BHR revision to THR

[mickymoko]

Hi everybody, it's  a bit of a moot point, since I am booked in for a revision from BHR to THR on the 10 the of November but I am interested in finding out if any body has had to have a revision from BHR to THR  due to psoas impingement and chronic tendonitis . The question is, did the revision get rid of the impingement and tendonitis, bearing in mind that I have already had a psoas lengthening  which did not work , due to misplaced  acetabular cup.

[chuckm]

That stinks Mickymoko. Until someone chimes in about revision to THR, why wasn't implanting a new cup at the right angle an option?


Chuckm

[mickymoko]

It appears that my anatomy was the original problem.It was difficult  to set the acetabular cup in the first case and consequently the acetabular was reset in a more anteverted position . Unfortunately ,  this has caused impingement of the psoas and chronic tendonitis leaving a revision to THR as the most likely solution, hopefully.

[chuckm]

Dr. Pritchett in Seattle has a cup with a special edge that is lower to accommodate the psoas.


Just a thought.


Chuckm

[mickymoko]

Thanks for that Chuck,   but I'm in the UK , under  Ronan Treacy new of the world's best.Unfortunately ,  I have been one of his few failures.  I havery tried everything over  the last two years,  PT, hydrotherapy, cortisone injections and psoas  lengthening  but nothing has really worked.We have discussed the option of a revision of the acetabular cup but as he had difficulty in setting it originally,  he is not too hopeful , explaining that my anatomy and integrity of bone stock will probably not support a revision of the BHR. I just hope that a revision to THA will solve the problem with the psoas  and was really just enquiring if anybody had experienced anything similar.

[chuckm]

He is one of the best so I'm sure he will get it right for you. Good luck.


Chuckm

[mickymoko]

Cheers Chuck.

[horse doc]

I hope somebody chimes in with a direct response to your question. 

I'm thinking along the same lines as Chuck in a way.  I take it that your cup component would not be revised.  Changing the femoral component will somehow change your psoas problem?  THR neck could be made shorter than your natural neck to relieve your psoas tension?

Not second guessing, just trying to learn

[karlos.bell]

  I would ask Dr De Smet before you go any further with Dr Tracey. Even yep though Tracey is one of the best. De Smet works with The BHR device he also works with the Conserve Plus.  You never know he also maybe able to sort your issue out and keep the resurfacing device.
Also too I know there are guys out there that have had a THR done by De Smet and are running on them. (Unlimited) You know the issue you know it may not get fixed if more surgery so ask around it also maybe a better option as he is in Belgium.
Ask and see what answer you get. I would. cheers K

[mickymoko]

Hi Karlos,  De Smet not an option, I'm in the UK, NHS.Anyway, I'm  64 and although I would  love to carry on playing squash,  my psoas problems has prevented me from doing so. If I can walk, hike, cycle, swim and play golf, I'll  be a happy man. I just need to sort out this chronic psoas issue.


Horse doc,  the acetabular  cup will have to come out because it is malpositionEd and rubbing on the psoas.There's also the possi ilty of edge loading.I hope that the smaller femoral component and the less than hemispherical acetabular cup for a THA , will ease the issue withas the psoas impingement and chronic tendonitis .

[karlos.bell]

  Hi Yep understand the NHS and your age. Sounds like you had better ask him to double check this time he has got it right. Cheers K