| Carl and Pam |
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This patient is experiencing a lot of pain and he is over 10 months post op. Still no conclusion as to why he is having pain. (April 2009 Update below and cause of pain found) Surgery November 19, 2007, 39 year old male From his wife He was doing fairly well after the surgery. If you see from the posts, the accident left him with inadequate coverage from the socket for the femur head. Maybe Posteroinferior coverage of the acetabular wall, or something like that. I will look at the radiology report and see what it said. I will include that as well. March 3, he returned back to work. He was doing Ok, but might have a bit of start up pain, and didn't seem like too much out of the normal of what some of the people with "slower recoveries "where experiencing. Again, he is a union, commercial plumber, so his job requires much bending and stooping. Since about the end of May, he's been complaining of pain. Somedays just throbbing, somedays aching, until finally we called Clohisy in first of August, and they got him in.  Main symptoms he was having then, and still now are, 1.) Sharp shooting pain in groin while Standing on operated leg and lifting other leg to put on pants, 2.) Sharp pains in groin when rising up after being in a bent over position, or sometimes from a squating position. 3.) Sharp pains in groin when he's been standing on a ladder, usually with more weight on his operated side, then, comes off of that leg. 4.) Some pain that goes to his knee. Not sure if it's just localized to the knee, or if it is a continual pain from groin to the knee. 5.) He complains like he freezes in a bent position sometimes. Not sure what that actually means, kind of like he gets stuck there.So...mainly he is having these pains that he was not having about 5 months ago. Sharp pains that take his breath away and stop him in his tracks. Seems mostly like when he is shifting weight from his operated, by taking the weight off, is when he has it a lot. Like I said before, he had an injection in the psoas tendon on Sept 9, and it provided NO relief. He is scheduled for a PT on Monday where they are going to try and release that tendon. The other day, he was limping just like before the surgery. So..that's a bit of his pain right now. When I try and get these cd's converted, I will send some details of the accident, and radiology reports so the docs have a bit of history for him. Thank You Vicky, Pam
Mon Dec 24, 2007, 8:16 am
Jan 24, 2008, 5:54 am
Thanks Vicky, Well...we live in Springfield, ILlinois, so, actually going to the radiology dept in St. Louis is a bit out of the way, but, if I have to, I will do that. However, I will try the other route first, and have them send a disc to us, and try to convert. I might need a bit of help doing it, so if I run in to problems, I might contact you if you don't mind. I kind of thought like you, and that they didn't need to know anything either, and that Carl has a right to those w/out any kind of questioning whatsoever. So...I will do that w/in the next few days, and try and have them FEDEX it to us. Thanks so much for your help. He had a painful day today as he has been having lately. Kind of scares me. I've been reading about other peoples symptoms of problems, and some of them sound a bit like Carl's. Also, he has been having pain in his knee as well. We don't know if that is from the traction rod that was in his leg for 4 days after the accident, or if it is from something with this. Thanks Vicky, and I'll be in touch, Pam Diagnosis Finally January 18, 2009 From First doctor From what I can see, I would say like I already mentioned before he has an impingement problem, with a non perfect placed prosthesis that results in conflict from the femoral neck with the cup. If the cup is well placed this can be solved with a stem and big metal head, if not, this means a full replacement. If the metal ions would be very high, it means also a full replacement has to be done. Second doctor response Thanks for sending the recent images. Now the diagnosis is very clear. As I had indicated in my first mail - he shows evidence of pincer type impingement with an indendation sign in the pre-op x-rays. This was due to effective acetabular retroversion consequence of the fracture. The hip resurfacing was not the ideal surgery for him as the same pathology would continue postop. The Aug x-rays that you sent to me later & the Nov x-rays show very clear features of impingement even in the A-P view. This is undoubtedly the cause of his pain. It is highly likely that he will need revision surgery. Third doctor Yes, it is now clear from his most recent xrays that the femoral neck is impinging against the acetabular component." January 26, 2009 Carl is now waiting for an appointment with the third doctor and we will keep you updated on his progress. It looks like he will need a revision to a THR. 
February 27, 2009 Update
Pam, wife of Carl, LHR Wright C+ Update April 23, 2009
Hi to All, Photo: Post op Pam and Carl in NYC, no crutches! Carl pictures during the surgery. He said that after he put him under, and he opened him up, he began to move Carl's leg in diffferent directions. The femur neck was hitting the cup implant (causing severe impingement) every time he moved the leg in all different directions about 2 inches each way. He showed Carl the divets, or notches it had carved in his femur neck. He also released the psoas muscle, and said Carl had severe inflammationan around the hip joint.
Dr. Su truely is a "Rockstar Dock" in our opinion. Photo: Carl back at home, finally pain free! |
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