Has anyone had a successful hip revision surgery?

Posted by vkent @vkent, 6 days ago

My husband is 2 years post op THA. He's had chronic pain in hip, groin, and thigh. We've had every test under the sun to find the source of the pain. We saw our fourth doctor yesterday, and he's recommending a full hip revision surgery (including stem). The doctor thoroughly explained the X-rays and the biomechanics of my husband's anatomy. We are weighing the pros and cons. Has anyone had a successful revision surgery, whereby they would do it all over again? Is your quality of life better after surgery?

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My wife has had a total of 4 revisions due to Cobalt chromium poisoning and fractured pelvic from being dropped at rehab. 2 years out hips are no longer an issue but where they gave the epidural the disk have fractured which has effected her lower back, sometimes one feels like they just cannot win but is going to physical therapy and the gym to help strengthen her back

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My sister had a very successful hip revision done following particle disease. The particle disease (caused by the body's reaction to shedding metal particles from the prosthesis) causes damage to the bone and tissue surrounding the joint. Hers was so bad that at PT her pelvis and fibula snapped! They had to delay the revision until the bones had healed sufficiently leaving her pretty much wheelchair bound for months. Now she gets around great with a walker and at home with just a cane!

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Thank you for sharing your story. I'm so sorry she's had such a tough road!! How far out is she from the hip revision surgery? Thank you!

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I had a hip revision and iliosoas tenotomy 7 months from the first THA due to groin pain, unable to lift leg and Meralgia Paresthetica. Revision did NOT relieve any of my pain.

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Thank you for sharing your story. I'm sorry your surgeries didn't provide any pain relief! If you don't mind me asking, what was the reason the doctors gave you for the hip revision? And did they replace the stem, or just the ball and socket, with your hip revision surgery? My husband also had an iliposoas tendon release surgery last year, and it did not help with the pain. The diagnosis for my husband is that the offset on the prosthetic is too wide, causing tension on all of the soft tissue.

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@dannyandebbie

My wife has had a total of 4 revisions due to Cobalt chromium poisoning and fractured pelvic from being dropped at rehab. 2 years out hips are no longer an issue but where they gave the epidural the disk have fractured which has effected her lower back, sometimes one feels like they just cannot win but is going to physical therapy and the gym to help strengthen her back

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I am waiting to see a surgeon about a hip revision. I had a hip resurfacing 21 yrs ago and have started having pain in my hip again. I was tested for Chromium and my levels were flagged as high. An MRI did not show anything wrong with that hip.I also have my other hip and both shoulders replaced all due to arthritis. I am now hypoglycaemic which is a side effect of high Chromium and have other side effects, fatigue and tin taste in my mouth. My biggest worry is do I have to have them all removed and what do they use instead of metal, or could it be just one joint causing the problem. I read that hip resurfacing could be a bigger problem when it comes to a revision. Any input would be appreciated.

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In addition to comments here, you may want to consider a couple of these:
1. Second surgical opinion from an orthopedic center known to do many hip revisions per year (dozens probably) and ideally can tell you outcomes. Sounds as though you have second opinions, but unclear whose opinion.
2. Not directly applicable but the Danish published patient satisfaction information comparing hip replacement patients,,with patients replaced who had dislocation and a third group having dislocation and revision. Quite a few with dislocation and revision had lower quality of life, apparently some revisions are not 100% successful. If you know a medical librarian or family who can access and understand orthopedic research articles that may help provide information to assist in deciding.
I wish I could point you to an orthopedic center of excellence for revisions - I'm guessing Mayo has one however, for an opinion. I might need this sort of opinion, so please let us know if you pursue this. Best wishes.

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My wife had total bilateral hip surgery, 9 months later a revision on Right due to doctor neglect and they could not do it sooner because femur nerve was compressed on left leg; she would of pretty much been bed ridden until either nerve regenerated or right hip healed. Both! Her Cobalt and Chromium levels were elevated, Cobalt was 17.7 and Chromium was .9. Honestly her levels remained elevated right up until she had her 6 th hip surgery. Once All the metal on metal was addressed her levels went way down; this is in the course of 11 years. Total bilateral, right revision, left revision, right (completely) removed, medicated spacer due to two Staph Infections with Cobalt / Chromium poisoning and finally a completely new implant on the right side. Once Ceramic coating was implanted only then did the levels go down. Should you have an MRI and Any indication of fluid this should be addressed. There was fluid around her right hip since her first revision and her levels remained elevated until it was revised again!
One thing we learned out of all of this! Should you feel that something is wrong; be a strong self advocate until you feel heard. My wife was put on heavy doses of pain medication and constantly being told that she had to “put on her big girl panties” and stop being so dependent upon her husband. They refused to check her Cobalt / Chromium levels, so we asked her primary physician to have them checked and once we got the results her orthopedic surgeon started to listen!
I do hope this helps! Advocate!

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Thank you, everyone, for sharing your personal stories, just heart-wrenching! We have gotten 4 opinions regarding my husband's case. Two doctors in CA, one doctor in TN, and one doctor in Utah. The two doctors in CA said nothing was wrong, that the hip x-ray looked great. Something is going on given his pain in the groin, hip, and thigh region. The Doctor in TN and Utah concurred that the offset is incorrect, and possibly a loose cup, despite the 3-phase bone scan only showing slight uptake in the acetabular region. The TN doctor said the pain was originating from his back, despite a lumbar MRI that showed very little. We concurred that he wasn't interested in helping my husband. The Utah doctor said he needs about 5mm to 8mm to correct the offset, which means a full tear-out. He's done many of these surgeries, and I'm confident he can help us, but understand this is a risky surgery. We are thinking about going to HSS in NY for another opinion. After trying to find answers for the last two years, we've realized not every doctor is equipped to perform a revision surgery or just doesn't want to touch the case. My husband did recently have blood work for cobalt poisoning, but he's really not showing the symptoms of it, but at this point its worth to rule out completely.
I have done some research on Pubmed.org, and found some articles that some of you might be interested in reading. I'm still searching for more articles.
https://pubmed.ncbi.nlm.nih.gov/30535720/
https://pubmed.ncbi.nlm.nih.gov/37871856/
Despite all of the surgeries, are your spouses able to walk without a walker and be pain-free? Honestly, that's all I want for my husband is to be pain-free while walking and sitting. I don't know if that's a realistic bar.

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@vkent

Thank you, everyone, for sharing your personal stories, just heart-wrenching! We have gotten 4 opinions regarding my husband's case. Two doctors in CA, one doctor in TN, and one doctor in Utah. The two doctors in CA said nothing was wrong, that the hip x-ray looked great. Something is going on given his pain in the groin, hip, and thigh region. The Doctor in TN and Utah concurred that the offset is incorrect, and possibly a loose cup, despite the 3-phase bone scan only showing slight uptake in the acetabular region. The TN doctor said the pain was originating from his back, despite a lumbar MRI that showed very little. We concurred that he wasn't interested in helping my husband. The Utah doctor said he needs about 5mm to 8mm to correct the offset, which means a full tear-out. He's done many of these surgeries, and I'm confident he can help us, but understand this is a risky surgery. We are thinking about going to HSS in NY for another opinion. After trying to find answers for the last two years, we've realized not every doctor is equipped to perform a revision surgery or just doesn't want to touch the case. My husband did recently have blood work for cobalt poisoning, but he's really not showing the symptoms of it, but at this point its worth to rule out completely.
I have done some research on Pubmed.org, and found some articles that some of you might be interested in reading. I'm still searching for more articles.
https://pubmed.ncbi.nlm.nih.gov/30535720/
https://pubmed.ncbi.nlm.nih.gov/37871856/
Despite all of the surgeries, are your spouses able to walk without a walker and be pain-free? Honestly, that's all I want for my husband is to be pain-free while walking and sitting. I don't know if that's a realistic bar.

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I do suggest that you go to HSS for a second opinion or consult. HSS is considered the Gold Standard in Orthopedics. I went there when I had a frozen shoulder. The pain was horrendous but after getting the shot of cortisone, I was feeling almost 100% better in just a few hours. I had a total hip replacement two years ago at Massachusetts General in Boston. Had I still been living in New York, I'd have gone to HSS. What I usually do is research all the doctors first before making an appointment. Read their bios. Read their reviews. I chose a doctor with a near perfect rating and I'm sure the doctors at HSS are all pretty much extraordinary. Do it. Get it over with. Find out once and for all what's going on. Good Luck.

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