So, I'm debating on when to have my next PCNL (kidney stone surgery) this summer.

I decide to have this chronic hip pain checked out in the mean time. It started off about a year ago, very infrequent. It would flare up, then go away. Well, the bad days now outnumber the good.
I get an X-ray, talk to the PA (you don't get to see a Dr around here anymore), discuss some family history, then back out for an MRI.

Avascular Necrosis of the Femoral Head.

Ok, what do we do now?
Total Hip Replacement.

SOB WOW! Are you kidding me? I'm a month away from my 46th birthday. Never a broken bone in my life, never any major trauma. Even with all the dirt bikes, street bikes, and livestock I've been exposed to in my life.

So I'm headed out next week to get a second opinion, and hit up a couple of Sports Medicine centers in the area.

This was gonna be my year to pay off debt and finally attend some training classes.
This year is the first year I would have use or lose vacation time @ work.

I'm....bummed. To say the least.

Get a second opinion, definitely. I'd explore every single option out there before I get a replacement.

quote:

Originally posted by Prefontaine:
Get a second opinion, definitely. I'd explore every single option out there before I get a replacement.

Absolutely. I don't see THR as one of those things "oops, you didn't really need that, let's just uninstall that big chunk of titanium & polyurethane."

AVascular Necrosis of Femoral Head means bone is not good. Only option is replace Femoral head aka hip replacement. Make sure orthopod knows his stuff.

There is an experimental surgery (in US) that is Metal on Metal (MOM) resurfacing of the head. Much depends on your age & general health, the severity of the necrosis/damage to the femoral head.

Find a good orthopedic surgeon, perhaps our own BoneDoc can offer more info.

Good luck & I hope everything works out for you.

Yes, I get that blood flow to the joint is gone, and the bone is dead. I just want to make damn sure of all my options in the matter.

I've read a little on the MOM surgery. Apparently it's gaining popularity in Europe as a viable alternative to THR.

Even if I do go the THR route, I don't want to end up at some Walmart drive through type situation...

< Rodney Dangerfield voice >

I finally caught a break...
Of my humorous...
Hey, it ain't funny people....

< Rodney Dangerfield voice >

My $0.02 worth.

You are doing the right things.

Bottom line from seeing people who have hip surgery:

Get the second opinion, even a third if you can swing it.

See what lifestyle changed you can make to stave of replacing the femur as long as it medically safe and practical.

If you get one, know in advance the specific make and model of the prosthetic parts to you can do independent research on the part's track record.

Plan in advance. Make three or four autogoulous blood donations. If they aren't needed, you can give the blood to th blood bank.

If you must do it now, do the post-operative physical therapy with vigor. The post-operative PT is a key piece of the good outcomes I've seen.

Good luck.

Sorry to hear of your hip problem!

I would recommend that you shop carefully for your Ortho surgeon. I had previously been uninformed that there are now two differing methods of doing the hip replacement: Posterior approach (the traditional method that requires going in through the gluteous muscle area.) and the newer Anterior approach that comes in from the front of your hip socket area, avoiding the major muscle injury of the old method.

My Sis had one of her hips replaced, using the Anterior approach, and her recovery time was remarkably shorter and less traumatic than the norm under the old protocol.

Worth looking into and asking questions about in my opinion.

I wish you well!
Don

Hip stuff is on hold, sort of....

Got kidney stone surgery scheduled so that'll take precedence for now.

I do have a consult with an Orthopedic Dr. scheduled for next week, then its off into pre-op and labwork for the PCNL.

And some "hip" appointments that I have already made will have to be canceled/postponed/rescheduled so I can get this done.

Also, there is apparently now a SUPERIOR method for hip replacement. In addition to the ANTERIOR and older POSTERIOR method.

There is some family dynamic stuff at work recently, also. I won't go into that since it already seems I am hung up on my own little pity party right now.

I try to keep an optimistic outlook, but it certainly gets hard.

I get told repeatedly "The Lord will not put more on you than you can handle"

Well, I'm flattered and all, but.....

Damn I had a difficult time reading this. A friend had hip op and he's past due to return to work. He's 30 years older than you hudr. Stop falling apart already will ya ? You are too young. Hope it all turns out good for you.

Following this.
I had legg-perthes in both hips as a youngster. Didn't walk from four to seven. I was advised I would likely get arthritis in my hips in my later years.
It is time I visit my ortho doc who fused my ankle. Steps are killing my right hip for the last six months.
Good luck, hudr.

AVN is not an automatic hip replacement anymore. Dr. Sierra at the Mayo Clinic recently performed stem cell surgery on a close friend with AVN and she is only 29. They harvest stem cells from the pelvis, drill a hole through the femur to the femoral head and inject the stem cells. Its fairly new but has been very successful, especially with younger patients. I would get a second opinion to be safe. This is the Bruce Gray of hips, see links below.

http://www.mayoclinic.org/medi...-of-the-femoral-head

http://www.mayo.edu/research/f...236201685.1493404427

No medical knowledge, so just going to send some prayers your way for the best health care possible.

This message has been edited. Last edited by: Skins2881,

quote:

AVN is not an automatic hip replacement anymore. Dr. Sierra at the Mayo Clinic recently performed stem cell surgery on a close friend with AVN and she is only 29. They harvest stem cells from the pelvis, drill a hole through the femur to the femoral head and inject the stem cells. Its fairly new but has been very successful, especially with younger patients. I would get a second opinion to be safe. This is the Bruce Gray of hips, see links below.

I agree. It would be important to determine the cause of AVN of your hip, so you can reduce your risk. As you probably know steroids, family history and cigarette smoking are risk factors.

Some good news. My third opinion Dr. doesn't want to do a total hip replacement. He recommends a Core Deconpression. It may rejuvenate the bone and restore new growth. He said there may only be a 30% chance that it works, but we can always do a THR if it doesn't....
Hell, I'll roll the dice on 30% just about any day of the week.

But first, I get some holes poked in my back for removal of "staghorn calculi"....

quote:

Originally posted by hudr:
Some good news. My third opinion Dr. doesn't want to do a total hip replacement. He recommends a Core Deconpression. It may rejuvenate the bone and restore new growth. He said there may only be a 30% chance that it works, but we can always do a THR if it doesn't....
Hell, I'll roll the dice on 30% just about any day of the week.

But first, I get some holes poked in my back for removal of "staghorn calculi"....

My very close friend has had great success with the core decompression, she is back in the gym and working her butt off after having had surgery less than 10 weeks ago. Good luck and let us know how it goes.

Home from the PCNL.
6 hours working on both kidneys Monday afternoon. Tuesday was full of tests and hits of dilauden (nectar of the gods, btw)
We played with the flouroscan a bit at one point and took a peek @ my hip. It doesn't look right even to a layman like me....but that discussion is for another day.
Wednesday was 2 more hours of work on my kidneys. Rest of the day spent trying to make my bowels work while weaning off the IV painkillers.
Finally got home about 8PM last night.
I gotta hand it to UT Southwestern Medical center; staff was great, doctors even better (same urologist worked on my dad years ago, she is a gem)
Nobody questioned pain management. Food was good. Their wifi actually worked. I need to take a break from YouTube while they add more content.
The whole experience was better than what I had locally the last couple of times I had this done. It was worth the drive.
I go back in a couple of weeks for a follow up, and we will make a maintenance plan for going forward. Apparently I'm gonna make stones no matter what I eat, drink, or supplement with....darn genetics!

Glad you're home and on the mend.

Did they have to use the ultrasound to breakup any asteroid sized stones so they could pull them out?

quote:

Originally posted by tatortodd:
Glad you're home and on the mend.

Did they have to use the ultrasound to breakup any asteroid sized stones so they could pull them out?

This was a Percutaneous Nephrostolithotomy.
A tube was inserted into my back & into the left kidney. Then she used a laser & a vacuum to clean out staghorn calculi.
She accessed my right kidney uretoscopically to remove a 2cm stone.

I will probably need the uretoscopic procedure periodically as a maintenance thing. I much prefer it, as it is day surgery done on an out patient basis. Show up early, home by noon and pretty straight that evening.
The PCNL thing is at least an overnight stay and pretty invasive.

I know it sucks, get a second opinion. BUT, being in debt is a hell of a lot better than being partially crippled and in pain all of the time.