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  • Osteoarthritis of the Hip

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    Old 10-11-2008, 02:33 PM   #1
    gunnersboy
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    Osteoarthritis of the Hip

    I'm new to the board and here to look for anyone who has been through the same experience or has any advice.

    I'm a 20 year old male and when I was 18 I had major surgical dislocation and re-sculpturing of the hips. I had my second one down in March of this year. I have been experiencing pains in the first operated hip and have had an MRI scan on it. I can now only lift the hip to 90 degrees and no further without having sharp pains. I have been given the results of my MRI and have found out that I have Osteoarthritis in that hip along with fluid in the joint.

    What is the next course of action that they will do? I'm obviously too young to have full hip replacement (I hope!). I have been told that they could go in through keyhole to drain the fluid and to clean up the hip. What happens if this doesn't work though? I'm looking at worst case scenario and if all the steps fail what course of action would they take at such a young age?

    Thanks for all your help.

     
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    Old 10-11-2008, 11:50 PM   #2
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    Re: Osteoarthritis of the Hip

    I am so sorry to hear you have these problems at such a young age. I think you need to drain the fluid and clean up the hip. But i am not sure what clean up the hip means! You
    had dislocation and re-sculpturing of the hips....why? First, having osteoarthritis in your hip does not mean you are looking at this moment to replace the hip. At your age, you
    should be looking at hip resurfacing which is a much better alternative than a total hip replacement. You would only be
    looking at these surgeries if the osteoarthritis was so bad that there was little or no cartilage left in the hip joint and your were bone on bone or close. That is when a surgeon will recommend a hip joint replacement. Karen

     
    Old 10-12-2008, 03:01 AM   #3
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    Re: Osteoarthritis of the Hip

    Thanks for the reply. I think what they mean by cleaning up the hip is to smooth out the bone to take some of the pain away. The reason that I had the surgical dislocation and re-sculpturing was due to the fact that I have a lack of movement and when moving the hip in a certain way the bone would clash with each other. Because the bone had to be removed all the way around the joint the hip had to be dislocated to give access of 360 degrees. The problem was in both hips and so this was carried out. It was also done to slow down the osteoarthritis in the hips but for some reason is has accelerated in the one. This operation is only 10 years old and one of the few surgeons in the country who does this operation lives close to me.

    My uncle has also had problems with his hip and when he was 50 he had hip resurfacing done followed by his second hip a few years later. What is the lifespan of hip resurfacing?

     
    Old 10-13-2008, 03:51 PM   #4
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    Re: Osteoarthritis of the Hip

    I had femorplasty 12 weeks ago for osteoarthritis. Of couse I am 58 and not 20. The OS I was referred to has been doing femorplasty for a long time and authored several textbooks on hip arthroscopy, representing the leading work on this subject, and has published numerous chapters and scientific articles. In addition he trains other orthopaedic surgeons at courses throughout this country.

    He developed several surgical techniques that are now commonly employed throughout the orthopaedic world and invented numerous instruments that have revolutionized aspects of orthopaedic surgery. He has served as a visiting surgeon and lectures frequently at national and international meetings. He is visited regulary by OS from all over the world. Almost every time I see him an OS is visiting to learn about femorplasty. He doesn't let them do the surgery on his patients but someone is always watching him.

    Femorplasty is technically more difficult than knee arthroscopy. He feels that when OS's develop more skill with the surgery femorplasty will be considered as an option before hip replacement, much like knee arthroscopy as an option before TKA.

    He said we would have to have a "wait and see" attitude and that I could probably have one more femoplasty. He also said that I might actually avoid hip replacement all together. As of now my hip feels great and I have had no pain at night at all. If I over-do-it in the day I do have some pain but it is gone the next day.

    I went to a well established OS group that specializes is hip resrufacing and they referred to the femorplasty OS. They felt I was a good candidate for femorplasty rather than jump right into hip resurfacing or replacment. Hip resurfacing techniques and manufactures in the US are just now making a reappearance so the life expectancy would only be a guess. Several years ago hips were resurfaced but the device was poorly designed and there were so many failures that OS stopped doing resurfacing. The success of the new designs and techniques used make it a good choice for most people. There are several web sites you could search to find more information. I am thinking of one site that is devoted totally to hip resurfacing. It has a forum for "hippies" (as they call themselves).
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    R.Knee: Arthroscopy: '06; TKA indicated
    R Hip: Arthroscopy '08;

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    Last edited by lthomas; 10-13-2008 at 04:21 PM.

     
    Old 10-13-2008, 11:57 PM   #5
    legallyblondied
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    Re: Osteoarthritis of the Hip

    Hi....the life span of metal on metal hip resurface should be pretty
    much for the rest of your life. I realize you are from the UK. Who
    did your Uncle's resurface. Derek McMinn i know does many and
    the UK uses the BHR device. My resurface was done 2 years ago
    by Dr. Amstutz in LA. He has resurfaces that were successes that are almost 20 years old. I have a conserve + but i think the device is not as important as the surgeon's skill. I am a dancer
    and i wanted full range of motion and longevity and i have it.
    Hip resurfacing is bone conserving. You need to explore it before
    a total hip replacement. I am not that familiar with femoroplasty
    but i am guessing it is a from of arthoscopic surgery. The problem with this is that even though it cleans out debris in the
    joint area, usually what qaualifies a person for a resurface or THR is the patient has very little cartilage left so you are bone on bone osteoarthritis. No form of surgery or magic pills or injections will build new cartilage in the hip joint. If you have been diagnosed with no cartilage or very little, you are looking at
    a resurfacing or a THR not a femoroplasty. karen

     
    Old 10-14-2008, 01:57 AM   #6
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    Re: Osteoarthritis of the Hip

    Thanks for both the replies. Knowingly my luck and the reason I've had to have hip operations in the past would be because there is a lack o cartilage but I will find out when I go along this Wednesday to my consultant. You asked who did the resurfacing for my Uncle, I believe it was a Mr Richard Carrington at Spire Bushey Hospital - quite renowned for his work. The specialist that did work on my hips first time is one of the few in the the area of the country - a Mr J G Hussell. He specialises in arthritis in younger patients and also has written many books and papers on this. He recently received a grant from the government to do more work in this field so I believe I am with the right person it will just be finding the next course of action.

    I've never heard of femoplasty before. However I am seeing my consultant this Wednesday and can update the thread if anyone is interested.

     
    Old 10-14-2008, 07:39 AM   #7
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    Re: Osteoarthritis of the Hip

    Femuroplasty (I mispelled it in the prior post) is an arthroscopic surgery for resection of a cam lesion and impingement. I also had a labral repair and partial synovectomy. It is something like plastic surgery. Like I said, it was a very technically demanding surgery. As with all arthritis you have damage to the cartilage There is a an organization, The American Osteopathic Academy of Orthopedics, made up of Osteopathic Specialist and they report the advances in hip arthroscopy,
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    Old 10-14-2008, 11:46 AM   #8
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    Re: Osteoarthritis of the Hip

    Gunnersboy,

    I would be very interested to hear how you get on.
    Who is your appointment with on Wednesday?
    I am 5 weeks post arthroscopy for cartilage delamination due to dysplasia. It was a very easy surgery with just an overnight stay, and I have had hardly any post op pain. There are not many surgeons here in the UK that do hip arthroscopy, but if you have a good one, it is well worth trying the scope before any other major surgery. It is a long recovery due to the traction needed, and it is at least 3 months before returning to most activities, with improvements made up to six-nine months post op. If you have advanced arthritis or cartilage loss then an arthroscopy will not help you. If it is mild then cleaning up the joint can sometimes be enough, or if there are small areas of full thickness cartlage loss then microfracture can be performed to produce scar tissue that can act as false cartilage to bide time before a replacement is needed.
    Hope this helps,
    Good luck
    Kate

     
    Old 10-15-2008, 02:09 AM   #9
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    Re: Osteoarthritis of the Hip

    Thank you for the information about Femuroplasty. I notice you mention it is for cam impingement. This is the reason that I had my surgical dislocation and re-sculpturing in the first place because of this impingement.

    oscarsmum my appointment will be with my surgeon who has done both my operations so far. Mentioned earlier his name is Mr J G Hussell. The operation has only been around of the last ten years and therefore they have no real idea how well my operation will last long term. He has never seen osteoarthritis in someone after this kind of operation. How old are you since you mentioned you had an operation to help with dysplasia? I'm interested in knowing if anyone round about my age has had anything similar? It's quite good that only an overnight stay was OK. For both of mine I had to stay in hospital for a week, was in intensive care for around 3 days and had both an epidural and general anaesthetic. I only got out of bed on the 4th day of my stay and was on crutches for 6 months post op. Not much fun!

    Thanks for all your replies and I'll keep you updated after my appointment today.

     
    Old 10-15-2008, 04:01 AM   #10
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    Re: Osteoarthritis of the Hip

    Hi Gunnersboy u mentioned your uncle had surgery at a spire hospital i hope you dont mind me asking but how did he rate them and were things successful for him and was the care he received good, im asking as my nhs hospital have a long waiting list for a procedure i have to have and they have passed my notes and me over to a spire hospital in oadby leics i have never heard of these and dont know how long they have been going for, i am very concernd as the last time i went to hospt my op went wrong and they nearly killed me, so im going with all my armour on if you like sorry to ask so many questions thanks kassi

     
    Old 10-15-2008, 09:27 PM   #11
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    Re: Osteoarthritis of the Hip

    I really think Thomas Byrd has been doing femuroplasty longer than 10 years. He doesn't do any replacements. He works on soft tissue. He is the team OS for the Tennessee Titians. He is a consultant to a number of other US pro teams. I was really intimidated on my first visit. He has autographed pictures and jerseys everywhere. But the one that got me was the autographed poster..US Olympic ski team

    My surgery was about 4 hours but it was out patient and I went home a couple of hours after the surgery. I used my cryotherapy unit until the next morning. I tool demerol that first night. I took an old an anti-inflammatory for 3 weeks...Dyclofenix (sp?). I have never had any luck with anti-inflammatories but this one worked for me.

    OS thought I might not need hip replacement either. Sound good to me..of course like he said..time will tell. He told me to take it easy for 6-9 months and to be on the safe side avoid high impact sports for a year. I am just finishing 12 weeks of PT. So far I couldn't be happier with the results.
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    Last edited by lthomas; 10-15-2008 at 09:37 PM.

     
    Old 10-18-2008, 02:12 AM   #12
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    Re: Osteoarthritis of the Hip

    After seeing my specialist on Wednesday I have found out that it isn't the Osteoarthritis that is causing my current problems. I do have osteoarthritis in my hip but it hasn't progressed since the operation. The idea of the operation was to stop the progression of this - which it has done successfully. What my specialist is now talking about is something of a "frozen hip" rather much like a frozen shoulder. Now I've done some internet research and haven't come across this. I have physiotherapy twice a week and none of them have come across it either. Basically, the way to deal with it is to inject the hip with local anaesthetic and steroids and move the hip through its full movement. The problem I am having at the moment is that I can only lift the hip up to around 90 degrees. The hip also wants to move outwards rather than up in a straight line.

    The idea of this surgery would then to force the hip through its proper movement and to almost break this "freeze" that the hip is having. It's a long shot but has anyone else experienced anything similar?

     
    Old 10-18-2008, 03:08 PM   #13
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    Re: Osteoarthritis of the Hip

    When you have knee replacement a fairly common procedure after knee replacement is something called manipulation under anesthesia. I have never heard it called a frozen knee but I can see where you might call it that. It is done when scar tissue forms and the joint doesn't get the ROM needed. Usually it is due to insufficient movement after the surgery.

    I didn't need it but I post on another forum and a lot of people on that board have had MUA.
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    R.Knee: Arthroscopy: '06; TKA indicated
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    Gymnastics is fun at 18 but not at 40.

     
    Old 10-19-2008, 02:44 AM   #14
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    Re: Osteoarthritis of the Hip

    It's strange that you mention about lack of movement after surgery. Because when I was still bed-ridden I was put on a CPM machine which basically moves the leg up and down to a around 45 degrees constantly until you want it to stop. I believe I was on it for around 8 hours. The second operation on my other leg I think I was on for less but have more movement in that hip. Strange.

     
    Old 10-19-2008, 09:51 AM   #15
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    Re: Osteoarthritis of the Hip

    Hi Gunnersboy,

    I have had that done. I had cortisone with a local anaesthetic injected into my hip then manipulation through all the ROM. This was done under a GA, as a day case. I had it before any other surgery and as more of diagnostic than anything alse. I got some relief , but not long lasing, but in your case if it is to break up scar tissue, and combined with continuing physio it might be more successful.
    Good luck
    Kate

     
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