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3rd hip replacement????

Posted by RuthAnn (My Page) on
Fri, Dec 31, 04 at 2:24

Hi, Due to an auto accident my husband had to have his hip replaced, got an infection in it, had it removed, spent several months in a nursing home, had it replaced again in March of this year. He just got the news that he had an infection in it again. Dr's appointments coming up. Has anyone had an unsuccessful hip replacement? How many times can they do that? I know, it doesn't look good. Thanks, Ruth Ann


Follow-Up Postings:

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RE: 3rd hip replacement????

Sorry I can't help you with the hip replacement info, but you need to ask "what kind of infection" it is. If it is a hospital infection, that may never go away. I have a friend who went to the ER for a cut and she picked up a staph infection that you only get in the hospital and she has been fighting it for two years. An aquaintance's nephew has the same infection and they were told you can only get it in the hospital. I am going to research it and see if I can find the name.


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RE: 3rd hip replacement????

Hi RuthAnn...I'm so sorry to hear of your husbands problems.

"Complications are certainly possible with any procedure and total hip replacement is no exception. One of the most difficult problems to deal with is an infection. On a national scale, infection occurs in total hip replacements 1% - 2% of the time. If infection occurs, it may be necessary to remove the implants and leave you without a hip joint. It is possible that at a later point the implants may be reinserted. This will depend on the bacteria causing the infection. "

I haven't had an unsuccessful replacement, but did have mine replaced at an early age due to a birth defect, not an accident. I think when the surgery results from a trauma, it's more difficult.

I don't know where to tell you to start in your State, but I'd suggest researching doctors. Don't worry about offending anyone, gather all the information you can just like you would in hiring any professional. My primary care/endocrinologist was really helpful there by quizzing other doctors, nurses in orthopedic surgical units are another good source; did you meet any when your husband had previous surgery? When I chose my surgeon after meeting three, I had been told by other doctors, a surgical nurse, and two radiologists that he was one of the two best in NW (and often called on to redo unsuccessful implants for patients).

I know your circumstances are more unusual for the surgery, but I'd insist on the very best surgeon experienced in the more difficult cases...Your husbands mobility is at stake. Good luck to you both....


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RE: 3rd hip replacement????

I know that this won't be a comfort, but bone infections are VERY difficult to clear up. It's hard to get the antibiotics into the bone. However, it can be done. New techniques are coming out all the time. All the advice I can give is to keep on trying. I know he feels dismal about the situation, but it can turn out OK.
Take care!
PB


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RE: 3rd hip replacement????

My nephew builds and designs joint parts.Not all parts are created equal.He has told us of knee joints and hip joints that routinely cause problems that require replacements and redues.Find out from your doctor which hip joint,who makes it,the track record of sucsessful replacements,and which joint they plan to reinstall if possible.BTW,his company requires one of their engineers to supervise all surgeries now due to the number of joints that have been installed upside down.scary isn't it?


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RE: 3rd hip replacement????

I have had an 2 unsuccessful hip replacements and going for 2 more....just read below. I have been in pain since Oct 2007 when the 1st surgery was done. Here is my story: In Oct 2007 I had a full hip replacement the Dr that did the surgery positioned a stainless steel cable around the femur due to the leg being cracked either before surgery or during surgery (even though I told the Dr before surgery I was allergic to stainless steel). I continued to have alot of pain after surgery and the dr had no idea why so he referred me to a pain management clinic. The pain management clinic after several months referred me to a Dr who specializes in revisions of implants. He found the bone and the hip were not growing together at all spots but I explained about being allergic to stainless steel. The new ortho decided to take the stainless steel cable out to possibly solve the pain issue on March 5, 2009. This was a simple surgery w/ an approx 3 1/2" incision. On March 12 the hip started to swell. It swelled to the size of a softball at the hip. On March 16th I went into surgery for an I&D (incision and draining) for the swelling. The Dr said there was no infection just a clear fluid buildup. On approx April 6, 2009 the hip started to swell again and the Dr said go, stay off of it and keep ice on it. On April 14th I saw the Dr at his office because the swelling kept increasing and the pain was horrible too. He stated he would put me into surgery on April 15th and he would go back in and do an I&D this time all the way to the hip joint and if needed he would replace the cup that may possibly be loose and was not growing to the bone as stated above. The Dr said he would keep me for a few days this time so he could watch it and keep the IV antibiotics running longer.I lost alot of blood and he transfused me 2x (by Sat April 18, 2009 my blood level dropped to 23). This time the Dr said it was again a clear fluid that grew nothing on cultures and he replaced the ball and socket so no infection or anything could grow out of those areas. He released me on April 20, 2009. On April 21 the day after being released for the 3rd time from the hospital, my hip started to swell again. It swelled fast and very hard and even more painful than before. The Dr wanted me to sit with the swelling over the weekend of April 24, 25, 26th. By Fri the 24th I was vomiting as the pain was so bad and the swelling was the size of a small watermelon cut in 1/2. My ins co. and home health care workers said to go to Vanderbilt hosp instead of St Thomas where I had been treated cause my Dr did not want to see me. I went to Vanderbilt around 6pm Fri4/24/09. (This is another story on how Vanderbilt dumped me and sent me back to St Thomas). Vanderbilt was confident of the work my Dr was doing and would not treat me and said I should go back to my Dr at St Thomas Hospital. I was back at St Thomas hospital by 10am and admitted to a room by approx 3pm on Sat 4/25/09. It was determined a vein was bleeding out and my kumadin was stopped, Vencomycin was started again and pain meds were started. The bleeding was stopped by approx Mon 4/27/09. They continued to treat the pain, run the antibiotics etc. I was released again on Wed 4/27/09 after the pain meds had been adjusted in a fashion to possibly keep me from vomiting and allow me to function at home. Note: This is another issue as well** I was released and instructed by my case manager at the hospital that home health care would be at my house at 6pm on Wed 4/27/09 to run my iv antibiotics as per my discharge instructions that I am to have iv vencomycin 2x a day. Home health care never showed due to the hospital not giving them correct information and instructions. That as I stated is another story. before discharge the Dr stated he felt the clear fluid pockets that he had done the 2 I&D's on were from a staph infection that I have had since the hip was put in back in Oct 2007 and after the iv antibiotics and the Cipro antibiotics are stopped on June 1, 2009 there is a chance that the pockets of clear fluid may come back again since it a staph infection. He labeled my diagnosis to the home health care agency as MRSA. For my ins co he labeled it infection and inflammatory reaction. On Tues 5/19/09 I went back to the Dr because though some of the blood swelling had dissepated, the swelling started again like before. The Dr finally stated it was a staph infection and the only way to fix it would be to take the ENTIRE hip out that had been installed in 2007 and insert a spacer w/ antibiotics in it that would course thru the body for 3 mths. I will be able to drive when im ready but I will be on cruthches the whole time. He feels this should cure the infection. In 3 mths from now I have to go back to surgery and take the spacer out and insert a whole new hip again.He has taken me off the IV antibiotics for the next 2 weeks to hopefully get something to grow on the cultures but w/ it being a very slow growing staph infection it may never do that. I have been told by otho chief of staffs at other hospitals along w/ several other drs that if the antibiotics were stopped it left me w/ a 10% chance of surviving. I continue to pray and pay attention to how I feel because even a slight chance of sickness i will be on my way to the hospital. I am only 48 w/ a GREAT life and am not ready to die by any means. I feel that a staph infection was presented into my body in either Oct 2007 during the 1st hip replacement or in March 2009 when the stainless steel cable was removed.
I really do feel for you and your situation as this will be my 5th hospital stay and 4 surgeries since March 2009 for this infection due to someone's negligence!
When you have it replaced if you must again they must place a temporary hip that has antibiotics that will release into your body throughput several mths to rid you of this infection. To simply replace the hip is not enough. IV Antibiotics 1500mg 2x a day....cipro antibiotics 500mg 2x a day was not enough to fix this. But they will do that same course of treatment for 3 mths along with the insertion of a spacer/temporary hip loaded w/ antibiotics should do it. I can let you know how I do if you want to send me your email address. Talking w/ people and research into this is very important for you. Best Regards, Margaret


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RE: 3rd hip replacement????

May 10 I had my first hip replacement and after the surgery, I was on an antibiotic (AB) for a few days, but I don't know which one.

June 7 noticed redness in wound and went to GP as I was concerned about infection. GP prescribed Ciprofloxacin in tablets

4 days later infection worse. Started intravenous AB of Clindomyacin and Ansif.

June 17 first hip revision. Dr. only changed liner and cleaned out area as the area was obviously infected.

June 19 Second revision. Complete removal of all hardware, cleansing of site and implant of all new hardware.

June 20 - July 18 in hospital. Began protocol of Vancomicin (intravenous) and Rifampin orally.

Had attacks of Gout every week while there which were brought under control with Indomethacin and Colchicine.

July 12 developed fever (40c/103f) which was found to be caused by the Vancomicin.

July 14 discontinued use of Vanco and Rifampin and began course with Linezolid (IV)

July 18 discharged and continue Linezolid treatment orally at home

Aug 10 AB treatment finished and Dr.'s want to give a rest for a week or so and then do some blood cultures to see if bacteria is dead

Aug 17 develop fever (39c/102f) and am at hospital 18th and 19th for tests including an abdominal cat scan, chest xray, bloodwork (including cultures), stool samples etc. I was diagnosed with C Difficile, Diverticulitis and possibly the infection in the muscle attached to his hip has returned. I was having difficulty putting weight on the hip joint which is an indication of potential infection.

They prescibed 3 AB's: Metronidazole for the C Dif and Refampin / Sulfameth for the potential hip infection.

Yesterday I was at the hospital where they inserted a needle into the hip area guided by an xray machine and tried to extract any liquid around the joint; there was none, which my surgeon is pleased about.

The C Dif seams to be well in hand. Nobody seems concerned with the Diverticulosis and I am bearing weight on my new hip better today.

The blood work from last week came back and none (including cultures) show any infection.

However, the truth is I can hardly stand on the new hip.

The Doctors say that if they have to replace the hip again, they will do a 2 stage revision. Stage one, they will remove the old implant and pack the area with AB soaked cement. I will also continue on a course of IV and oral AB's for 2-4 months and then they will try a new implant.

I don't know what to do. If I do go ahead with this next revision, what happens if it gets infected again? When does it get to the point where I tell them to take the implant out, fuse what is left of the bone and I'll live with no hip.

Are you now living without a hip? Is anybody out there living without a hip? What are the options? I don't know what to do.
Greg


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RE: 3rd hip replacement????

Hi, I'm the original poster of this subject. My husband had 3 different hip replacements put in, then the last one was taken out because it was infected also. He didn't have any put back in because the Dr. felt it wouldn't improve my husbands situation. He was a very negative man and wouldn't do anything to help himself. He could walk around the outside of the house when the therapist came, but would never walk a step otherwise. He wanted to die, and would not do anything to help himself. He died 4 years ago. Good luck to you all, and think POSITIVE!


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RE: 3rd hip replacement????

JamieG81, My husband got rid of the MRSA when they took out the hardware for the last time. He didn't have pain in the hip then either. He just knew he didn't have a hip bone so he wasn't going to walk on it. He COULD walk with a walker, but he would not. That isn't really what caused him to die, he died of heart problems, but I'm sure it was all part of the same thing. If he couldn't 'walk' (meaning walk normally), then he wouldn't try, he just laid in bed or sat in his wheelchair and did nothing.

Good luck with your Dad. I hope you have help with him. It can certainly wear a person out, physically and mentally. We were lucky I guess, because we had health care aides. He was injured in a car accident. Good luck, I guess it's all up to your Dad if he wants to fight or not. I hope he does. It's a long slow process. Good luck to you both. Ruth Ann


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RE: 3rd hip replacement????

Well I had a motorbike accident a year ago. Had a double fracture, upper left femur and was in need of a hip replacement. I was walking for more than a year on crutches. Now, I went to hospital to get that hip replacement. They found out, I had an infection in my hip. For the last 9 weeks I'm in hospital now, had a few times surgery to clean up the infection. This morning my surgeon told me they either put in a real hip replacement or just a temporary one. So at least I could get up and walk. Would have to take antibiotics for a year or so.


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RE: 3rd hip replacement????

My mom's hip was finished off by a woman "texting" as she was driving out of mini-mall. She was looking down when coming out of driveway while mom was stopped ready to enter. Mom was broadsided! She had months of therapy & finally an MRI & looked like a birds nest on that side. Other side looked fine. So her bone rotted away & she can still walk. You have muscles & tendons that "hold" you together. Her leg is shorter & walks with "lift" in shoe which makes back of her heel get raw so she mostly sits in her recliner & walks around the house. She is 90 & uses only 4 prong cane when she goes out to dr. So you can live without a hip but with some with lot of other problems they might be only able to get out of bed & into wheelchair(knew woman like that) she had to have help doing that. Good Luck with any of you facing surgeries. Septis(bone infection) is very bad & hard to get rid of if that is what you had. Some of staph infections are very resistant as my GD had 1 about 4 yrs ago & took 3 rounds of antibiotics to get her well & she was in junior high so just a kid & healthy otherwise. They are called "superbugs" & resist treatment!


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