Has anyone experienced the need for bone grafting when having a hip replaced? I would be interested in hearing about the outcomes for people. Has anyone heard the term 'protrusia acetabulae' and is it the same as congenital hip displasia?
Poly insert wore on my 14 yr old hip replacement.. Debris caused bone loss. Surgical revision placed new acetabular shell, positioned w/two screws into pelvis, and bone inplant to restore lost bone.
A year later, in feb. '04 progressive protusio abnormality noticed: "acetabular shell protudes into the pelvis". In mar. '04 screws sheared and acetabular prosthesis fell into the groin! [screws won't support body weight; bone growth to prosthesis is required.]
re-revision surgery removed sheared screws and placed larger shell, w/larger screws, and added significant bone graft.
Muscle laxity due to months of bed and walker restrictions, plus second hip revision have led to five [anterior] dislocations. Agressive pt on quads and abductors is supposed to resolve this problem.
Btw, nsaids are known to impede bone growth, and I now try to minimize these arthritis pain relievers in order to enable bone growth to, and around, the prothesis.
Thank you for your reply to my query. You have been through a lot with your hip problems! I have a case of protrusio acebabulae that will require a bone graft to rebuild the socket. They will use bone from the femoral head to refill the space and then they will screw the prosthesis into the grafted bone, or so I am to understand at this time. The doctor doesn't seem to have any concerns about proceeding in this fashion. I am being told that I can do no weight baring on that hip for 6 to 8 weeks to allow the bone to grow in and take over the work of the screws. I'm going to keep getting very fit between now and then and also attempt to drop my extra 20 to 30 lbs of weight.
I had hoped that this surgery would restore my mobility and not cause me worlds of other problems, as seems to have happened in your situation. Thank you for making me aware of some of the possibilities.
my husband underwent his 3rd hip surgery on the left hip. We won't talk about the first two times but the last hip revision was this past october (2003) done by a wonderful doctor. He had to do bone grafting as the acetabular was loose and was grinding into his pelvic area. Right before his surgery I could audibly hear crunching sounds when he'd get up from his chair. The surgery took about 8 hours and he was in the hospital for 8 days. Because of all the stress put on his right hip from years of having to limp and lean towards his right side, his right hip had to be done last month. He is now pain free. He says the right hip feels so natural like nothing has ever been done to it. The left hip feels good too but that will take a year and more to completely heal.
Note: those little screws that they put into your pelvis are not for weight bearing! Mine sheared off when the bone bond to the acetabular cup failed.
Getting in shape before the surgery sets you back is very important. Tha destroys hip socket retension ligaments and the hip muscles must be restrengthened to retain the prosthetic joint in place. So, mind your restrictions after surgery and do not lean back either!
I am going to have this done in about 3 weeks. Bone graft is only way for me to be fixed as well. My question is would you do it again? I am tried of this pain and being crippled. Doc says he is no hurry to do this risky surgery. Your opinion please. Thanks