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Pain in hipa after METALLOSIS due to implant.

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Hi my name is Dan, I'm a 55 year old male that used to live a very active life and I live to hunt and fish. I've had a THR in my left hip in February 2013 16 months later it was discovered the cup had moved so far it was rubbing against the stem (started squeaking) when they opened me up the cup had worn a groove in the stem and I had Metallosis and in their words had to cut out the grey meat. It took the doc 3.5 hours to get the cup to come out and when it came it took most of the socket bone and some of my pelvic bone with it. The plastic in the cup was also shattered sometime before surgery so they had to pick out plastic pieces, who knows if they got them all. I was in terrible pain before the surgery and I'm still in terrible pain after the surgery. The revision took place on June 17th 2014 and I'm pretty much bed ridden. We have our building permits to build our dream home in northern WI, we have a buyer for our house but I need to get fixed before any of our dreams can come true. My wife and I worked very hard to retire at 55 but my work has told me to get fixed and back on my feet then retire which is very nice of them. My pain is in 3 places, my butt bone on my left side feels like I got hit with a sledge hammer, I can't sit on it for any period of time without increased pain, the top of my thigh the best I can explain that is I feel like someone has driven a spike down the center of my femur (which they have) and I have groin pain that bites me all the time and it runs down the inside of my leg not quite to the knee. The pain is unbearable, my chromium and cobalt contents are in the red and Mayo Clinic in Rochester has taken me on and wants to do another revision but the doc is so busy they can't get me in till June 24th 2015 for the surgery, there is no way I can make it to then so I called the University of Minnesota and I see a specialist in hip reconstruction April 30th and I'm praying he will also want to do surgery but immediately. I would like your opinion on what might be going on. I can get you surgical notes from the revision, reports, bone scans, x-rays you name it if it helps foryou to understand the problem. Also in the last 6 months they have conducted 3 hip aspirations looking for infection and everytime they have gotten a syringe full of orangey reddish fluid out but the test's come back negative, but the doc still isn't ruling out infection but the doc that did the aspiration made the comment that there's defiantly something going on in there because of all the fluid. They've done MRI's, CT scans and bone scans and it appears the bone hasn't grown to the cup and the bone is also growing back funny. They never replaced the stem during the revision and I want it out of me. Could that stem be what's causing some of my pain? The doctor that did the revision had never done one before I was the first and I think he bit off more than he could chew that's why I'm going to a specialist on hip reconstruction and also because he had told my wife after the surgery that if he had to do another revision he didn't think there would be enough bone to do it. This all scares me to death, the pain is unbearable I'm afraid my leg is dying inside and I could lose it. Could anyone there offer advice on what else we should be looking for before my appointment at the U next Thursday? I have to get rid of this pain and get my life back! If you would like anymore reports or x-rays, bone scans etc. just ask. Thank you for your time!

Category: Orthopedic Surgeon

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Category: Spine Surgeon
 30 Doctors Online

Hello,
Thanks for your query at DoctorSpring.com
I want to explain some details which will help to understand answers.
Our hip joint is supplied by some nerves who share the sensory supply with area over anterior and medial aspect of thigh. Swelling of joint capsule may irritate the nerves which can lead to irritation of the nerve and this irritation of sensory nerves at anterior and inner aspect of thigh.
Going through your details it looks that you are having a severe intra-articular reaction with implants wear and feared particles.These particles have initiated an inflammatory reaction in the joint which is leading to intermittent swelling at your hip joint and thus pain at your thigh, groin and other area f hip.The pain at the back of hip is also due to loss of bone during surgery.Your previous surgeon did good try to give his best for you.
In such cases, good debride meant of joint with revision hip surgery is the only answer.
Hope this will help you
Feel free to discuss further


Patient replied :

OK just one more question with all that I've told you about where the worst of my pain is I also have been experiencing more and more pain in that same leg on the outside top of my calf just below my knee the pain runs downward just a few inches and seems to be like where that tendion is. Could that be from my hip as well? And by the way you have been a great help with helping me feel we're doing the right thing to go in and do surgery and start from scratch. I believe when the doctor gets in there he's going to find a mess.


Hello,
Welcome.
We have learned during our academics and with clinical practice that if a person having the hip pathology then this can be referred in knee.This pain at knee and near knee may be due to hip problem.This can be also due to gait problem arises due to hip pathology.
Regards.


Patient replied :

I had a hip aspiration last week and they got out about 9cc of bloody cloudy fluid and my Mono/Macro Fluid was at 93% and Neutrophils Fluid was at 3% and Lymphocytes Fluid at 3% WBC was 300. I had a hip revision a year ago and I've been in terrible pain since and I'm due to have another revision in June, the doc just decided to do another aspiration, I got the numbers off my patient portal but they don't give the normal ranges of these fluids, whats your take on those numbers? And could it have something to do with my pain?


If there is less then 300 cumm of WBC then there is no need to worry.It looks to be traumatic aspiration.
Regards.


Dr. Mukesh Tiwari
Category: Spine Surgeon
Experience: 
Fellowship - Khandaka Hospital, Jaipur
Residency - MS, Rabindranath Tagore Medical College, Udaipur, 2000
Medical School, Internship - MBBS, SMS Medical College, Jaipur, 1995
Dr. Mukesh Tiwari and 4 other Medical Specialists are ready to help you

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