Dislocation at 11 months post-op

[ruraldiy]

Hi...I'm new to this forum...is this forum connected to the old Yahoo surfacehippie forum?

In any case, I had returned to the level of exercise I was doing pre-op and before becoming dysfunctional hip-wise.  I can(could) bend over and touch my palms to floor, put on socks easily so had good flexibility and RO.  The tendancy for my knees to "fall in" (abduction?) toward the midline at odd moments was still present and I knew I should have been doing exercises to address the ab/adductors.  So, after chain sawing some logs with jeans and heavy workboots on, I unlaced the boots, stood up, picked up the boots with my left hand to place them out of the way under a coffee table.  After bending at the knees, i shifted my left knee toward the midline (boots in left hand) and it went further with much twanging of tendons in the front of my left pelvis.  I tried to straighten up but it was clear the left hip was stuck.  After being transported to the ER 1 hr away and having it "located" I was fitted with a brace and told by the on-call OS that I should wear this thing for 2 monthes.  He wants a big scarring on the rip in the capsule which he assumes is there. 

My questions are:  1.  How long does the capsule take to make the "big scar", 2.  Since they can't see the capsule on x-ray is it really torn?, 3.  Do other surfacehippies have the twanging of tendons over their replaced parts when they exercise heavily or bend/stretch?, 4.  Have I really screwed up this time and weakened the resurfaced joint?

Linda Dickens, Dr. Barrack, 9/19/06, bilateral BHR.

[Pat Walter]

Hi Linda

I am really sorry to hear about your dislocation.

This Discussion Group is not part of the Yahoo Surface Hippy Group http://health.groups.yahoo.com/group/surfacehippy/  That group is part of the Yahoo Websites that host free discussion Groups.  There are over 6000+ memebers. I think it might be a good idea for you to join it because you will find a lot more people to talk to there.  There have been a few dislocations of BHRs, but not many.

This group is part of my personal website http://www.surfacehippy.info  A lot of the info I post is from the other group.  I do get permission before I post anything.

I started this group as a smaller, more personal group, but there are only 76 members right now. I just started it a couple months ago.

I would talk with your doctor that did your hip resurfacing. This sounds like a serious problem that needs to be addressed by a doctor that understands hip resurfacing.

The one case I knew of was when  fellow was doing exercises and jerked his knee to his chest fast and hard.  I don't remember how many months post op he was.

I would hope things would heal, but I certainly would want a doctor that does hip resurfacing to talk to and look at the x-rays, etc.

I also am not sure if all the hip resurfacing doctors keep the hip capsul.  I know Dr. De Smet and Dr. Bose do, but I think I read somewhere that not all do. That is a question you need to ask your hip resurfacing surgeon.

I hope you can find someone on the other group that might have had a similar experience, but I don't think there have been very many. Again, I hope things work out for you. 

Pat

[Vicky]

It sounds to me like you duplicated the movement done with dislocating your hip during surgery.  But I don't think I have heard of anyone that has had their leg just fall into the midline like that.  Did you send your x-rays to Dr. Barrack and get his opinion?  I would not just listen to any OS that doesn't have resurfacing experience on this.  Find out from your doc what you should do.  You probably need to start some aggressive PT once this heals up.  It is supposed to be just as difficult to dislocate a resurfaced hip as it is to dislocate a normal hip.  But, I guess once it has been dislocated, the body has excellent memory and if you follow the same movement, it can happen.  But I would think it would only happen with a lot of force.  It doesn't sound like you caused a lot of force for it to dislocate.  Maybe you should send your x-rays to one of the top resurfacing surgeons to get an opinion?  I would recommend Dr. DeSmet in Belgium, he has fixed a lot of surgeons mistakes.  I am not saying your surgeon made a mistake, but it wouldn't hurt to get another opinion.

Vicky

[ruraldiy]

I've contacted my OS, Dr. Barrack, and he'll get the x-rays and follow-through.  It was a duplication of the movement done in surgery (as I understand it).  Should that be avoided? Should it still be weak at 11 months?  The metal parts seem to have good bone ingrowth and are stable...so maybe there are precautions that I will have for life?  or maybe there are exercises that I didn't do for the ad/abductor so they're still weak? 

Thanks for the comments to both of you...

[Pat Walter]

Hi Linda

It does sound like you are going to have to be careful for awhile.

Please keep us informed about what you find out.  It might help other hippies in the future to avoid problems, too.

I sure do hope you can do some exercises to improve you weak hip. After all, that's what we all get hip resurfacings for - so we can do anything we want to. That is one of the biggest selling points of the surgery.

Good Luck.

Pat

[ruraldiy]

I have a followup appt with the ER Doc that did the reduction tomorrow and have a list of questions for him.  One of the frustrating aspects of this is the "one of a kind"..."never seen this before" one.  No dislocations of BHR patients exist that I can find except those that happen immediately after surgery and there's parts movement.  No one has both hip and knee replacements that are reading/replying to the forums.  No one has experienced the invloluntary knee rotation post-BHR...nor the involuntary knee collapse(just an inch and it catches itself) post-replacement.  The Doctors and their people even tend to make lots of assumptions and jump to the wrong conclusions generally...the story to my BHR OS was that I fell.  The ER guy who also does BHR's but is really a newbie to it wanted the "capsule" as "God" intended.  What does this mean??? 

As a retired computer systems person, the fuzzy thinking (not the technical "fuzzy") is really disturbing.  This isn't rocket science and it's not religion...just body mechanics.

OK...I'll quit now...but will get back on this forum as I progress because there have to be other people out there with the same problems...if not it needs to be documented somewhere.

Linda, Bilateral BHR, Dr. Barrack, 09/06, 66 years old.

[Pat Walter]

Hi Linda

I agree with you that your dislocation problem should be posted and shared with others.  One reason many of us had the hip resurfacing was because they are not supposed to dislocate.

As I said before, I only remember 1 other case in the 2 years I have been on the Yahoo Surface Hippy Group.  The posts there get buried and it is very difficult to ever find them again.  That's why I started my website.

I will think about how to make an article about your dislocation and post it on the regular part of my website.  Of course, I hate to tell anyone that their hip resurfacing could dislocate, but it is a fact and should be faced and understood.

I will send you the link when I get the page up and running on the website.

I would appreciate any further input to complete the story. I am thinking of writing to Dr. Bose with your story to try and get a very experienced doctors input about the dislocation.  He is good about letting me post articles and always says he will help if possible.  I will let you know about it when I do.

Meanwhile, I wish the very best for you.  Thanks for sharing. It might make some newbies a little more careful about the excessive exercise some of them do.

Pat

[ruraldiy]

I think a page on this dislocation might be useful to others.  I was sure led to believe it was virtually impossible to dislocate.  My stretches were to the point that I could place my palms flat on the floor with straight legs...always been somewhat limber but I had returned to that level of ROM.

Two other things that could have had an impact on this dislocation were; 1) my heavy exercising on a recumbent bike to the extent that my quad was sore on that side, and, 2) that I live on a ranch and don't have access to a good walking surface as in a town so haven't done the walking others have probaby done.  That may account for the that involuntary hip rotation/weakness.

That other surfacehippy forum has too many people on it I think...this is welcome and thanks for starting it.  They may want to subdivide into age groups or some other functional subgroups over there. 

Lastly, I got an email about a Smith&Nephew (Birmingham) recall due to mislabeling the acetabulum sizes.  It came from the UK and was in the BBCNews...it wasn't clear how many resurfacing parts were affected vs THR parts...may be the same acetabulum part.

[Pat Walter]

I wrote to Dr. Bose and am waiting for a reply about your dislocations. I thought it would be good to have some input from an experienced doctor about the situation. I doubt your doctor would be willing to write one for the website. But I guess you never know. 

Yes, the other Yahoo Surface Hippy Group is very large.  I get very tired watching the over 100 emails a day looking for new stories and information.  It takes a lot of reading. I always ask for permission before I post anything from the emails over there. 

Sometimes new people post and just never get answers because someone doesn't take time to talk to them or just doesn't see the post. So I am hoping this new forum will be helpful to people even though it is much smaller.

The Smith and Nephew BHR recall is very interesting and makes a person wonder if you might have a mis-matched set in your hip which might have caused the problem.  Just a little too loose to do the job properly.  I certainly hope not.  I imagine that have all the serial numbers of the acetabular cups involved.  I have the serial numbers of mine.  I imagine you do too. It was given to me as an ID card by Dr. De Smet.  I always carry it with me in case I had an accient and needed a revision. At least the ER surgeons would know the size of my acetabular cup to match it with a new thr femur bottom.

I will have to watch for more news about the recall.

Thanks for sharing.

Pat

[Vicky]

Did you get the email actually from Smith & Nephew or was it just a news bulletin that you had signed up for?  Just curious if they are notifying the recipients of the bad batch.

Thanks,

Vicky

[Pat Walter]

Here is a link to the BHR recall by Smith & Nephew

http://www.hipresurfacingnews.com/archives/88-BHR-Recall-by-Smith-Nephew.html

It says: The mismatched pieces can cause the implant to fit loosely, the MHRA said. Doctors should review post-operation x-rays to see if patients have improperly fitting implants, and consider another operation, the agency said. Unused products should be returned to Smith & Nephew, the agency said.

Could this possibly be your dislocation problem? You could be the first BHR lawsuit in the US.  I can't imagine having to have a revision because of a acetabular cup that is too large. 

I certainly hope this is not what caused your problem.

Pat