Page 5 of 6 FirstFirst 123456 LastLast
Results 41 to 50 of 60

Thread: i have no hip

  1. #41
    Senior Member cali's Avatar
    Join Date
    Sep 2005
    Location
    where everyone knows your name
    Posts
    4,608
    thanks, Keiser! i've decided to get the girdle stone because if i get a replacement done now, i won't be able to do anything indepenently including a transfer because no matter what, i'd break the 90 degree limit, causing an invitation for a dislocation.

    i know everyone says no no no never get a girdle stone because it's a one and done thing, but if/when i'm able to get muscle control in the hip and leg, my surgeon is able to go in and put a hip replacement in for me. that way i'll be able to have full range of motion and not risk dislocating it again.
    Never take life seriously, nobody gets out alive anyway

    Frank's blog:
    http://www.franktalk-scurry.blogspot.com
    My regular blog:
    http://www.ithinkithinktoomuchblog.blogspot.com

  2. #42
    Senior Member
    Join Date
    Jul 2008
    Location
    Brisbane, Queensland, Australia
    Posts
    273
    Sorry, I shoulda done more research or even asked about your movement capabilities. I know nothing of the girdlestone . I must admit I am a little confused with the 90 degree limit you quote. Dos that mean you will not be able to lift you leg more than perpendicular (90 degree)toward your chest? Off to do a little more research...

  3. #43
    Senior Member cali's Avatar
    Join Date
    Sep 2005
    Location
    where everyone knows your name
    Posts
    4,608
    Quote Originally Posted by Keiser View Post
    Sorry, I shoulda done more research or even asked about your movement capabilities. I know nothing of the girdlestone . I must admit I am a little confused with the 90 degree limit you quote. Dos that mean you will not be able to lift you leg more than perpendicular (90 degree)toward your chest? Off to do a little more research...
    girdlestone is where they cut the head of the femur off and let it as is. since a hip replacement removes the ball of the hip anyway, it'll basically be an unfinished hip replacement.

    when people get their hip replacement, they have limitations as far as range goes, maning they don't want to stress out the replacement and the muscles and tendons around it. this is set for three months with an able bodied patient along with physical therapy to keep the muscles and tendons healthy. since an sci's muscles and tendons are flaccid and not holding the hip in place which caused the dislocation in the first place, plus those muscles and tendons are used to being in the stretched position when it was dislocated, those restrictions reserved for able bodied people are our restrictions forever instead of the typical three months.

    those limitations are not lifting the leg past 90 degrees from your chest. so even leaning forward the littlest bit is breaking the restrictions. the constraint ring could help keep you from breaking the restrictions, but the more you slip up, the more wear and tear you'll have on the ring and the rest of the equipment.

    hope that answered your questions!
    Never take life seriously, nobody gets out alive anyway

    Frank's blog:
    http://www.franktalk-scurry.blogspot.com
    My regular blog:
    http://www.ithinkithinktoomuchblog.blogspot.com

  4. #44
    Senior Member
    Join Date
    Jul 2008
    Location
    Brisbane, Queensland, Australia
    Posts
    273
    it did answer my questions... but something I forgot to mention with my replacement, is the surgeon went out of his way to conduct a release of the tendons and ligaments and so forth, I have more movement than I had before the operation - sorry I shoulda mentioned that earlier. I may be off base (again) but, Ask your doctor if this may be an option for you...

  5. #45
    Junior Member
    Join Date
    Apr 2009
    Location
    Costa Mesa California
    Posts
    29
    Cali, I don't know but this may be of help. You may well have seen Stem Cell Treatments in the news a lot. This is a video of a child who was helped. It's tear wrenching but uplifting to know there is hope and help. May at least help with the arthritis.

    http://www.stemgevity.com/video.html

  6. #46
    Senior Member cali's Avatar
    Join Date
    Sep 2005
    Location
    where everyone knows your name
    Posts
    4,608
    i have a lot more going on than just arthritis but i appreciate the effort, thanks.

    we did talk about the tendon issues and it's that they don't have tone and are used to the dislocated position, so loosening them wouldn't help.
    Never take life seriously, nobody gets out alive anyway

    Frank's blog:
    http://www.franktalk-scurry.blogspot.com
    My regular blog:
    http://www.ithinkithinktoomuchblog.blogspot.com

  7. #47
    Senior Member CurvySAT05's Avatar
    Join Date
    Mar 2009
    Location
    Southern California
    Posts
    492
    Cali,
    Have you spoken with the ortho about the possibility that with the Girdle Stone procedure that your hip will continue to dislocate and deteriorate the 'new' femoral head? I would be concerned that because he basically just shaves down the femoral head so you have a nice fresh surface that it too will wear and when it comes time for a hip replacement they will need to cut that off and have even less bone to anchor the replacement to.
    Is there any way you could see Scotts surgeon at Cedar Sinai Hospital in LA? Sounds like he has done quite a few of these procedures with the constraint ring and had patients with SCI, so he might have a good idea for treatment in the meantime if you decide you are not ready for the replacement.
    In your other thread you were asking about "expiration dates" for hip replacements and mentioned not noticing a "expiration date" for spinal hardware involved with fusion. The reason for this is the spinal hardware is meant to hold the vertebra in place while the new bone is forming that actually fuse the vertebra together. In the end, instead of having 2 (or 3 or however many vertebra you had fused) vertebra, the bone grows in between the 2 vertebra to form one longer vertebra. In my case (I had severe scoliosis) I had 17 levels fused (from T2-Sacrum) so all those vertebra are now one long bone. After the bones are fused the rods don't serve any function and can be removed if needed, but surgeons like to leave them in unless they cause any problems (sometimes they will irritate nerves, etc). Since the bones in the vertebral column don't move after fusion, the rods don't (or shouldn't) get any wear and tear.
    With a joint REPLACEMENT the metal hardware actually takes on the function of the joint and will rub up against the surface it is in contact with (whether it is actual bone from a 1/2 replacement of the joint, or whether it is another titanium piece from a complete joint replacement. Because there is motion there they tend to wear out with time.
    Hope that answered your question a bit. Don't give up on second (third, fourth, fifth, etc) opinions until you are COMPLETELY comfortable with the surgeon AND the treatment option. You know your body the best, so don't try and let a surgeon manipulate you into believing there are no options. If multiple (more than 2) surgeons suggest the same treatment plan than you know that you are gonna be in good hands and can choose the surgeon you feel most comfortable with, that has the most experience with the procedure you are going to have, and has experience with patients with SCI.
    Good luck!
    Mandy
    ~Mandy~
    SCI as a result of spinal surgery
    TiLite Aero Z!!!

  8. #48
    Senior Member cali's Avatar
    Join Date
    Sep 2005
    Location
    where everyone knows your name
    Posts
    4,608
    i've never heard of a girdlestone causing additional wear to the femur. i'm assuming my spasms will be decreased significantly because there won't be any direct or constant contact with the femur and the hip. my spasms began when i started to have arthritis start. nothing is written in stone as far as when or what operation, but i really am leaning towards getting the girdle stone done since i can have a replacement put in later on. i was told as well as others that have written here (by their doctors) that there is no worry for a dislocation with a girdlestone. i will ask my doctor if there is any risk for additional wear to the femur if i do get that procedure done.
    Never take life seriously, nobody gets out alive anyway

    Frank's blog:
    http://www.franktalk-scurry.blogspot.com
    My regular blog:
    http://www.ithinkithinktoomuchblog.blogspot.com

  9. #49
    Quote Originally Posted by cali View Post
    i've never heard of a girdlestone causing additional wear to the femur. i'm assuming my spasms will be decreased significantly because there won't be any direct or constant contact with the femur and the hip. my spasms began when i started to have arthritis start. nothing is written in stone as far as when or what operation, but i really am leaning towards getting the girdle stone done since i can have a replacement put in later on. i was told as well as others that have written here (by their doctors) that there is no worry for a dislocation with a girdlestone. i will ask my doctor if there is any risk for additional wear to the femur if i do get that procedure done.
    Cali,

    I have read and thought more about your situation, what you said about the pros and cons of the Girdlestone procedure and a total hip replacement. As I understand it, a Girdlestone arthroplasty is simply a procedure that removes part of a necrotic femur head without replacing the femur head with a prosthetic femur head. Normally when they replace the femur head, they cut off the entire head some distance from the joint and insert the prosthesis into the femur. By not replacing the femur head, it means that the hip will not be able to do any weight-bearing at all.

    Let me make sure that I understand what you are saying. Because you have had this hip problem for many years, your orthopedic surgeon is concerned that the tendons and muscles are lax and not capable of holding a new prosthetic femur head in place. You refer to a "constraint ring", an acetabular prosthesis that holds the femur head in place. The failure rates of acetabular prostheses range from 5-15% amongst able-bodied people who get total hip replacement. I don't think that you will be putting as much stress on your hip joint as an able-bodied person.

    In the post-operative phase, the general policy is to not flex your hip more than 90˚ for a period of time. You are concerned that this would interfere with your transfers. How long does your doctor recommend? Most protocols that I have seen suggests 8 weeks. As I indicated to you in a private message, I do understand your logic. Cutting back the femoral head would resolve the irritation and arthritis in your hip joint, which may be causing your spasticity. That is your primary concern right now. A Girdlestone would indeed do that but would leave you without a weight-bearing hip joint. You can get a hip replacement later. Sooner or later, however, you would have to undergo the hip replacement if you intend to do weight-bearing. Why not sooner and in one procedure?

    I looked into acetabular constraints and found that the degree of acetabular constraint failure depends on the device used, including S-ROM constrained acetabular polyethylene liner made by Joint Medical Products, Stamford, Connecticut (Source) and Osteonics Constrained Tripolar Implants (Source). These are the two products that have been approved by the FDA (Source).

    Large diameter femoral prosthetic heads allow more ROM and less hip dislocations (Source). One large series by Daniel, et al. (Source) indicate no dislocations in 206 hip replacements using large diameter femoral heads, compared to the usual 3-15% dislocation rate of regular size femoral head prostheses. Large diameter femoral heads appear to have fewer dislocations (Source) even without acetabular constraints (Source).

    Wise.
    Last edited by Wise Young; 04-17-2009 at 09:46 AM.

  10. #50
    Senior Member cali's Avatar
    Join Date
    Sep 2005
    Location
    where everyone knows your name
    Posts
    4,608
    i replied to you message, but i'd like to clarify here as well for those who might find the information useful. my doctor wants me to keep the initial precautions for a total hip replacement (which are kept for 8 weeks as you said) at all times. that means i won't be allowed to break the 90 degree angle from my chest and thigh at all. this will essentially render me dependent, and i just can't go back to that.

    my concern is if i get the girdlestone done, all i have is a promise that my doctor is confident that he can do a complete hip replacement when i need it and an article showing that it was successful for one other person.
    Never take life seriously, nobody gets out alive anyway

    Frank's blog:
    http://www.franktalk-scurry.blogspot.com
    My regular blog:
    http://www.ithinkithinktoomuchblog.blogspot.com

Similar Threads

  1. Replies: 0
    Last Post: 08-07-2008, 08:27 AM
  2. Researchers in England Develop a New Type of Artificial Hip
    By Max in forum Health & Science News
    Replies: 0
    Last Post: 12-15-2004, 07:58 PM
  3. Replies: 0
    Last Post: 03-30-2004, 05:17 PM
  4. Replies: 0
    Last Post: 08-21-2002, 01:43 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •