dr. Pritchard can sort it out for you.

This may not be any comfort to you, but FWIW the UK National Joint Registry report is available online and there is a 2014 version.  The revision rate for the conserve plus at 10 years is now 14.22% which is disturbingly high  BUT (And it's a big one IMO)  the sample size is only ~1322 across an unknown number of surgeons.  Dr DeSmet has implanted aver 1665 C+ alone and as Tim noted has a revision rate ~1%.   I think the UK has a natural bias to the British Smith & Nephew BHR (18927 implanted in the same registry study) and perhaps the better surgeons there all use that.

Link to 2014 UK joint registry report http://www.hqip.org.uk/assets/NCAPOP-Library/NCAPOP-2014-15/NJR-11th-Annual-Report-2014.pdf
Dr Kim Ottawa LHR Cementless C+ Feb 2013

Roboclimber

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Re: Canadian with a Conserve Plus requires a revision. Any others out there?
« Reply #5 on: December 30, 2014, 05:28:41 PM »
This is all great information - thanks!

I just got back the results of my blood tests. This is the jist of it, although there is more (see attachment):

[size=0pt]Sept 24, 2013: Cr 8.27 ug/L, Co 5.69 ug/L
 Oct 29, 2014: Cr 8.19 ug/L, Co 5.76 ug/L
 
 Values under 7.0 ug/L are considered within normal limits for patients with metal joint implants.
 
[/size]Dr. Pritchett feels these values (and the others in the report) support moving to a polyethylene bearing surface.

Surgery is scheduled for January 12th.
Rock-Climber with L1 to S1 Spinal Fusion (w. S1 to S4 nerve Damage); R Conserve+ Dr. Antoniou Feb 17,'12. L Conserve+ August 17, 2012 with Antoniou. Revisions to Synovo Cups in 2015 by Dr. Pritchett: R On January 12, L on June 9th, with femoral unit revised, too (TARA prosthesis from Biopro)

Roboclimber

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Re: Canadian with a Conserve Plus requires a revision. Any others out there?
« Reply #6 on: January 22, 2015, 04:34:22 PM »
I had my surgery successfully completed in Seattle on January 12, 2015. I have started a blog to document the situation and progress:


http://mysynovorevison.blogspot.com/.


As planned, the Conserve Plus cup was removed and replaced with the Synovo. The femoral head component was left in place.
Rock-Climber with L1 to S1 Spinal Fusion (w. S1 to S4 nerve Damage); R Conserve+ Dr. Antoniou Feb 17,'12. L Conserve+ August 17, 2012 with Antoniou. Revisions to Synovo Cups in 2015 by Dr. Pritchett: R On January 12, L on June 9th, with femoral unit revised, too (TARA prosthesis from Biopro)

Dannywayoflife

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Re: Canadian with a Conserve Plus requires a revision. Any others out there?
« Reply #7 on: January 22, 2015, 07:24:46 PM »
That's great news robo! Hope your recover goes well ;)
Train hard fight easy
LBHR 10/11/2011 Mr Ronan Treacy Birmingham England
60mm cup 54mm head
Rbhr 54mm head 60mm cup 12/02/15 Ronan Treacy ROH Birmingham England
;)

Roboclimber

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Re:Conserve Plus requires a revision. Synovo is only option other than THR
« Reply #8 on: January 24, 2015, 04:16:59 PM »
Thanks DWOL. I saw Dr. Pritchett yesterday, and all looks good.


Interestingly, an infection developed in the incision, and I ended up going on heavy duty Septra for Super bugs. All good now.


We'll see how this one works out, but I may have to have the left swapped out, too.
« Last Edit: January 24, 2015, 04:23:37 PM by Roboclimber »
Rock-Climber with L1 to S1 Spinal Fusion (w. S1 to S4 nerve Damage); R Conserve+ Dr. Antoniou Feb 17,'12. L Conserve+ August 17, 2012 with Antoniou. Revisions to Synovo Cups in 2015 by Dr. Pritchett: R On January 12, L on June 9th, with femoral unit revised, too (TARA prosthesis from Biopro)

hernanu

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Re: Canadian with a Conserve Plus requires a revision. Any others out there?
« Reply #9 on: January 26, 2015, 10:24:16 AM »
Congrats, I'm glad you were able to keep the femoral component. Good luck on starting up again...
Hernan, LHR 8/24/2010, RHR 11/29/2010 - Cormet, Dr. Snyder

Roboclimber

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I have moved onto another thread: http://surfacehippy.info/hiptalk/index.php?topic=5621.msg53275#msg53275, after having both hips revised.
Rock-Climber with L1 to S1 Spinal Fusion (w. S1 to S4 nerve Damage); R Conserve+ Dr. Antoniou Feb 17,'12. L Conserve+ August 17, 2012 with Antoniou. Revisions to Synovo Cups in 2015 by Dr. Pritchett: R On January 12, L on June 9th, with femoral unit revised, too (TARA prosthesis from Biopro)

 

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