Symptoms Timeline: HIP PAIN

Kind of Hip Pain I Experience:
- When leaning forward
- When walking with big strides
- After any form of exercise
- Sharp pain when I get up from being on my haunches
- Pushing my hip to the left whilst standing
- Stiffening discomfort after walking for more than 20 minutes continuously
- Sensitivity and pain around the scar tissue. This area has been warm and appears inflamed. I have noticed it getting progressively worse. 
Over the past 18 months, I have been aware of an ever-present discomfort, which my surgeon attributed towards tendinitis and ligament strain.

View from side
Swelling of left thigh at incision area


















11/02/2012

Email sent to my original surgeon:
[Hi Dr,
I have had some tests run at Panorama, and I am awaiting a chromium and cobalt level test, after my physician suspects this could be the cause of my symptoms.
Can you recall which product you used on me? I have an appointment tomorrow at Panorama again to see a neurologist who is investigating my recent headaches and problems with speech.
Please let me know how you can assist me - my symptoms are getting progressively worse.
Regards,
Dominique Attree]My surgeon calls me back and tells me it was the DePuy ASR. We schedule an appointment for 20/02/2012

15/02/2012
Consultation with an orthopedic surgeon for a 2nd opinion. He is not familiar with the recall issue, but continues to discuss my case with me. He looks at the x-ray, and commends the surgeon for perfect placement. He does not know anything about the complications around the DePuy, and we go through a brief physical examination.
I explain the pain that I have to him, and he suspects its the ligament moving over the joint, but does not exclude complications from the DePuy prosthesis.


20/02/2011
This is the first time my surgeon has told me about the recall. The seriousness of the recall was down-played, but this is what was discussed:-
- How many revisions have you done as a result of the DePuy ASR? > 5%
- How serious is cobalt and chrome toxicity? > It is only a problem if the placement of the device is incorrect
- How do we explain the hip pain? > We will X-Ray to check the positioning, and MRI to check for effusion or pseudo-tumors.
- Should I need revision surgery, who will pay for it? > DePuy will pay for all your costs related to your revision.
I WAS DEVASTATED. The thought of undergoing another surgery so soon was too much for me to handle!!!!!
My surgeon asked me to complete a form from DePuy/Crawfords, and the reason for completing this was so that I could register with them in order for them to pay for all of my consultations and costs associated with my hip. I was immediately given a DePuy recall card with a number:
I could honestly not even talk further about this with my surgeon. I just wanted to go home and do some research. try to understand this.
I went downstairs for the X-Ray and my surgeon talked me through the positioning, and confirmed no osteolysis, good placement and no loosening of the femoral or acetabular component. We scheduled a MRI and blood test, which would be sent to the UK toxicology lab (this test takes 2 weeks).

02/03/2012
This is a follow-up consultation with my first surgeon, who presents me with the results of my blood test, and acknowledges that the cobalt level is high, but that it is normal for anyone living in an industrial area, i.e. Cape Town. Now I had done research and found papers from various medical journals, saying that a toxic level is >5 ug/L. Mine is 16.9 ug/L. Naturally this frustrates me and I am pissed off by how my surgeon is down-playing this. He tells me I will probably not need revision surgery - everything looks good. We discuss the MRI result and he says there is nothing wrong - all looks perfect. I questioned him on the MRI protocol used, and I said that the MRI is in fact useless - as the radiologist put it: "if a small lesion is present, it cannot be seen due to the artifact". My surgeon tells me he will not book me for surgery until I have put thought into it, and recommends to me that I do not need revision surgery.

05/03/2012
I consult with the 3rd surgeon, who has special interest in revision surgeries. Read more about our discussion here. He does the first proper (in my opinion) examination. We discuss my hip pain at length (my consult was just over 70 minutes).
He also looks at the scar, which looks terrible. Based on our discussion, we both agree that revision surgery is needed.