Hip revision: How can I get the best recovery?

Posted by gfred @gfred, Nov 8, 2020

Anyone have experience with with failed hip revision or slow to heal?

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I had two hip replacements with metal on metal implants, then revisions after metallosis and pseudotumors, and recently developed a bump on my right hip that has become an oozing sore. The doc says it is infection and going in on June 9th to take it out and have a spacer put in for the 6-8 weeks of antibiotics. Can someone tell me the best way to get around without putting weight on it?

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@bcs123456

I am having a revision soon and have read about failures as part of my “due diligence”.
What are you considering, things like the obvious where do I go from here?

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Revisions for me were pretty easy except for a bleeder that caused a hematoma. That went away after a few weeks of Ice. All was great until the hip revision got infected. I have no pain, no fever, no dislocation, no fluid, no signs of infection by x-ray or bone scan but started as a large bump under the anterior scar that has now become a perfectly round oozing sore about the size of an eraser on a pencil that won't heal.

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@kbarun

Revisions for me were pretty easy except for a bleeder that caused a hematoma. That went away after a few weeks of Ice. All was great until the hip revision got infected. I have no pain, no fever, no dislocation, no fluid, no signs of infection by x-ray or bone scan but started as a large bump under the anterior scar that has now become a perfectly round oozing sore about the size of an eraser on a pencil that won't heal.

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I am a retired doctor/pathologist but have no special expertise in ortho other than my wife and I have seen a lot with my own case.
Have they cultured this bump/wound? Are you on antibiotics?
I had an infectious disease expert state to take me off antibiotics for a questionable wound infection with my first hip replacement so “the infection could declare itself”. Well, I still wonder if that allowed it to take hold and give me 4 years of hell alternating with some great periods. I just don’t know and don’t know if experts would agree or disagree. You don’t want an infection ever much less with a revision as our options diminish. Get a good infectious disease consult. Keep us informed and good luck.

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@bcs123456

I am a retired doctor/pathologist but have no special expertise in ortho other than my wife and I have seen a lot with my own case.
Have they cultured this bump/wound? Are you on antibiotics?
I had an infectious disease expert state to take me off antibiotics for a questionable wound infection with my first hip replacement so “the infection could declare itself”. Well, I still wonder if that allowed it to take hold and give me 4 years of hell alternating with some great periods. I just don’t know and don’t know if experts would agree or disagree. You don’t want an infection ever much less with a revision as our options diminish. Get a good infectious disease consult. Keep us informed and good luck.

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Thanks for responding. I do appreciate it. Originally when this bump presented itself on my hip and started to drain I went to my GP who put me on an antibiotic. The bump went away after he removed some of the fluid but when it healed it came back quickly and turned red and purple around the wound. When I finally went to my hip doc he kind was very disappointed that I had waited so long before going to him. He ordered a hip aspiration that produced no fluid in the joint which I thought was a good thing. x rays showed no signs of infection and I had no other symptoms. But the wound still drains.

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An infectious disease expert may need to be consulted in combination with your orthopedist.

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I've had 3 attempts at replacing my hip and they all failed. I am now without the ball and a considerably shortened leg. Is there a possibility that I can walk again without the use of a walker?

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@adamsstephan

I've had 3 attempts at replacing my hip and they all failed. I am now without the ball and a considerably shortened leg. Is there a possibility that I can walk again without the use of a walker?

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Hi Adam, welcome. You may have noticed that I moved your message to this existing discussion called "Hip revision: How can I get the best recovery?" I did this so you can connect with other people like @oregonjan @ladyelaine @gfred @cynthiaarment @bcs123456 @sueinmn who have experienced hip replacement, revision and failed revisions.

You may also be interested in these discussions:
- If you're living without a hip like me, please reach out to me https://connect.mayoclinic.org/discussion/if-youre-living-without-a-hip-like-me-please-reach-out-to-me/
- Walking without a hip joint https://connect.mayoclinic.org/discussion/walking-without-a-hip-joint/
- Living without a hip https://connect.mayoclinic.org/discussion/living-without-a-hip/

Adam, are you working with physical therapy to regain mobility?

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@sueinmn

Cynthia - It sounds like you are in good hands. After all the recalled hips between 2009 and 2013, there are a number of orthopedists who now specialize in complex hip revision surgeries. I hope that is who you have found!

To anyone else suffering a hip implant that doesn't "feel right" please listen to @psg25 - the complications of metal poisoning from these protheses is real, and can be life-altering. When my failing implant was removed, my thigh muscle was described by the surgeon as "looking like oatmeal" and it took a lot of time to recover.
Sue

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I’m replying to #itssally (I think) and someone who said their muscle was “like oatmeal”. I’ve tried for maybe 2 years looking for legal councel to no avail…unfortunately, when I had my 1st implant, it was 6 weeks after my last child (c-section) & a 2 yr old at home. Needless to say I was busy. I saw the Stryker recalls on tv, but I had no idea that they were being recalled for metal issues. The commercials said “failure”, I thought I was a lucky one…I didn’t know what model my hip was then. That was in 2004. Just had rev. due to metallosis…I had never heard of that either. So, to who said their …was like oatmeal…I had my rev. in 2020. Was never told about having blood testing for metal. I finally got the op report. It stated area around the implant was “like grated cheese”. I have no idea how long I had metal seeping. But I can say it’s done quite a bit…I don’t even know who I am anymore. My oldest left home because I’ve changed so much.
I don’t want to live like this anymore…it’s been 2 years & my mental state, not to mention all my gut issues, have not gotten better.
It’s the most helpless feeling…
I don’t even know who or what I was sending this to. I’m practically brain dead…it comes & goes at different degrees. Good luck

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@bcs123456

I have been waiting for a discussion of hip revision as I currently have an “antibiotic spacer” in and am awaiting completion of antibiotics then a new or second prosthetic hip. Any info is appreciated. My story is long and sad but I am looking frwd to a new hip. Unfortunately my spacer dislocated and I am living with that until new surgery. I love hearing about all patient experiences but someone with a revision of 10 years is nice to hear!

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I developed a hip infection five yrs. after total hip replacement. Don’t know where the infection cam from. I finished antibiotics, and had spacers eight months ago. From the beginning, the plan has been to remove spacers and place new hip. My last doctor appointment, the doctor completely changed the plan. He began discouraging me from having this surgery. He recommended physical therapy to see if I could reach a point where I am happy keeping the spacers, and not having metal hip replaced. I had no questions, as I was in shock. I just started PT, and am very frustrated. I think it will be my decision whether to keep spacers or get new hip. I need his advice, or somebody’s advice about what to do. My “normal” leg isn’t recovered strength after little use all these months. I welcome any response. At this point, I just hope to walk with a cane, hopefully. Thanks for caring!

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@cathy19

I developed a hip infection five yrs. after total hip replacement. Don’t know where the infection cam from. I finished antibiotics, and had spacers eight months ago. From the beginning, the plan has been to remove spacers and place new hip. My last doctor appointment, the doctor completely changed the plan. He began discouraging me from having this surgery. He recommended physical therapy to see if I could reach a point where I am happy keeping the spacers, and not having metal hip replaced. I had no questions, as I was in shock. I just started PT, and am very frustrated. I think it will be my decision whether to keep spacers or get new hip. I need his advice, or somebody’s advice about what to do. My “normal” leg isn’t recovered strength after little use all these months. I welcome any response. At this point, I just hope to walk with a cane, hopefully. Thanks for caring!

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This sounds odd and I need to know the doctor’s reasoning before commenting further.
I am a retired physician who also needed a revision at 5 years. These scenarios can get tricky
but there is legitimate room for hope. Please let us know the reason behind this change of plan then perhaps we can gain the insight needed to make some suggestions. Best of luck.

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