Is A Repeat Hip Replacement Surgery Advisable?

Posted on Thu, 7 Jul 2016

Question: Left hip replacement Nov. 2014. Age 71 at the time. Excellent health. Muscle and walking recovery expectations? Two months, four months, six months to get back to normal balanced walking.Posterior/lateral procedure surgery.

Left hip procedure (posterior/lateral surgery) Nov. 2014. Through Feb 2015 exercises and pt positive. Feeling confident. March 2015 two events. Went to a flower show exhibition and walked for three to four hours using a cane. Thinking this would be ok. Next day in the swimming pool my left leg was a noodle when I tried to kick.
Event #2. And I cannot recall which was first in March. I tried to ride a regular bike encouraged by my six mile experience on a stationary bike at the gym. Riding the bike felt great. When I stopped to cross an intersection I needed to hop off the bike.
I automatically put down my operated left leg. There was no muscle strength to hold me up. My leg was like air. I free fell right onto my left leg operated incision.
QUESTION Is this weakness normal?

May 2015 a bone scan was done. The report suggested the prosthesis had been infintessimally moved.
QUESTION Is my body and leg muscle trying to compensate for the disturbed prosthesis? Is this part of the issue keeping my operated left leg weak to where I still cannot stand on it for putting on my trousers. I need to brace myself against a stationary something.

Opinion. Hip replacement. Posterior/lateral surgery versus anterior (supposedly less invasive approach). What are the pros and cons?

The left hip replacement needs to be redone.
QUESTION What concerns should I have going back to the same incision and once again cutting the muscles and ligaments?
And how long should I expect a positive recovery time for a normal walking gate when doing the appropriate pt exercises.?

Answered by Dr. Dr. Naveen Kumar Sharma (5 hours later)

Brief Answer:
It should be done by same incision

Detailed Answer:
Hello,
I have studied your case.It is very difficult to go for repeat surgery.If implant is loose or changed it position then this is only choice. I have following suggestions for you.
1.Both posterior and anterior approaches are good. I used posterior only. Choice depends on surgeon. If your surgeon is happy with posterior then he should use that only. No difference in results.
2.As you have already operated by posterior approach, now we should not change it to anterior as it is harmful. Two scars at different place is not advisable.
3.Your weakness was most probably due to weak implant position. So once position is corrected there should not be any weakness. Make sure that you do not have any nerve problem or Diabetes. They can also cause weakness.
4.Recovery depends on many factor but if cemented hip is done then you can walk from next day only. In uncemented hip it can take three weeks to four weeks.
I hope this answer will be useful for you.Let me know if there is any other followup questions.
thanks

Above answer was peer-reviewed by : Dr. Sonia Raina

Follow up: Dr. Dr. Naveen Kumar Sharma (10 hours later)

What are the pros/cons for the prosthesis being cemented or natural grafting by the bone to the prosthesis?
QUESTION #2
What concerns should I have with the 2nd procedure?
QUESTION #3
Operated leg will be SHORTER as a result of the replacement procedure?

Answered by Dr. Dr. Naveen Kumar Sharma (12 hours later)

Brief Answer:
Uncemented in better in revision hip

Detailed Answer:
Hello,
I have studied your case. Choice between cemented or uncemented depends up on bone quality and surgeon's choice.So if bone is good then uncemented implant is good.
2.There is chances of hip fracture or some bed rest in revision hip. recovery may take time. But there is no major concern.
3.No there will not be any shorting just because it is a revision case.
thanks

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Naveen Kumar Sharma (10 hours later)

Four months after my LEFT hip replacement I still needed a right side cane for walking. My strength had improved. I went to a large(football field size) conference exhibition flower show.I believed I would be ok walking with the cane for three to four hours. I was wrong.
Next day in the in the swimming pool my left leg was like a noodle. On my right side I had a sore sensation in the center side of my right buttock as if I had fallen on a hard surface and I also experienced a weaker right knee. Now fourteen months later I still experience some sore sensation and the weak knee, however, improved with the exercising I have been doing. In the pool now the left and right leg are strong and work well.
QUESTION What muscle nerve combination did I over stress that impacted my left leg and affected my right knee.?

Answered by Dr. Dr. Naveen Kumar Sharma (2 hours later)

Brief Answer:
Prolong standing causes hip pain

Detailed Answer:
Hello,
Hip replacement changes hip joint but thigh and hip muscles remains same. So there can be pain on prolong standing. This pain is due to superior gluten nerve and Gluteus medius and minimus muscles. It can also be due to weak bones due to calcium as I mentioned earlier. For treatment you need to take calcium 1000mg and vitamin D regularly.
Also increase protein in diet.
Thanks

Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar