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Author Topic: Birmingham resurfacing failure after 14 years - now what?  (Read 1625 times)

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johnieappel

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Birmingham resurfacing failure after 14 years - now what?
« on: December 23, 2021, 09:29:48 PM »
5 days ago I took a 3/4 mile walk, not at all out of the ordinary for me, I try to walk 2-3 miles a day. After the walk I had hip pain at my resurfaced hip like never before. It migrated to my lower back and sciatic nerve on my left side where my resurfaced hip resides. The next day the sciatic and back pain were gone but not the hip discomfort, especially if I tried walking on it. I'm now on crutches and trying not to put any weight on it. The pain discomfort is at the hip joint. A month ago I had some discomfort and became concerned. I contact my Dr. who did the surgery, Dr. Keith Ure out of Mercy Medical Center in Mt. Shasta. I got it xrayed and the radiologist report stated everything looked normal. I have not heard from Dr. Ure yet because his office just received the x ray and its now the holidays. I have not been kind to my hip, I manage 5 rentals, do all the work they require and just finished a complete roof replacement on a 2000 sq foot house. It was after that job that I noticed some discomfort. I'm bracing for what is most likely the inevitable, a THR. I've been learning about the Dual Mobility type of hip replacement, which has a much less dislocation chances and looks better for an active person. I'm 57 years old and very active and this is the last thing I was expecting! My questions are many but one I'm most needing some answers to are what happens when the resurface implant fails? I think it is coming loose but how do I know? Aside from discomfort and pain, will it dislocate? I'm being extremely cautious, I do not want an emergency situation, I want to make an educated choice on what type of replacement to get and what Dr. is best. I'm in a rural town in Northern California, 3 hours from Dr. Ure who did the initial resurfacing surgery. I'm not sure I'll go back to him, I've been told the Coon Joint Replacement Institute is a great place and it is 4 hours away. I'm also wondering if anyone has had a Dual Mobility type of THR.
Any help would be very much appreciated.
Thank you , Happy Holidays!
John Chapman

petemeads

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Re: Birmingham resurfacing failure after 14 years - now what?
« Reply #1 on: December 24, 2021, 02:59:00 AM »
Hi John, sorry to hear about your predicament.

For what it's worth, I have had sciatica since 1st June following a very active few days (long hill walk, 5k race, long bike ride) and the pain/electric shock feelings centred on my THR hip. I could not stand straight or even lie down straight for a couple of weeks but this was definitely a spine problem and is being resolved by IDD machine stretching treatments and I can now run and walk again, even though there is still a tendency to avoid weighting that leg when standing. Let's hope your pain is similarly spine-related...

My BHR is 7 years old and still working well, I got the ceramic THR on the other hip because my bone broke  during the operation for another BHR, this was nearly 5 years ago. I have had no worry about dislocation with this device and I have been running and climbing throughout the period. I don't think modern THRs do dislocate except in heavy and unfit (and possibly unlucky) people who are careless during the early days in their recovery. THR is not the end of the world...

I know of a climber in France who has a dual-motion THR joint in each hip, they tend to fit these to skiers and climbers to avoid the dislocation risk, he is very happy with his fancy hips. We are both in our 70s but as I say, very active. My ceramic THR has a slightly better range of motion than my BHR and feels great.

Hope this provides some comfort, and that you get to the bottom of your problem quickly, I can't imagine that dislocation would be a failure mode whatever might have gone wrong, especially since all looks to be normal on the x-ray.

Cheers,

Pete
Age 72, LBHR 48mm head 18th Nov 2014 and RTHR 36mm head Zimmer ceramic/ceramic 2nd May 2017 by Mr Christopher Kershaw, Spire hospital, Leicester UK.

catfriend

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Re: Birmingham resurfacing failure after 14 years - now what?
« Reply #2 on: December 24, 2021, 09:40:56 PM »
Try not to go to worst case scenario just yet. First, you want to hear from your surgeon. You need a diagnosis as to what your actual problem is before worrying about what the best course of treatment is. If your resurfacing has indeed failed, or partially failed (maybe you just need a new cup), consider seeking out a second opinion before jumping to a THR. Dr. Pritchett in Seattle does revisions, as do a few others. Good luck.

Pat Walter

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Re: Birmingham resurfacing failure after 14 years - now what?
« Reply #3 on: December 25, 2021, 08:53:03 AM »
Hi John
I think you should take a breath and wait to see what is really going on.  If you had x-rays a few months ago, then most likely your device wouldn't fail that quickly.  There are tons of things that can cause a lot of pain, even bursitis.  You can email your x-rays to several other hip resurfacing surgeons to get their opinions.  Dr. Gross, Dr. De Smet, etc.  That way you have a little more input.  Sometimes it is very difficult to tell whether it is hip or back pain.  I hope you will find an answer soon.  If you have to have a revision, people with THRs are also very active too. Some are even athletes.
I would give yourself a little time and wait for a little more input. I have stressed my hip resurfacing a couple times by pushing something too heavy or more recently falling against a chair.  I thought I was going to have real problems, but with a little time it got better.  I had bad bursitis in my other hip and thought I was going to have it replaced.  Some time, meds and relaxation has helped it.  Our bodies take a real beating sometimes and we think we will never heal.  But fortunately, it usually does. I have been there and done that. 

So I wish you the best.  Here is the list of surgeons for email consultations   https://surfacehippy.info/hip-resurfacing-doctors-over-1000-hip-resurfacing-surgeries/
Webmaster/Owner of Surface Hippy
3/15/06 LBHR De Smet

johnieappel

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Re: Birmingham resurfacing failure after 14 years - now what?
« Reply #4 on: December 26, 2021, 05:08:37 PM »
Thank you for the responses, I appreciate it very much. I am trying to not stress about this but going from being normal to being disabled is a hard one to come to grips with. If I put weight on it it hurts so I'm using crutches. It feels like the socket cup as the pain does not radiate down my leg, its more in the pelvic area of the socket. It was my understanding 14 years ago that they did not redo a hip resurfacing with another hip resurfacing. Is that still true? When I got it Xrayed a month ago I was not anywhere near this much discomfort / pain, it definitely feels like a major change has happened. I know I need to be patient and see what the Dr.'s say but having this happen just before the holidays doesnt help!
Thanks again for the responses and support.
~ John

johnieappel

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Re: Birmingham resurfacing failure after 14 years - UPDATE
« Reply #5 on: February 07, 2022, 02:59:57 PM »
Since my original post I have seen Dr. Ure, who did my surgery 14 years ago. Turns out the bone behind my chromium socket is failing, due to Osteopenia and stress shielding from the chromium cup. I got a second opinion from Dr. Pritchett who agreed with Dr. Ure. He said I should get on Tymlos or Forteo immediatley and that I would need a bone graft as well to make sure the replacement socket doesnt fail. Dr. Pritchett is willing to replace just the cup with his Titanium, polyethylene lined cup but insurance wont pay for it so I'd be looking at $30k.
Insurance will pay for a total revision with a THR.
Has anyone else on here experienced this situation, bone loss behind the cup? I'm trying to get my insurance to pay for the Tymlos but it is not looking good. Has anyone else used Tymlos and if so did insurance pay for it or were you able to get a discount on it somewhere?
Any help or info would be greatly appreciated.
thanks,  John

gray horse

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Re: Birmingham resurfacing failure after 14 years - now what?
« Reply #6 on: February 23, 2022, 02:28:24 PM »
I had Dr. Pritchett replace my Acetabular component in November, as I had the same kind of pain you are describing, weight bearing was hard / almost impossible on some days. I had a Wright C+ component with spikes that was not placed correctly. Pritchett fixed the problem, it was a bit scary as we didn't really know what was causing it until he had me on the surgery table. Before going into the OR, I said please try to save my resurfacing and he did. :) I did give him permission right  before surgery to do a THR if needed, but was  going to be heart broken to wake up with that.
It's been a slow recovery, but the pain I dealt with on and off for 16 years is gone! I now look forward to travelling and being able to walk more than just an hour, and then be crippled for 3 days! I have full faith in Dr. Pritchett, you just need to decide if you want to come out of pocket. I would really push on insurance, I mean why would you replace the femur component if that is still in good shape?
 edited to add: age 58
« Last Edit: February 23, 2022, 02:39:34 PM by gray horse »

johnieappel

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Re: Birmingham resurfacing failure after 14 years - now what?
« Reply #7 on: February 26, 2022, 11:09:05 AM »
Thank you for your story Gray Horse,  it is great to hear other peoples experiences. The only thing holding me back from having Dr. Pritchett  replace my failing socket is the out of pocket expense of $30k +. That is the cost of the component, bone graft and surgery, not even counting the hospital stay or anything else. I live in California and have mediocre insurance because of low income. I can take out a loan or get a dual mobility hip (THR) from my Dr. here, but nothing is even close to happening thanks to the slow pace of the medical system. I've been on crutches since early December and I'm just trying to be patient at this point.

 

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