How did you know.

[AnnieO]

I've had my BHR 12.5 years.  I always thought I was doing well and had very little discomfort and few clicks.  Over the past 3 months I've had more discomfort, more clicks.  My buttocks is always freezing cold so I have to sit on a heat pad.  My soas has been tight with that going to my back.  At night my hip feels heavy and achy and that burning cold.  I can handle a lot of pain and mostly I never expected to by "normal" again so, I just lived with it.  Plus I've had bad knees for two years that yell louder than my hip sometimes. 

In dealing with my knees, I had a lower extremity X-ray.  The doctor said I was not a candidate for a procedure I wanted because my meniscus was destroyed because my hip is not situated correctly and is wearing on that side of the knee.  Now I have a problem.

I always thought I had a very well position implant. I'm sure I was told that by someone.   Low metal levels when tested (a number of years ago.)

Can anyone tell me how you knew that you had a problem with the BHR?  How was it diagnosed?  Can any surgeon diagnose a problem that needs to be addressed?  I've been looking for doctors in Denver that are experienced with revisions but, have not been successful.  I would really appreciate any info on how to get the best surgeon as I would like to keep the BHR.  Any information anyone can give will be greatly appreciated.

[Diane11468]

Hi posted a similar question a few weeks ago and didn't really get the answers I had hoped for. I am 18yrs post op right hip resurfacing. After initial recovery, I have had zero problems, with the exception of an occasional squeak, with deep bending over. Mu hip turned 18 Jan 23, 2021. Since then I have been on a accelerated downhill turn as if someone flipped a switch. Mine started with groin pain that mimicked that of pre-surgery. The groin pain has lessened and now is ischigluteal in orgin, like that of what you speak of. I contacted my surgeon, whi has been following my hip for the past 4yrs and got an appointment 3 weeks ago. At that time, he ordered labs including cobalt chrome ions and a nuclear med bone scan. I have since become fairly disabled, walking with one or both crutches and unable to weight bare in that hip. My hip now clucks with bending motion and feels very unstable. I got an emergency appt yesterday because the pain and disability has become unbearable. My bone scan was negative for loosening or fracture, cyst or pseudotumor. My cobalt chrome labs are not back yet but my CRP and ESR labs show infection or inflammation so now on Monday I will endure a hip aspiration to rule out infection. I was told that my hip is probably just wore out after 18yrs. I went from complete denial to urgency in wanting revision because of the pain and disability it is causing. I would get an appointment and get the ball rolling with testing while you can and in the mean time search for a surgeon you trust to revise it. My surgeon has done this type of revision and I trust him to do right by me. I am miserable after 6 weeks of this. I am stunned at how fast it has deteriorated. Good luck and I will let you know if my cobalt chrome levels are elevated when I get the results. 

[blinky]

Please do let us know. Not many have made it to eighteen years yet.

Hmm....infection. That can come on suddenly and be debilitating.

[Pat Walter]

Hi  Most people have pain or very noticeable problems.  You should ask you surgeon to do a metal ion test and take x-rays. Usually problems show up with both of those.  Sometimes it's not the hip but back or even knees. Anytime your body is not in normal balance, it throws the hips off, too. 

I definitely would get several opinions. You can send your x-rays to several of the top surgeons and they can see if your bone ingrowth has changed or there are any obvious problems. The experienced hip resurfacing surgeons are really good at reading the x-rays.
There actually have been some people that had no pain or problems, but found very high metal ions from their blood tests.
Problems like this need to be solved by the surgeons. It is almost impossible to guess.
Here is the list of surgeons that do free email consults. They are use to seeing older implants and what the bone growth around the device should look like.  I wish you both the very best.
https://surfacehippy.info/hip-resurfacing-doctors-over-1000-hip-resurfacing-surgeries/

[jimbone]

Annie-

Sorry to hear you're dealing with this.  If you don't find an experienced surgeon with extensive revision expertise I would highly recommend contacting Dr. Pritchett's office if only for a consultation and opinion based on imaging.  He has done a lot of revisions including those to BHR.  I'm pretty certain his opinion would help clarify your condition and the best path forward.  From what I read here, Dr. Gross is also highly experienced with revisions and worth consulting as well.  It might mean some travel for the surgery if needed but many here have accepted that hardship for the benefit it provides. Best wishes.

[AnnieO]

Thanks to all for responding.  I am amazed at how fast the discomfort is progressing.  No way to get relief now, sleeping, sitting, and of course standing.  I have an appointment with a Denver surgeon on March 27.  At least that is a step.  I will check on getting another opinion before moving ahead.  I’m confined to surgeons that accept Medicare and AARP so I may not have the best choices.  Such is medical care in the good old USA.  Given I also have knee issues to address, I’ll be busy visiting doctors.

Diana, please keep me updated on your situation.  I’m sure life is even more of a challenge for you right now. 

[AnnieO]

Are there surgeons that specialize in revisions.  It appears that Dr. gross and Pritchett are the main two.  Or, perhaps more but they don’t opening say they do revisions?

[Saddlepal3]

Hello all,
I had a revision after 12 years. Dr. Pritchett did the original resurf in 2006 and also did the revision. He replaced the metal acetabulum cup with a poly-lined cup, so was able to preserve the resurfacing joint. That procedure was in September 2018 and recovery was very smooth.
Unlike others, I had no noticeable symptoms. I had blood ions tested in March 2018. Numbers came back somewhat elevated (7s & 8s), so I had a MARS MRI. That showed a build up of fluid and debris in the hip capsule. I sent the images to Pritchett, DeSmet, Brooks, Raterman and Gross for opinions. Everyone except Gross recommended revision. Gross thought I could wait and watch, but the other doctors felt there was potential for infection or further deterioration if I waited. I decided to go ahead with it and have never regretted that decision. Currently, I live in Florida, so I flew back to Seattle for the surgery with Dr. Pritchett. He and the hospital accepted Medicare and my AARP supplemental insurance. Feel free to PM me if you have questions.

[Diane11468]

Hi Annie
The hip aspiration went as well as could be expected. He got 20mls of fluid out in the blink of an eye. The fluid was very dark almost brown in color. I asked if it was normal and he said is was much darker then normal but it is not looking infected. They are sending it to a lab out east for a definitive diagnosis. I see him again on April 12th to discuss a plan. I did finally get my cobalt and chrome lab results and both are elevated so they are confident in believing its metallosis. I have had vertigo since June of 2020 which I read is a side effect of metallosis. I had seen ENT and neurologist and after many tests, they could not explain why I was so dizzy. I think now that may have been my 1st clue, months before the pain started.  I spent yesterday with decreased pain and increased mobility probably due to the 20mls of fluid removed. Sadly it was short lived and today I am back in moderate to severe pain. Getting the diagnosis of metallosis has brought me peace of mind since I was struggling with the decision to revise my hip just because the pain is so bad. I plan to go ahead with the total if my hip culture's come back negative for infection. My resurfaced hip bought me 18yrs of pain free normal life and I would still recommend this procedure to anyone young to preserve bone stock and a lifestyle with no restrictions. I am glad you are moving forward with getting answers. My insurance prohibits me from going to anyone out of network as well. My surgeon has done this type of revision so I feel confident in his skill set to do the job. I am also a retired OR nurse so I asked my former colleagues for there opinions and they too said he is the right man for the job. Do you know anyone in the medical field who can point you in the right direction of whom to see?  I will touch base after my appointment on the 12th. Take care

[jimbone]

Wishing you the best Dianne.

[Hippyu]

Hi posted a similar question a few weeks ago and didn't really get the answers I had hoped for. I am 18yrs post op right hip resurfacing. After initial recovery, I have had zero problems, with the exception of an occasional squeak, with deep bending over. Mu hip turned 18 Jan 23, 2021. Since then I have been on a accelerated downhill turn as if someone flipped a switch. Mine started with groin pain that mimicked that of pre-surgery. The groin pain has lessened and now is ischigluteal in orgin, like that of what you speak of. I contacted my surgeon, whi has been following my hip for the past 4yrs and got an appointment 3 weeks ago. At that time, he ordered labs including cobalt chrome ions and a nuclear med bone scan. I have since become fairly disabled, walking with one or both crutches and unable to weight bare in that hip. My hip now clucks with bending motion and feels very unstable. I got an emergency appt yesterday because the pain and disability has become unbearable. My bone scan was negative for loosening or fracture, cyst or pseudotumor. My cobalt chrome labs are not back yet but my CRP and ESR labs show infection or inflammation so now on Monday I will endure a hip aspiration to rule out infection. I was told that my hip is probably just wore out after 18yrs. I went from complete denial to urgency in wanting revision because of the pain and disability it is causing. I would get an appointment and get the ball rolling with testing while you can and in the mean time search for a surgeon you trust to revise it. My surgeon has done this type of revision and I trust him to do right by me. I am miserable after 6 weeks of this. I am stunned at how fast it has deteriorated. Good luck and I will let you know if my cobalt chrome levels are elevated when I get the results.

Hi, how are things now going for you?

[imgetinold]

AnnieO,  Dr. Pritchett does a lot of revisions.  I would start there as others have mentioned.


Diane, it looks like you might be a good candidate for revision to a poly-lined acetabulum and be able to save the original femoral implant like Saddlepal3 did.  I wish you luck.