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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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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.
Mon, 5 May 2014
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Orthopaedic Surgeon, Joint Replacement 's  Response
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.
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Length Difference In Legs, Knee Pain. Hip Replacement, Cemented Prosthesis. X-ray Shows Fractured Cement. Treatment?

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.