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?

@amandajro

Hello @bcs123456 and welcome to Mayo Clinic Connect and this discussion. I can see you feel hopeful after having read the post by @sueinmn about her 10-year post surgery update. It sounds like you have had quite a journey but are also really looking forward to a new hip, which is a great attitude.

What are you most curious about or in need of in terms of support from members?

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I really appreciate this site. As I commented previously, any and all info about hip prosthesis revision surgery is appreciated and strongly desired. My infection was discovered 4 years after my original surgery, but it seems clear it was infected shortly after the original surgery. It sounds bizarre in retrospect, but I had numerous episodes of fever and night sweats, pneumonia and extreme pain alternating with periods where the hip felt really good! Anyway, I am currently faced with a dislocated spacer while on antibiotics but trying to be positive and find hope I could get a second hip and do well. Currently contemplating if second surgery a success, what are my legitimate expectations? I am 63 yo and love to golf and swim and walk with my wife. Anyone with any info would be great. Thanks.

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Please see my comment below. How are you doing?

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@bcs123456

I really appreciate this site. As I commented previously, any and all info about hip prosthesis revision surgery is appreciated and strongly desired. My infection was discovered 4 years after my original surgery, but it seems clear it was infected shortly after the original surgery. It sounds bizarre in retrospect, but I had numerous episodes of fever and night sweats, pneumonia and extreme pain alternating with periods where the hip felt really good! Anyway, I am currently faced with a dislocated spacer while on antibiotics but trying to be positive and find hope I could get a second hip and do well. Currently contemplating if second surgery a success, what are my legitimate expectations? I am 63 yo and love to golf and swim and walk with my wife. Anyone with any info would be great. Thanks.

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Attitude can be huge when facing a challenge like yours. I do hope they can replace your spacer – some wonderful adaptations are being made now that so many of us are living with implants at a relatively early age. My "new" hips are about to celebrate their 11th birthdays, and I can do just about anything reasonable. With my grandson, I discovered this winter that I can still climb steep snow piles and slide down, and even climb trees. Twisting motions (eg golf swing) are still a stretch for me, and at my doctor's request I quit playing volleyball due to repeated jumping, but I can walk, run, dance, garden. Now my knees are beginning to announce their age when I overdo, but nothing I cannot tolerate.
Good luck, and I hope they find a solution for you. Remember, after surgery, thorough PT with gait training is crucial to fullest recovery.
Sue

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Thanks lady! You had a revision to one of your hips first prosthesis? I will miss golf but could do an arm only swing if necessary. I will do my best with rehab. I am living with the dislocated spacer as I have no confidence it won’t come out again if fixed. Thre is no acetabular cup with the temporary spacer. However, I am anxious for the new hip to be put in. My best to you and thanks.

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@ltsally

My husband's was a Wright Hip Implant and every lawyer he has talked to has said the statute of limitations means no legal recourse. Bummer. His implant was in 2007 I think…. and he had the revision this past March.

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Sorry to hear about the statue of limitations running out on your husband's hip. That's why I said I wasn't sure what the legal ramifications were. I didn't see WHY your husband had his hip replaced. Was it RECALLED due to an manufacturing defect or did he have a reaction to the metals over time?? I believe that is called a "Delayed Hypersensitivity to Metals." A "Delayed Hypersensitivity" would probably not be an issue you could sue over. If it was RECALLED, when were you or weren't you notified? And then if you were notified, how long after his original surgery? Seems to me if the hip had problems with its manufacturing they should still stand behind it. Although, if he originally received it in 2007 and he started having problems last year, that would be about 14 years, falling close to the low end of the specified life span of an artificial hip. My first knee replacement only lasted 15 years before I had a second replacement.
I had my original hip implanted in 2009 and it was RECALLED in 2012. I actually complained to my physician long before 2012 that something wasn't right. I finally had it replaced in 2014. My doctor actually made me wait until my poison levels reached HIS desired levels before he would finally replace it. I actually had to fight it out with him. I told him the levels were high enough for me and to get it out of my leg. I guess he was following some established revision guidelines from the manufacturer but him making me wait was just ridiculous and almost killed me. Had I had a better understanding of what was happening to me at the time, I should have sought out a new physician and had the revision done earlier. I did have about 6 months worth of trouble with my IT band after the revision. After that, fortunately everything worked out and I haven't had any additional problems with my hip. My challenge now is an unresolved, severely painful, knee replacement, 21 month outs. I cannot find a physician who wants to play detective with me to figure out the problem. Seems like its always something with these artificial joints . . .

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@bcs123456

Thanks lady! You had a revision to one of your hips first prosthesis? I will miss golf but could do an arm only swing if necessary. I will do my best with rehab. I am living with the dislocated spacer as I have no confidence it won’t come out again if fixed. Thre is no acetabular cup with the temporary spacer. However, I am anxious for the new hip to be put in. My best to you and thanks.

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Actually both prostheses have been replaced, one of them twice. The first round of rebuilds was a recall due to metal poisoning. The last tweak was to put in a bigger ball because the darn thing dislocated- sitting in a chair! Now they're great. Just dod 9 hours of gardening and mowing today.
Sue

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@amandajro

Hello @cynthiaarment and welcome to Mayo Clinic Connect. It sounds like you may have went the route of attaching a prosthesis. Is that right?

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Still trying to figure out which route is best. Total revision or attaching a prosthesis.
My hip resurfacing was in 2006. The metals have entered my femur and it is at risk for fracture.

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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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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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