Replacing Joints

I have so much on my mind and not sure where to start. I guess I'll start from the very beginning. When I was 23 (I'm now 27) I was told I would need my right hip replaced because I wore all of the cartilage out in the hip and was walking bone on bone. The doctors could not tell me why this had happened because there was no injury and my blood work came back negative for RA. 2 years were spent going to different doctors to try and figure out what is going on with my body and 2 years of no answers. The main answer I would get was that I was to young to be having this problem and that I was only looking for pain meds. When I was 25 I could no longer take the pain of the bone on bone grinding and told the surgeon to replace it. I am a Apartment Manager so my job is very physical. While x-raying the hip before surgery he came back in and said well I'm sorry but the left hip will need to be replaced as well. It was a shock and alot to take in at 25yrs old. The left hip still had some life left in it so I decided to just take care of the right one. The surgeon suggested that he wanted to do a new style of hip replacements called Hip Resurfacing. It was designed for younger people and they would not have to cut the head of the femur off and put a rod in place of it. They would just grind off all of the bad parts on the head of the femur and put a ball shaped cap over it, put a new socket in my pelvis and thats it. It would save bone for future hip replacements. A normal hip replacement only last 10-15yrs before its worn out. So on 2/20/09 I had it done. I was very scared before the surgery because it was major surgery and not knowing what to expect. Everything went well, 2 blood transfusions and I was home from the hospital in 5 days. When I started my PT I started to feel a "click" in the new hip. I was told it was normal and it was just things inside my hip starting to streach and get use to the new joint and it would go away. 6 months after I went to my surgeon for a follow up and told him that the click has not gone away and the hip still hurts about as much before I had it replaced. He didnt say much and I get the "Well your young" deal. I went back after a year of having the hip in me and talked to the surgeon again. I told him that the hip is still clicking and now its squeaking and I can feel it grinding. He x-rayed it and said well everything looks great inside and I dont see anything wrong with it. I told him I was in a large amount of pain and yet again I get the "Well your young" deal. During this time I wore the left hip out to the point it was bone on bone. In early Feb of this year I went back to the surgeon to have the left hip replaced. I told him that I was still having alot of problems with the right hip. He starts to tell me that there has been a recall on these style hips, all the symptoms I have been telling him over the past 2 years were signs of it failing. He said they have to do a revision surgery on the right hip...meaning take out all of the parts they put in me and this time do a total hip replacement. He also went on to say that revision surgerys are never good...meaning that even thought they are replacing it again with new parts, the pain im in now with that hip will not go away. They wanted to replace the left hip first before they did the revision on the right one so on 3/2/11 I had a total hip replacement done on the left hip. While in the hospital and doing my PT the left hip started to click...Im like you have to be kidding me. I know its to soon to be thinking that this one is going to fail because I am not even 2 weeks out of surgery but its following the same path as the right one did. I was told again that its normal and will go away. I dont even know what to think if this one fails in 2 years. I can only have so many hip replacements before they cant do them anymore because there is no more bone to work with. The doctors talk to me like im almost making it up and not to worry. Well thats what they said last time! I'm 27 and in 4-6 weeks I will be having the right hip replaced again.... It truly does feel like I am having years of my life taken away from me. I would think the doctors would show some more sympothy because of my age but not really. People keep saying to stay positive but its hard to be and its even harder when I can feel the brand new hip starting to click and having the feeling that its going to follow the same path as the right one. I just dont know.... I'm sorry this was alittle long but I just needed to vent some of it out...

I would both get a lawyer and another surgeon. You should not have had those problems for two years with the doctor lying to you and making it look like it was your fault, etc. I would not let the same surgeon who wasn't helpful and screwed up in the first place operate again on the other side!

I'm so sorry you are having these problems; my husband's ex-wife has had problems with hip replacement too (her "new" hips keep popping out of their sockets and the replacement parts were put in backwards for one at one time!) and I know it is no fun, even when it goes well. But you shouldn't have to put up with continuous misinformation and bad experimentation, just because you are "young" (what does age have to do with the fact you have a problem!).

Before I set the date for my operation I went and saw the surgeon who replaced the right hip. He told me to go and see a Revision Specialist about taking the right hip back out and replacing it again. So I went and met with this other surgeon about doing the revision. The Revision surgeon is the one who just replaced my left hip...so it was a different surgeon. I went to PT yesterday and did everything they had me do and while I am starting to walk out of the building (I'm walking with 2 crutches) every step I made with the left leg...click, click, click. I know its still way to soon to be getting all worried but this one is following the same exact path as the right one. But it hurts so much and I am sure everyone here knows that pain messes with your head and how you think. The right hip hurts all the time.
I do have a large law firm working on all of this for me and I have been reading online about all of the hip recalls, the revision surgerys to fix the problem...and reading about that, talking to the surgeon, and my PT, the revision surgerys are always a mess and dont relieve any pain and it could get worse. Its so hard because I dont know what to think, who to believe. I have been raised to be a worker and I enjoy cutting down trees for firewood, splittling wood, building things...I enjoy working with my hands and I like the physical part of doing all of those things. I feel like I am having my life taken away from me and am being forced to consider sitting behind a desk all day. That isnt who I am nor what I want to do.
Alot of doctors think well your young, and your just here looking for pain meds. Well you walk bone on bone and tell me how you feel. You walk on a replaced hip that is failing and you tell me how you feel. Anyone living with rheumatoid arthritis will tell you it hurts. I already have it in both wrists now also. Everything seems like a constant struggle!

I see you are from ny -- I am also from NY and just had both my hips replaced and in the near future will have both knees done --- also having had difficulty with pain and walking since my mid teens.
I saw several surgeons before I chose Hartzband ---all they do is hips and knees replacements and now 6 months after having bot hips replaced I am extremely happy -- no pain, walking for miles (before i could barely make it 1 block)
Hartzband is in Paramus NJ if you are looking for a 2nd opinion

When you had your hips replaced, did yours give you the feeling of a click when you walked? I had one surgeon say its normal and will go away, another say its not normal. I take it that your hips are not the ones that have been recalled? My right hip is recalled and I have large amounts of Ion particals in my blood and that is because the hip is metal on metal. My left hip is ceramic on plastic. When the right hip clicks it feels like a very solid click or clank...like to peices of metal hitting together. When the left hip clicks its a very hollow clunk and the only thing I can think of describing it is if you were to tap a ceramic jug. So Im not sure whats going on with the left one just yet.

sorry to hear you are having problems with your right hip bryan...that doesn't sound good on a number of levels, especially with ion particles floating around in your bloodstream...and the clicking is NOT normal...I have been doing a lot of research about this (for my own hip replacement) and the things I have been reading have all said clicking is NOT a good sign at all...it is like the bone on bone affect...and the only thing I can liken it to is when your brakes are grinding because you have let them get too worn down and they sound like metal on metal (which is what they are) and it wears them down so far that eventually there is nothing left of the brake, the rotor, etc., and so you have to get the whole braking system done, which means major repairs/replacements/etc. If you need a second opinion, and I would suggest you do need it, find a dr that specializes in hip and joint replacements. He/she will be able to tell you what is going on, and what needs to be done...you don't want the metal on metal to go on too long because then there won't be anything to work with. Hoping you will find what you need.

Jewels

Shoot, am I glad my surgery is a core decompression: for now. But the pain is worsening, my surgery isn't scheduled until April 15, and now he thinks that the Avascular Necrosis has possibly progressed to joint collapse, from what he put at Stage II just three weeks ago, when I saw him on March 9th. Stage II to Stage IV in three weeks? Just my luck! But do anything at all for pain-oh, no-that's too much to ask of anyone...I get that they need to minimize it before surgery to control it after, but this is absurd. But at this point, what the heck... I can't say I have much faith in many of the docs in the medical community these days...there's a few decent ones out there, but for the most part, they've either got their heads up the insurance company's butt, or the FDA's.

But yeah, that's rotten luck with your hip-and I agree: get a lawyer and a new surgeon-limp away from that moron as fast as your bionic body allows!!! To imply you somehow are responsible for your body's own betrayal, because you're young??? He really is a moron! Not to mention insensitive and a bunch of other things!

They're going to try and move my surgery up from the 15th-and I hope they can. Otherwise, I may see you at physical therapy rehabbing it from a new hip myself! Nice way to end the week! And it's gonna be a good weekend, but the weather is supposed to be decent, so maybe I can park it outside for a bit. I'm supposed to "rest it." Like is there something else I can do? You mean the NYC Marathon is out this year? Doggone it-I was really set on that!!! LOL..

Group hug anyone?

The doctor who replaced my right hip was a joint replacement specialist. The surgeon who just replaced my left hip is a revision specialist. It makes me a bit nervous because I have been with my original surgeon for 10 years now and he said that he would be replacing my left hip..not the revision specialist. Everything now is going to the revision specialist and my original just seems to be backing out of the picture very slowly. I just feel so lost in all of this, I dont know whats going on and they dont want to give up much info on the subject. And I dont know who is at fault for any of this. It does feel like they just took years away from my life...I can only have that hip replaced so many times before I am at the end of the line.

Bryan,

Not if you had about $100K laying around...there's hardware out there (a more "financially sound" friend of mine, at the time, in his 40's also...granted, thanks in part to his daughters' settlement to a shooting of which he was a victim [long, ugly story] they split the cost with him) that is hard, ceramic hardware that can be used, but even 15 years later, the FDA calls it "experimental", thus giving the insurance companies an excuse, even in younger patients, an excuse not to pay for it; and he had his right hip, I believe, replaced with it. The average life expectancy of this so-called "experimental" hardware is about 30-35 years. Fine how even in younger populations, we're not "entitled" to a longer life of the replacement. Their feeling after yesterday is my surgery, albeit as uncomfortable as I am, is my surgery can waiit until April 15.

I've made some "adjustments" in who is responsible for my health care. The orthopedic surgeon is staying on, but I have fired my PCP and my PMR doctor-the doc previously doing my prescribing is going to resume my care when he signs off Monday morning. Enough is enough and it burns my butt.

I'm sorry for your situation--still make sure you find out if it's a DePuy. There's a class action lawsuit involved and it may help you recover some damages; but not the bone that's been cut out; but something is something. Here's the link I found to the announcement:

http://www.transworldnews.com/NewsSt...=712780&cat=10

As with anything, there's a statute of limitations with anything: usually 2 years from finding about the injury or "violation." So, if you are interested, and I would be, but I'm not you, of course, I'd recommend looking for an attorney...I believe there's several national firms involved. With the disability this is causing, and further disability it is likely to, I'm sure the ambulance chasers would be happy to "help." Don't let them charge more than 40-45%. They do have considerable expenses; medical experts who are willing to testify are not cheap, and so forth, but anything more than that is highway robbery.

Good luck.

Im not 100% sure what I have in me. I have papers from the surgeon that he gave me a month before surgery (2 years ago) that said he would use DePuy. I also have papers that say Richard Birmingham and after some looking around online that is made by Smith and Nephew. I did give all of my info and medical records to a law firm and yesterday they sent a letter back (with my records) stating they could not pick up my case. They did not say why. I know in other countrys they are pushing for a recall of all metal on metal inplants and now the FDA is starting to look at that also. Back to square one! Again

That sounds weird that they wouldn't pick up your case; likely though because of of the "Birmingham Papers." Good to know. If my hip ends up replacing; I won't allow them to use either.

Sorry-I don't know what to say: rotten luck seems to fall so grossly short of what this has done to you. Other than maing sure you hae a good Pain Medicine clinic on your side, I guess I don't have any "sage advice," but hang in there, know you aren't alone.

It's funny how a doctor's opinion is forever changing. Mine isn't: I hate them in general. At this point, the doctor is going to have to work dang hard to earn my trust, let alone any faith I have in them.

I trust my orthopedist, but yesterday I fired my PCP and my PMR doctor (my psychiatrist is going to resume prescribing) so no matter that the jerk is now out of my life, as with the PCP. Guess how well I slept last night and relaxed I am today? I don't feel the level of stress and anxiety I have for the last few months. The clinics I use have one with PCP's O cam go to; they can assign me to whomever--I don't care since I do't plan on them sucking the life out of me, so I won't be going uless my temperature is 104....lol, but with all the stress, it's not been worth it. Sad, but unfortunately true.

Now I can relax this weekend!!!

I'll have my surgery on the 15th and do the rehab, etc, and only the post op visits required of me. But otherwise, I am done with doctors-except if I need an antibiotic: but even there, my dentist gave me a bottle of 100 capsules of amoxicillin that's good until Dec 2013. So even then-I probably can stave it off for a while. As an RN; I know: complete 10-14 days, take them four times a day, don't miss a dose, and make sure it's not the flu: and I know the difference between when it's a cold, and when it's greenish/brown garbage I cough up, and clear, uninfected, viral stuff. So it's gonna be a long time before I go again.

Sad, huh? Good for me, sad for them!!!

Im not sure if it was because of the Birmingham papers or what? I saw my surgeon on Monday and from what he said all the info they are getting on all metal on metal replacements is coming from over seas. No one really knows what to do with these things, they dont know if there is a "safe level" of ions that can be in your body. The way the surgeons see it is that all metal on metal replacements are pretty much made the same no matter who makes them and they are starting to stop using them all together. Its only going to be a matter of time before they are all recalled. And speaking with the surgeon about replacing it again he said that because I had a hip resurfacing done on the right hip, when they replace it again with a total hip there is a very high chance I will lose some mobility. He said that if I had a total hip done the first time it wouldnt be a big deal to replace it again. Hes afraid to take it out and being 27 he doesnt want to see me loose my mobility. So hes telling me to wait. I dont know if that is the best decision to do...?

Sheesh, not an easy decision!!!

I wish I had some "words of wisdom," to swing you one way or another...but I have a friend who did fork over the $35K and get the hard ceramic about 10 years ago; when he was in his 40's (he was shot, and the bullet richoceted around in his gut, shredded that, and then lodged in his hip, shattering the entire joint; forcing a replacement...but initially, his condition was obviously so critical--he was listed as "extremely critical" for two months we didn't know from day-to-day if he'd survive; I got to be friends after providing his pre-hospital care as an EMT in my nursing school days, but he had access to the funds because of a settlement resulting from the shooting); and I called him last week to ask how his hip is holding up, and he said he had no pain, great mobility; and that there appears to be no wear and tear on it at all: it's made of a cemented-type hard ceramic hardware: like your doc said-no metal at all.

The innate problem with any kind of metal implant is essentially twofold: First, your body sees it as a "foreign invader" and the immune system; as with any "transplant" it will begin to reject, but releasing large amounts of immune cells; as well as red blood cells-which leads to clotting. Clotting leads to "pulmonary embolus" or blood clots in the lungs (very deadly), heart attack (if the clots end up in the coronary arteries), or stroke (if the clots go to the brain and lodge there), but the body's natural response to any kind of large metal implants (some cause worse responses than others, one of the multitude of problems with Depuy) is to form clots. And the clots will lodge somewhere, and not always the "Top 3: the lungs, heart and brain" but can lodge in peripheral blood supplies to different limbs, cutting off blood supply there. So many, if not all, patients with the replacements, particularly the hip; are placed on blood thinners, such as Coumadin (which is extremely hard to regulate; and requires a lot of education, because one salad; if it's spinich salad for example, can totally neutralize the coumadin they've taken that day because Vitamin K is the antidote to Coumadin; and spinich is very high in Vitamin K; just one example), otherwise known as Warfarin. The dosing is tricky; like Monday, Wednesday and Friday you take 2.5mg, Tuesday and Thursday you take 1mg, Saturday you take 1.5mg, and skip it Sunday. Who the heck can keep regular track of that??? I know it'd be hard for me. Planners help; but they don't solve the problem.

So, if given the choice, and if they can keep your pain under control, if it were me--I think I'd wait as long as possible. Then there's a higher likelihood that you're going to also have better technology, so that means no metal, no blood thinners; which could potentially make the most minor injuries potentially deadly; emergency surgery trickier than it already is, and so on. My friend is on no medications to thin his blood, and the hardware they used has relieved his pain so well that when he does take anything for pain; it's usually an OTC med, and even if not, it isn't related to anything about his hip.

The question would be: How long can you stand it? It seems that would be what it kind of boils down to. Which means there's no easy answers. But avoid metal implants at all, if you can.

Also, I might consider contacting Johns Hopkins: they are the leaders in bone grafting: taking (yeah, sounds morbid, I know) donor bone from consenting cadavers (obviously before they were cadavers ), and graft the bone into your hip instead of using anything artificial. I don't know, but I believe in some cases, depending on diagnosis, it may be considered experimental, particularly in cases of the hip. But it's had excellent success in crushing injuries, for example, when the tibia would be crushed in a car accident. But in the case of the latter; the health insurance company isn't paying the bill, so the rules of payment are totally different, and straight up, I can tell you-not cheap, so check it all out. And I don't know your particulars, so bone-grafting may not be an option since you've had the resurfacing. But your age needs to be taken into account...being wheelchair bound has to suck, let along spending your mid-life in one...

Just some thoughts. I hope someone/something leads you to the decision that's right for you.

Good Luck.

I wish I was rich! lol These days very few of us are and I am like most, living pay check to pay check. And my employer does not offer health ins benifits so I pay for my health ins out of pocket...and its not cheap! I just dont think hip replacements are made for younger more active people. I am still at that point in my life where its to soon to start slowing down.
My fear of waiting as long as I can is that I have been reading reports from the FDA and other things around the Web that with alot of the metal particials floating around in and around the hip joint its self, it starts to turn the bone soft. Im afraid that if I wait it out as long as I can there will be a lot of soft tissue damage and that will mean more work to fix the problem (less good bone to work with). I would feel better having the same type of replacement on both hips also. The surgeon also said that he wants my left hip at 100% and then I can start putting more of my body weight on that hip to relieve some of the stress on the right one. Umm ok? So that will make the left one start to wear out faster and who knows...doing that for 2 years or so I could be where I am at now, them talking about replacing it again. But I know doing that will buy me time with the right hip..again at what cost though? Then he said for me to start back up on my RA meds and see if that will help the right hip. How is RA meds going to stop metal from wearing?? I know this is going to sound mean (I dont mean for it to!) I am 27 and I would think that they would be alittle more concerned and try to do more because I am young and I still have 50+ years ahead of me....

Bryan,

Idk-I see you live in New York. Check with your insurance first; but I think given your age, and history, they might be able to refer you to Johns Hopkins--my orthopedist trained there, did his residency in orthopedics there (part of why I trust him; but other reasons too), and they're the ones who do the best on bone grafts: this might be the best (only) option for you...you're right about the particles.

I know insurance is expensive. You should check out Blue Cross' rates when you have lupus and multiple autoimmune diagnoses. And are part-time oxygen dependent because of EDS-III. But, I pay it because it's cheaper than letting myself be victimized by the crummy state insurance, or trying to pay it all out of pocket--but when I shopped around, I realized that with lupus and EDS, I can't afford to screw around with an HMO, like Group Health or anything other than a PPO. Which left Blue Cross and United Healthcare. If you're signed up with United, I say run like heck-limp like heck, whatever, as fast as possible to the nearest Blue Cross office when the enrollment periods start, and get signed up: my hip surgery next Friday (7.5 days and counting!!! My preoperative MRI is tomorrow: it's going to be the deciding factor if they do the core decompression-Please, God!!!--or a total hip) didn't even have to be pre-authorized, as is with most insurances-the scheduler merely looked and saw what my insurance is, and scheduled the surgery! United, I garauntee, it would have been weeks to a month or so of wrangling, screaming and yelling-maybe a threat or two...lol-to get it approved; and even then, it would be with "Three months of follow-up care after your surgery, and then go back to your PCP." Can you tell I was stupid enough to buy a policy from them? Dumped it one year to date and signed up with Regence Blue Cross/Blue Sheild, and I love them.

No chest pain (figuratively) when I have to consider calling Customer Service (how United justifies calling what they do as "Customer Service," I think "Member torture and inducing cardiac disease" would be more appropriate...), and the BC reps are always pleasant, friendly, and helpful. The are nice. I've even become friends with one of them-we don't share that fact with BC, but when I fired the PMR doc and the PCP in one day, I text messaged it to all my friends, and she responded first, and goes, "You go girl-right ON!!!" These are the people that work there.

Ok, off track, I know--got the ADHD meds late-sorry.

But definitely look into Mayo or Johns Hopkins. This is so complex that you really need the experts to look at it. I just hope that your insurance would be flexible enough to pay for it. Or if you could get even to NYC, and one of the better hospitals there; I'd have to research which NYC hospital is best with this stuff, but I can and get back to you: I still subscribe to the professional websites that get me this information. Let me know if you're interested. I am happy to help if I can; if you were West Coast, I'd be able to tell you stright off where to go...but this would take some digging...sorry.

But you are undoubtedly in a tough spot. Maybe look into seeing if you could persuade the insurance to cover the cemented ceramic implants? Doubtful they would, but you never know. My friend is still doing great-no complications, etc...

Wow, I know this is hard to hear; but I don't have much in the way of "words of wisdom." And what sucks is I'm in essentially the same boat.

Send me a PM if you wish...

yes Depuy hip replacements recalled...so sorry for all the trouble!!!