Hi,I am Dr. Herrick J. Siegel (Orthopedic Surgeon). I will be looking into your question and guiding you through the process. Please write your question below.
Length difference in legs, knee pain. Hip replacement, cemented prosthesis. X-ray shows fractured cement. Treatment?
I am a 69 yr.old male. I had a total hip replacement (right) in June 2008 at age 65. It was a cemented prosthesis although I did not know that at the time. About 2 years ago I started to have a lot of leg pain and I noticed that my leg had shortened by about 21mm. The pain has been resolved through the use of alternative therapy . However the leg length become progressively worse until now there is a 60mm difference between my legs. X-ray has shown that the cement holding the femoral stem has fractured. Blood tests have revealed no infection. Following a bone scan my surgeon (not the original surgeon) recommended that I wear a shoe lift which I was already doing. I have no pain in the joint itself but I sometimes get pain above the knee, especially during a long drive and I am experiencing increasing back pain which i think is being caused by the leg length difference. Should I insist on revision surgery and if it is revised can it be replaced with a cementless prosthesis.
I think there is some confusion. Shortening occurs at the time of surgery and no shortening is possible after 2 to 3 years. If you are not feeling pain and you can walk i do not think that you need a revision surgery.Also I would suggest you to wear shoe raise . As far as cemented or uncemented stem are concern this depend son bone quality, so if surgeon feels that your bone quality is not good, he can not use uncemented stem.
Answered: Sat, 3 May 2014
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