My father fell & broke his hip at age 83. Until then was very active and working (driving tractor 8-10 hours a day, etc). Hip was repaired with pins that failed and several months later a total hip replacement. Pain after surgery was better than prior but has steadily gotten worse and worse until now at age 86 he can barely walk, cannot put any weight on that leg. He states pain is terrible at night and now even when just sitting. Pain is worse if he tries to walk or stand to do dishes etc. Could his hip (Sulzer) be failed and how can this be determined? What type of tests, xrays etc. should be done? His doctor said MRI would be of no value and feels it is a sciatic nerve problem and nothing can be done. What do you think and should we get a second opinion? We also just found out this Sulzer company has had problems with their hips so I am...a worried daughter.

-- Diane Rehder (instype@redwing.net), August 16, 2003

Answers

There was a recall involving Sulzer implants. It only involved a certain lot of implants from 2 years ago. If your father had one of these, he should have been contacted. There were approximately 4000 patients involved in the recall. If you think your father may have a recalled component and you have not been contacted, you can inquire of the company, which is now called Centerpulse.

Generally, loose components are fairly easy to identify on a plain xray. Mri is not of any use.

Are you sure he had a total hip replacement. At his age, and after a fracture, it is fairly likely that he had a partial hip replacement. In this case the femoral head is replaced but the socket is not. These devices can become painful after a while. The solution is to convert them to a total hip replacement.

Good luck

-- Marc Hungerford, M.D. (mhunger@jhmi.edu), August 20, 2003.

Absolutely you should get a second, third opinion. Like your father, after 1 1/2 years I was still in severe pain from first replacement at age 35. The third doctor finally discovered from the last bone scan taken that the stem was entirely loose. If his doctor has no desire to pursue an answer when obviously your father can't even sleep or assume any position to alleviate the pain, it is time to move on to someone who gives a damn. It was very hard to leave my first surgeon because I felt he knew my case, after all, he installed the equipment, but when he made me feel incompetent about not healing I knew it was time to be an advocate for myself. Please help your dad pursue another opinion and get a bone scan. Many xrays show no problems with placement of joint, but a bone scan will indicate possible loosening or infection. Gallium scan or CBC would indicate infection also. Be persistent and good luck.

-- DeAnn Major (WthrngHite@aol.com), November 22, 2003.