Two stage hip revision from infection.

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Hi my names matt I'm new to this site. Looking for any advice or information I can get towards my situation. I underwent a left total hip replacement on November 24th of 2015 at 28 years of age due to bone on bone pain from arthritis and bone spurs. My surgeon believes I tore the labrum in my hip about 10 to 14 years ago playing football. The surgery was painful but I recovered fairly quickly I was able to jog without a ton of pain after 6 weeks. Jump ahead a year and a half to April or 2017. I developed severe pain in my left hip again and went back to the hospital where they aspirated my hip to discover I had an infection a form of staff. They had to remove my hip replacement break the spike out the femur and the titanium cup out of the acetabulum. They inserted a temporary antibiotic cement spacer. I underwent 6 weeks of iv antibiotics. Then after 6 weeks they re-aspirated the hip to learn it was still infected. I underwent another 6 weeks of iv antibiotics, another 6 weeks off. The aspirated again and the infection was gone. Doctor wanted to wait another month then aspirated again to make sure we were good before he put the hip back in. That's where I'm at right now. I'm scheduled for surgery on January 17th for the last surgery hope to god. But I have many concerns. My surgeon told me not to torture myself with pt since I could not advance to far with the spacer and to not cause myself to much extra pain.  I have done some pt anyway and tried weight shifting as much as possible to prevent my leg from being completely atrophied from the past 8 months. In the meantime it has become winter here in New England and I had a fall on the ice last week. I was thankful after my fall that I did not hurt my hip bad. But two days later and my hip was very sore and I can't do the excersiozes I was able to just recently. I'm concerned About going into get a new hip when my leg is so weak. Last time I had the first the I was in pain but much stronger I was able to walk. I can only toe tap now. Is it ok to get my hip put in while I'm this weak. I'm only 30 years old do any of you think I will b able to get to walk again without a terrible limp. Iv read a lot about hgh doing wonders for surgery recovery, anyone have experience with this. I quit smoking ciggarettes and just started the paleo diet. I'm trying to make myself as healthy as possible. Any insight would be greatly appreciated.

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  • Posted

    Hi Matthew

    You do seem tio have had a time of it. I had a two stage last year. Hip out in March and new hip in in July so 5 months with a spacer. Like you I tried to keep myself fit during that time but I did lose a lot of muscle tone, and I imagine I put on a bit of weight. I borrowed an exercise bike but it was too painful pedalling so I just walked with crutches. I'd been a bit sore since the infection flared up in September 2016 so it was a long period of inactivity (and I am nearly 70)

    My advice is to get the new hip done as soon as possible. If it is anything like mine you will be more or less pain free after the op and able to start getting your leg working again. My experience is that it is a much slower process than after the original THR but I am confident that I will get more or less back to normal in the end.

    I had a fairly long period of inactivity when I broke the hip in 1975 (3 months in traction and three months on crutches) but I was a young man then and recovered very quickly. So I hope you will recover quickly too.

    My goal is to cycle 70 miles on my 70th birthday in May. I've been on the bike a bit though recently I've just been on the exercise bike because of the weather.

    I do walk with a limp. Though I think I have been doing so for years. If I really concentrate and am on flat ground it is not much of a limp. My physio says it's my glutes and I am working on those.

    Good luck

    Mike

     

    • Posted

      Dear Mike

      It's great that you are doing well given your set backs.

      I suggest that you go back to two crutches for a few weeks just to see if this helps to get your body used to walking without a limp and to help the muscles increase their strength. I did this for only a week and found that it really helped me.

      Good luck, Richard

    • Posted

      Richard

      You may well be right but I'm getting used to not having the crutches and being able to get about more easily.

      Mike

  • Posted

    I am teying to use the crutches more and decrease the weight bearing. I have had spacer for 3 mos but so anxiety-ridden over having a mortgage and work disability not kicked in yet. I have 90 to get this done!!!! Thankfully i have a sit down job.
    • Posted

      Just got a call that my CRP is non detectable-meaning no sign of infection. Tuesday i have my aspiration! So excited even tho it is not very pleasant. If it is infectionfree then i can have the thr!!!!!
  • Posted

    Hi Matt...I am sorry to hear of your problems with your hip. Due to bone infection,I too have had a two part revision done on my right hip. Later on,I also had to have the same carried out on my left hip...namely,an antibiotic spacer and not quite one week of IV antibiotics.That first stage of the hip revision was carried out two years ago,I am still waiting to have the second part done.Now I find much more pain on walking plus I have had a high temperature for a week now.My surgeon is seeing me in Outpatients on the 4th June 2018.I really do feel quite unwell.Do you ,or anyone have any advice for me?
    • Posted

      Hi Laura

      Have you really had to wait 2 years for stage 2?

      I think you should go and see a doctor, preferably st the hospital. It may be that you just have a 'normal' infection but better safe than sorry.

      Mike

    • Posted

      Dear Laura

      I would insist on seeing a doctor urgently like tomorrow latest. This needs attending to without delay IMO.

      All the best Richard

      Ps I'm not a doctor.

    • Posted

      Thank you for replying to my post-yes, I really have had to wait for two years for the second stage of the hip revision to be done, Now I am worried in case I have another infection as I really do not want another spacer for a further protracted period of time. Plus,if there is bone infection,surely I should be given IV antibiotics for around six weeks instead of just one week? Just giving me one week of IV antibiotics seems to me like shutting the stable door after the horse has bolted ! Also,as there is a much greater chance of dislocation following revision surgery, surely a hip orthotic would help-to give support to the post - operative hip and to also prevent dislocation. I shall be voicing this and all my concerns to my surgeon when I see him on 4th June ( I cannot get an earlier appointment unless I present myself to A  & E,which I do not wish to do.I will,of course, post again as soon as I have seen my surgeon. Thank you for listening,everyone!

    • Posted

      Laura

      How awful, 2 years was far too long. I had injected antibiotics for a week and then  6 weeks of oral antibiotics when I went home. After that they waited two weeks and did blood tests to confirm there was no residual infection. But my surgeon said the only real way to tell is to take samples when they remove the spacer and put in the new hip and culture those. I am pleased to say they were clear as well.

      Although I am not paranoid about it, I do wonder, every time I have the slightest pain in the hip area, if I have a new infection. My original THR was posterior so the scar is not readily visible when I look at myself in the mirror (and in any event I tend not to look at my naked body in the mirror) which was why I hadn't noticed how red the scar was 18 months ago. But I do now occasionally have a look at the scar which is a nice healthy pink.

      I do hope yours does turn out to be something else.

      But as for dislocation. I'm not sure there is a greater risk of dislocation after stage 2. I just followed normal 90 degree and no twisting rules for 6 weeks. But check that out with your surgeon.

      I think I was very lucky because my original THR (and the 2 stage) was done at the Nuffield Orthopaedic Centre in Oxford which has a specialised bone infection unit. At the time of my THR you could "choose and book" and the Nuffield was close to me, I knew one of the surgeons and the NOC had a good reputation.

      good luck on June 4th

      Mike

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