Re: THR following BHR, 33 year old female UK

July 25, 2004

Hi,

Well as McMinn is one of the godfathers of the prothesis I suspect you are

in about the best hands you could be if that is any reassurance to

you...............

We have another poster here with hassles that could be related to metal

impinging on tendons or AVN under the cap........ she may well see this and

comment - or you can find her postings amongst the last few weeks...........

I also wonder if we could get one of our drop in to the list OS's to explain

why the metal impinging on tendons can only be solved by having the BHR

replaced?.......... I keep wondering why there isn't some way of stretching

these or is it something to do with the breakdown of the bursia and

lubrication that wouldn't stop the problem even if stretched.........? And

why the THR head wouldn't also rub onto the ligaments as well??

On the lighter side I am a little concerned to hear your original surgeon

migated to Australia........... If he got yours wrong I dread him practicing

here............ groan.......probably end up in my end of the country where

so many others who are 2nd rate come to settle.............

Otherwise sad to hear of your hassles - you must be truly fed up with hip

problems having had them for most of your life it seems....... That is very

annoying I know from personal experience...........

Edith LBHR Dr. L Walter Syd Aust 8/02

> Just logged on today - a website for people like me - how great! At

least, I know I'm not alone now! I am a 33 year old female, born with a

dislocation in right hip, diagnosed at 2 years old and bascially have

suffered ever since. I spent most of my childhood in traction, plaster,

calipers,, etc until 10 years old - looking good. Arthritis set in at 25

years old and I was diagnosed as having a Dysplastic hip. I underwent a

Birmingham Hip in June 2002 in Liverpool, England. I really had high hopes

for this op, as at the time, it was big news and surgeons were really

excited. I was given two options, either a Pelvic Ganz Osteotomy in Bristol

or the Birmingham in Liverpool. Second option was most reasonable.

Unfortunately, I never gained anything from this operation. After 12 weeks

post-op I was still in a lot of pain. It has now been over 2 years since

the op I am under another man in Liverpool now as the guy who carried out my

op emigrated to Australia. I am not convinced he is the right one for me

(his bedside manner leaves a lot to be desired) and I recently paid

privately to see McMinn in Birmingham for his opinion as I was at the

end of my tether. Mr McMinn thought my problems maybe one of several

things - metal impinging on tendon, avascular necrosis. He thought my only

option would be to have a Total Hip Replacement - as this gave the best

chance of any future problems arising. The downside is the number of

revisions I could need. I was absolutely devastated, but I trust his

judgement more than I would of anyone else and know it's the only way

forward to rid this enormous pain and stop taking painkillers by the

minutes. Has anyone else had a similar experience to mine - THR following

BHR - please share with me and ease my worries a bit? THR is booked for 2-3

months. I would appreciate any replies. Thanks in advance.

>

July 25, 2004

Hi Edith and Sharon

I replied to Sharon on her individual email address and here is what I said

(like you Edith I asked De Smet why the BHR would avoid the tendons rubbing and

as you can see below he does not really have a good answer to that question):

Hi Edith

just read your email on surfacehippy and thought I would respond personaly.

Oh boy, I know what you are and were going through and I wish you courage and

that you can find a solution quickly.

My story is a bit similar to yours although more recent.

I had a BHR in Belgium (with Dr De Smet) on January 6 2004 and have never been

out of pain since then. It is somewhat different kind of pain as before surgery

(I had severe osteoarthritis). i am from Canada and went to Belgium cause here

they were not doing the resurf. and also there is a 2 year waiting list...

De Smet (corresponding through email so I have not seen him in person since

surgery time) thinks it might be tendons rubbing against prosthesis but a

surgeon I saw here thinks it might be AVN (avascular necrosis). It sounds a lot

like you. So I know how you feel and it is soooooooooooo depressing. But there

is fortunately the solution of a THR that hopefully would solve the problem.

I asked De Smet about the size of the THR: if they leave the acetabulum cup in

there and place a corresponding size THR (big ball) why would it be any

different in terms of tendons rubbing against prosthesis??? he said that the THR

head edge is not as sharp as the BHR but he said he would check with the company

that builds the BHR/THR. But the company was not interested in that problem and

there is not a good answer to that; De Smet said that there is not yet enough

people /data to know the results... Not fun to be a guinea pig. Anyway did Dr Mc

Minn say anything about that? Of course if the problem is AVN then the THR would

sove the problem.

AS far as several revisions, I think that the THR metal on metal should last as

long as a BHR unless there was loosening which could happen on a BHR also. They

don't have the data here either but metal on metal in theory should last a life

time and more...

Did you have a bonescan or any other tests (blood for infection?). I had the

bonescan which did not show anything but you cannot tell under the BHR cup. and

my blood test do not show any infection. Did they talk about possible loosening

of one component?

Who is going to do your THR? is he/she going to leave the acetabulum cup in?

Overall from what you said in the first email, I think the THR will be the

solution for you eventhough it seems so unfair and scary.

I would trust Dr Mc MInn like you said you do. He is certainly an authority on

this subject.

I wish I could help more but feel free to email when you want.

Sunita