revision due to stem looseninggreenspun.com : LUSENET : About Joints : One Thread
This is a fantastic site...wish I had known about it before my first replacement. After suffering for many, many years and being diagnosed with CHD (bilateral), had my first replacement (June 2000)at age of 35. Shortly after operation, began experiencing sensations of "grating" within the joint, extreme pain (enough to make me cry), and radiating pain throughout the thigh. Following three doctors, three bone scans, two years on narcotics and a growing desparation and depression, my third surgeon discovered the stem had been loose that entire time. Evidently, the bone had never bonded to the stem, not one bit. The surgeon explained to me that the stem that had been used was of a smooth metal surface with only the top quarter of it having grooves. My revision (done in May 2003) used a stem that was grooved the entire length and porous to enable the bone to grow and attach to it more easily. It was also placed further into my femur to be anchored. At 6'3" for a woman I posed a challenge for my first doctor to maintain similar leg length. I am wondering if other people have experienced hip replacement failure due to a smooth stem being used and therefore, the bone never attached. This did result in tremendous bone loss and a trickier revision. The jury is still out on the revision almost 6 mos. since surgery.
-- DeAnn Major (WthrngHite@aol.com), November 22, 2003
I am curious as to the exact etiology of your CHD- did you have coxa vara by any chance? I am 43 years old and have had both hips replaced within the past year due to advanced osteoarthritis caused by the hip dysplasia. Both of my surgeries were quite successful and I gained one inch of height overall after both hips were anatomically corrected in position. The problem I have is that both hip joints "jiggle" in the sockets and try to pop out of the joint when I step away from midline. This popping is audible and palpable as well. I have found one other gentleman on this site who has the same popping problem and his surgeon suggests it is due to the neck of the prosthesis hitting against the acetabular component. I explained to my surgeon that it feels like the muscle imbalance in my body is trying to torque the prosthesis out of the bone. After all, if your body had adapted to hips being in a certain position your whole life and then suddenly the hips are moved to a new and unfamiliar position, then everything will be out of whack from your neck down to your toes. Perhaps in your case, this torquing action is not allowing the bone to seat itself in the femoral shaft properly. I take Fosamax to grow new bone since I had two uncemented prostheses and I try not to strain my hips too much. I have not returned to work after one year (the second hip is only 7 months old) and I still have extensive physiotherapy and pool aquatic therapy four times a week. I have a really swingy gait (picture Charlie Chaplin meets Quasimodo) but the muscles are slowing developing- lots of hard work! Did you have both hips done? How is the other one? I just breezed through both my surgeries so I really feel badly when I hear about other people that have problems- I feel the benefits far outweigh the inconvenience of having to learn to walk all over again. I would be interested to know your circumstances before surgery, since my surgeon and the other gentleman's doctor cannot offer any helpful answers to our problem. I am attempting to help my surgeon find the cause so that we can write an article about the condition (coxa vara) and the treatment (it is quite a rare condition and I have only heard of 2 other people who have had it). Let me know if this makes any sense to you and perhaps we can help each other and the surgeons too.
-- christina delottinville (email@example.com), December 08, 2003.