Hip Replacement Revision

[Morganalefaye]

I have both osteo and psoriatic arthritis, degenerative disc disease, osteoporosis, (-3.2) and a Grade 1 Spndylolistheseis, Sjorgren's Syndrome, (plus Crohn’s Disease). In 2012 I had an extremely severe flare of the Crohn’s and around the same time my hips began to seize up, (literally). In 2015 I had a second bowel resection, in 2016 my left hip was replaced, and in early 2017 my right hip was replaced.

The first, left hip replacement, was an absolute nightmare from the start, pain-wise and functionally, and has never properly settled down. No trouble at all from the second hip replacement, (right hip), which was clinically, in fact worse that the left hip, although, strangely, less painful pre-op. My left hip was cemented in whereas my right hip was ‘screwed’ in. The second, more successful right hip replacement, left that leg slightly shorter than the painful left hip. I realise my questions are pretty specialised, but anyone with personal experience might have similar problems in which case I’d like to hear from you!

If my left hip-joint had been affected by psoriatic arthritis at the time of the hip replacement, could this have affected the recovery?

Are hip-replacement ever positioned ‘wrongly’?

Thanks for reading!

[Batty1]

Psoriatic arthritis definitely could effect the recovery process…. I developed a horrible flare in my right knee after a meniscus repair (regret) I could hardly walk and took 3 years for my knee to properly straighten I pretty much walked on my toes…. My orthopedic surgeon kept saying PSA won’t effect your knee like that “yes it can and it did”.

My PSA attacks my tendons (Enthesitis) are you on a biologic medication for your PSA?

[Morganalefaye in reply to Batty1]

Thank you. Yes, I think the psoriatic arthritis is attacking my tendons. I’ve been telling anyone who’d listen that for years, but I didn’t know what it was.

Until recently I was on Azathioprine for the Crohn’s, but the rheumatologist I finally got an appointment with, (who diagnosed psoriatic arthritis), suggested my gastroenterology team changed me to Methotrexate, which would help with the Crohn’s and the psoriatic arthritis. (I’ve also been on Salazopyrin for years). That was last August - still waiting because the gastroenterologist ‘didn’t see the letter’ from the rheumatologist until I emailed him a copy two weeks ago. The rheumatologist suggests the gastroenterologist effects the change, and vice versa. I’ve got an appointment with my G.P. in two weeks. Maybe she’ll do it?

[Batty1 in reply to Morganalefaye]

Sorry to hear that no one listens. Hopefully you can get on methotrexate soon versus later.

I inject Cosentyx monthly and take Otezla twice a day everyday. I believe if I wasn’t treated like a crazy person for 2 years when I complained relentlessly about my pains maybe just maybe If I got treatment sooner I could have gotten this relentless monster uncontrolled…

Recently I have been reading a bunch about collagen supplements (powders) being helpful with arthritis it sounds interesting and something Im considering. I also use Australian Dream Cream and it’s absolutely helpful but expensive (amazon).

[Morganalefaye in reply to Batty1]

I presume someone did eventually acknowledge that the longstanding problem with your knee was indeed due to the psoriatic arthritis? Is that why you were put on the medication which you are now on, and did it alleviate the long-standing problem with your foot and your ability to walk? Have you ever been on Methotrexate and if so, did it help?

[Batty1 in reply to Morganalefaye]

My knee issue actually stemmed from being athletic and simply damaged from marathons, 1/2 marathons and fitness classes for years.

I have a crazy PSA story:

I started Stelara in 2015 for (psoriasis) NOT PSA I did always have minor aches and pains but nothing earth shattering… in 2016 I became very ill with eye popping issues and eventually I went to my eye doctor he discovered something off in my eyes and he sent me to the Endocrinology department who said my thyroid was enlarged and needed a fine needle biopsy thats when I found out I had (thyroid cancer). I was instructed to stop Stelara two weeks prior to my thyroidectomy and this is when my world crashed.

My pain started 2 weeks after my surgery it was so bad I could hardly walk at times but I still managed to exercise everyday. I went out for my 10 mile walk and found myself 5 miles from my home in the middle of the woods when I collapsed on the ground in 35 degree temperatures and I was unable to get up I had no cell phone this walk would normally have taken a little over and hour round trip but this day it took me over 5 hours to drag myself back to my house … this was my ah-ha moment when I realized my pains wasn’t normal at this point it took me 2 more years to get a PSA diagnosis in-spite having moderate to severe psoriasis my entire life….

The biggest mistake ever made was listening to the doctors and stopping Stelara before thyroid surgery ….My Rheumatologist said this is what caused my flare ….. My nightmare started 7 years ago and destroyed my career and sucked the life out of my soul…. Little dramatic but thats what it feels like.

[Morganalefaye in reply to Batty1]

‘35 degree temperatures’! Not in England then? 😊 My story is not dissimilar. Slightly more convoluted. I too was fairly athletic despite being diagnosed with Crohn’s when I was twenty. I managed to keep it under control, but as I grew older controlling and balancing all of my many ailments became more  difficult. I suspect now that while I had only osteoporosis in my right leg, where the hip replacement worked very well, that I actually had psoriatic arthritis in my right leg, thus, the hip replacement had never really settled. I do ‘get’ that it is difficult for medics when we have these rather more complex problems. Difficult for us too! I’ve never heard of the medication you’ve mentioned in the U.K..

[Batty1 in reply to Morganalefaye]

My medications are called biologics Im sure you have them but your just starting out with these types of meds (methotrexate) your on what we in the US call step program for meds …. Start you off on least expensive meds and work up from their….. I skipped all the steps went straight to the top of medication for PSA … Im seriously in horrible condition with PSA which is relaxing a little but I still walk like a robot no flexibility at all …. My PSA is currently attacking my arm and hand … such a joy!

35 degrees is my early fall temps yesterday we hit 17 degrees… bring on summer which I will complain bring on winter because summers here can be so humid.

Thyroid disease go hand in hand with PSA so you should have thyroid levels tested and not just TSH thats not adequate. The things I never knew until it happened.

[Morganalefaye in reply to Batty1]

It’s just below freezing here just now. 17 would be a coolish midsummer day! I loathe winter more and more every year, and I’m not keen on anything much over 25.

I appear to have osteoarthritis along with psoriatic arthritis, CPPD, Sjorgren’s and Crohn’s. I had osteoarthritis in both hips, but the more I learn, the more sure I am that I had psoriatic arthritis in my left hip, alongside the osteo. That hip, (left) has never healed properly, and my left foot and ankle is agonising just about ALL of the time, and has been since before the hip replacement. I was told the problem was sciatica, and it was only after I finally saw a neurosurgeon to have a back decompression to solve the ‘sciatica’ last year that he questioned whether my foot pain was actually sciatica, which is why I was finally allowed to see a Rheumatologist, who diagnosed psoriatic arthritis, CPPD and slightly raised parathyroid hormones.

[Batty1 in reply to Morganalefaye]

I also have Osteoarthritis along side PSA (Joy) and I have IBS the problem is doctors blame Osteoarthritis for every ache or pain you have, sadly but at the end of the day the treatments are pretty much the same no cure just bandaids…. Ive been grounding flaxseed and adding it to my fruit/vegetable smoothie every morning and it seriously seems like Im feeling less pain it could be me just being hopeful but it really does.

I wish you well and I hope the Methotrexate works if your not improving after a few months or less I would speak up their is other options.

Try Australian Dream Cream … it really helps!

[Morganalefaye in reply to Batty1]

The Australian Dream Cream doesn’t seem to be available in the UK. Our National Health Service was struggling before the pandemic. Since the pandemic, it’s on its last legs!

Having had two resections for IBD, I have to be really cautious about what I eat.

[DorsetLady in reply to Morganalefaye]

It is online -just search for it... defo on the big A as well as eBay

[Morganalefaye in reply to DorsetLady]

Thanks. I did look on Amazon. Couldn’t see it. I’ll try ebay.

[DorsetLady in reply to Morganalefaye]

Just looked now - says it’s out of stock……and EBay …😟

[Morganalefaye in reply to DorsetLady]

I’ll keep my eye open then.

[Cup-cake7 in reply to Batty1]

what is it in the cream that helps pls

[Batty1 in reply to Cup-cake7]

verywellhealth.com/australi...

[Cup-cake7 in reply to Batty1]

Thankyou! And very well documented. Much more than others 😊

[Cup-cake7 in reply to Morganalefaye]

anyway. It's Marcus Cope orthopaedic ! He has various videos on u tube and a fb

[Jackie1947]

My right hip replacement in 2015 has left me with bursitis so I'm in constant pain. Steroid jabs help in the short term. Left hip replaced 2020 not perfect but okay

[Morganalefaye in reply to Jackie1947]

Did they replace the hip knowing you had psoriatic arthritis?

[Cup-cake7 in reply to Morganalefaye]

could it be the sacriotic joint sorry about spelling.

Il send a link this guy seems knowledgable

[Jackie1947]

I have RA and made no difference to surgery. Both are auto immune disorders

[Morganalefaye in reply to Jackie1947]

Apart from the fact your hip replacement has left you in constant pain with bursitis?

[Jackie1947 in reply to Morganalefaye]

I've seen the orthopaedic surgeon many times and my Rheumatologist many times and it has nothing to do with RA. It's not widely mentioned that many people are left with after pain fit or not

[Morganalefaye in reply to Jackie1947]

I believe there are significant differences between RA and PsA. My question really was, can PsA exist simultaneously in the same joint, (in this case the hip), as osteoarthritis? Several people have assured me that it can, and that if the individual is suffering from a flare of PsA at the time of the hip replacement, the healing process following the joint replacement would be affected negatively. Obviously osteoarthritis is not considered an autoimmune condition, whereas if there was underlying and unrecognised PsA, (or indeed RA), the inflammation of an autoimmune type of arthritis within the same joint, would be greatly exacerbated by the clinical ‘insult’ to the joint, (particularly a large joint such as the hip.) Thus, the healing process would be much delayed, and prolonged.

I understand whereas RA affects both sides of the body equally, PsA can and does affect single joints. My left hip replacement has never healed properly and remains very painful seven years after the op. My right hip healed quickly and reasonably well, and has never caused a problem with pain or mobility.