Necrosis of the hip

[D.W.]

Hi all,

Just wondering if anyone can relate to this: The ortho tells me that my cartilage is destroyed in my hip because of radiation. So it is painful--bone on bone. He told me that it will not get better, but worse. I could get a hip replacement but he says it probably won't work because of necrosis (no blood supply). He says if I get a hip replacement then if the surgery did not work I'd be crippled. Crippled! Ugh.

Thanks for any input,

D.W.

[ElaineM]

I don't know if this is the same thing, but I had a total hip replacement after an accident which cut off the blood supply. My new hip is okay and my leg is okay and there is blood supply to the area. Maybe the fact that you had radiation on your hip changes the circumstances. I would get a second opinion to see what another orthopedic doctor says about the situation.
Good luck. Take good care of your health.

[Lani]

Sounds like you need a second opinion at a major teaching hospital and cancer center where a specialized orthopaedic surgeon with extensive experience in treating those who have had radiation therapy to the area can interact and consult with a radiation therapist who can evaluate how much radiation you got to what area/to what affect.

An orthopaedic surgeon at Stanford (who trained @ Harvard) referred a friend of mine who lives in Indianapolis to a Dr. Capello@ Univ. of Indiana (her case differed from yours but was quite severe as I understand it and she remained in a physically demanding job within the field of dance and was therefore in need of something which would meet high demands and LAST.)

I googled him and found the following:


William N. Capello, M.D.
Professor Emeritus of Orthopaedic Surgery

Appointment Scheduling:
317-274-7372



Clinical Interests:
Hip replacement with special interest in revision hip replacement
Research Interests:
Development of hip prostheses and related research investigations of these implants

Board Certification:
American Board of Orthopaedic Surgery, 1974

Education :
MD: University of Pittsburgh , Pittsburgh , Pennsylvania ; 1968
Residency: Straight medical internship, Presbyterian University Hospital , Pittsburgh , Pennsylvania
General Surgery, University of West Virginia , Morgantown , West Virginia
Orthopaedic Surgery, The University of Iowa , Iowa City , IA

Publications:
Dr. Capello is the author of more than 40 peer-reviewed journal articles and numerous book chapters .

Honors, Awards and Recognitions:
The Hip Society John Charnley Award, Bone Imaging: A Means of Evaluating Hip Surface Replacement Arthroplasty; 1980.

Clinical Orthopaedics and Related Research - Guest Editor, Proceedings of the 1987 Hip Society Meeting; December, 1987.

Honored Member of Who's Who in Health & Medical Services for 1991.

The Hip Society Frank Stinchfield Award, Acetabular and Femoral Morphology: Anteversion Angle and Implant Positioning; 2001.

Listed in Best Doctors in America:
2001 - 2002
2003 - 2004
2005 - 2006
2007 - 2008

Orthopaedic Research and Educational Foundation. Shands Circle Member. 1999- present.

Listed in Marquis Who'sWho in America: 2007, 2008

Listed in Marquis Who'sWho in the World: 2007, 2008

Listed in Marquis Who'sWho in US: 2007

Listed in SDL Industries, Inc. "Guide to America's Top Orthopedists: " 2007, 2008

Listed in Biltmore Who's Who Executive and Professional Registry: 2006/2007

Listed in Cambridge Who's Who Among Professional Physicians: 2007/2008

Current Academic Appointments:
2007 - Professor Emeritus of Orthopaedic Surgery, Department Of Orthopaedic Surgery, Indiana University School of Medicine, Indianapolis, Indiana

Appointment Scheduling:
317-274-7372

I cannot recommend him personally as I have never met him and can only tell you my friend was very happy with her result.

I cannot tell you he has extensive experience with post radiation cases, but would wager he would have more experience in this than the vast majority of others in the Indianapolis area as those cases (potentially difficult) usually get referred to university teaching hospitals and unless someone has transferred into Indiana after training/teachiing at some major cancer center like MD Anderson or Dana-Farber or Memorial Sloane Kettering, he may be your best bet.

I did not look up the University in Pittsburg as it seemed you are close/to in indianapolis itself.

Since he is listed as emeritus, he may no longer do surgery (or he might)..but in any case with his long experience he may be best able to provide a thoughtful second opinion and could certainly identify for you who DOES have the most experience in treating post-irradiation patients.

Hope this helps

PS have you had steroids with your cancer treatment or treatment for anythiing else(these are well known causes of avasular necrosis of the hips)?. Was the diagnosis made based on an MRI? if so, did your other hip have any evidence of avasular necrosis as well?

Best of luck