Dislocations are terrible because they have such a bad effect on your confidence. If a hip dislocates 3 times then in my experience, it needs to be revised. Good to hear that yours has been sorted out.

@@scottsymington176 did your hip completely dislocate each time? And did you need to go to the hospital each time. I’ve been having my hip pop out the socket and thump back in to place on several occasions now since my THR 14 weeks ago. Really distressing when it happens.

@@tkd4 yeah I was hospitalised each time it dislocated and my confidence went down hill fast but thankfully this new dual mobility hip it’s never dislocated since I got it fixed

@@scottsymington176 one more question. How painful was it when fully dislocated and were you able to move after it. I’m asking because I’m really worried it might happen to me.

@@tkd4 ohhhh it’s really very painful when it dislocates! It’s horrendously painful!!! It took a 91/2 hours operation to fix the damage done by the dislocations.

Sorry to hear about this. Take each day as it comes and try not to think too far ahead. Take plenty of rest.

@@Lathamhipsurgery Thank you for your advice. Will it hurt me to skip my PT excersises on occasion when I’m very tired/painful? I’ve been doing them since day one. Some days, like today, I’m so exhausted and sore. I just want to sleep.

@@audnbob1surrender to the tiredness. Rest is good and a very important part of your recovery.

@@Lathamhipsurgery Thank you so much. My regular Dr called me yesterday and did an evaluation. After it was all said and done, she said I definitely have PTSD, anxiety, depression etc from all of it, by now he answers I’d given to the tests. She’s called me in meds for the pain in my spine, feeling it’s nerve pain, anxiety meds, something else with serotonin to help me sleep etc and she will monitor me very closely to see how it works and for any side effects etc. I’m praying for some relief, I think it will help me greatly. Thank you again!!!! I so appreciate all your feedback🙏

Which surgeon shouldn’t practice? What is it that’s beyond appalling? Please explain.

@@Lathamhipsurgery I’m referring to the surgeon that knew her hip dislocated 7 times. Her surgeon from what I understood?

Thanks Lee. Good to hear from you and thanks as always for your positive comments.

@@Lathamhipsurgery Bizzy week ahead for you jeramy.?Do you ever get nervous going into theater like a great pianist might do before a performance.?

@@leemcdermott1770 Good evening Lee. I'm off for a couple of weeks, which is nice! The day I don't get anxious about doing surgery, is the day I give up TBH Lee. Once I'm in theatre, I channel the anxiety into focus and concentration on what I have to do. Trouble is never very far away in surgery. The trick is to avoid it at all costs. Sometimes it just comes and bites you though. Surgery is a cruel mistress sometimes.

@@Lathamhipsurgery Thats a great analogy jeramy.Its going to be nice weather the nx 10 days at least.So enjoy your time off.Am still saving jeramy.I will see you.Take good care of those hands until then.

@@leemcdermott1770 will do! 🤞🙏

@@tkd4 you should speak to your surgeon about this.

Thank you for your comments. I am pleased to hear that you find the video helpful, but very sorry to hear about your dislocations. It is a horrible complication. Four of them in a year means that there is a mechanical problem with the hip replacement. It's good that your surgeon has referred you to a revision specialist. You will need to have a careful clinical assessment and appropriate investigations such as a CT scan to identify the problem. It is likely that you will need to have the hip revised, so that any technical issues can be remedied. I will often use a dual mobility socket in revision surgery because it is more stable, and doesn't have the problems of a constrained, captive bearing. I hope that it all works out for you so that you can get on with your life again.

@@Lathamhipsurgery Thanks for replying so quickly, and for your kind words. In cases where a dual mobility cup is used as a replacement, is it also necessary to replace the femoral stem as well, or can the existing implant be adapted to suit the new cup?

@@chuck1outzz no problem. If the stem of the hip replacement is solidly fixed in place and its position is satisfactory then you can leave it in place. If there’s a problem with the length/offset/rotation then it will probably need to be removed and a new one inserted. There are adapters that can be used to overcome technical problems but your surgeon will discuss all of this with you. Hopefully this information will help with that discussion.

@@Lathamhipsurgery Thank you so much. I'll remember to have this conversation when I see my specialist in a few weeks time.

@@Lathamhipsurgery Hello there. I trust you are keeping safe and well. Further to my comment about a month ago, my specialist has now recommended revision surgery using the dual mobility cup; I'm just waiting for an operation date. Basically, my understanding is that although this is a more complex operation with a longer recovery period than that with a 'standard' replacement, the outcome is a far more stable and flexible hip joint, but the risk of dislocation remains, albeit a far lower risk than that with my existing (i.e. standard) hip joint. Would you agree that this is an accurate summary? Thanks for your time, as usual.

Thank you for your kind comments. I really appreciate them. I’m sorry to hear about your client’s problem. I would advise her to see her surgeon for an assessment and further investigations as necessary.

You should have a check up with your surgeon.

I’m sorry to hear about your dislocation. It is very traumatic physically and mentally. I can’t offer specific advice without a thorough clinical assessment and review of the imaging. Your surgeon will guide you through the next few weeks. Physiotherapy is very important once the brace is removed. A single, early dislocation will usually be an isolated event. If you have recurrent dislocations then revision surgery will be needed. My rule of thumb is if it happens 3 times then it’s time for surgery. I hope that everything settles down without further trouble for you.

@TheHipSurgeon Thankyou for replying back to me, my physio starts next week so fingers crossed it will help my limp.

Sorry to hear about this. I hope you get it sorted out asap.

My advice to you is that you should speak to your surgeon if you have concerns.

Sorry to hear about your problem. My advice is for you to see a specialist paediatric orthopaedic hip surgeon.

I’m sorry to hear about your multiple dislocations. It must be very difficult for you. Normally one would recommend revision surgery after 3 dislocations to address any technical problems.

Thanks that's life

I have titanium. Done 6 years ago. Mine has been coming out on a regular basis. Started occasionally..little by little it's now happens ALL the time. I I can hear it. Getting more painful. I have arthritis. I also have osteoporosis. 2:35 Appointment this week. Little nervous.

Thanks for an excellent question. Short answer, no as long as it's done for the right patient. I use them routinely in patients >75y, and anyone with neurological/anatomical factors that increase the risk of dislocation. The downsides are potentially increased wear in younger active patients, and the possibility of corrosion between the bearing liner and the titanium socket. Monobloc implants eliminate this risk but are less versatile.

@@Lathamhipsurgery thanks! Yeah I have a condition that has a high risk of dislocation, so I guess the potential joint life expectancy decrease is worth the decrease dislocation risk.

@@Soljarag5 Agreed. Your surgeon will no doubt have a good plan for you.

Sorry to hear about your problem. I can’t offer specific advice without doing a formal assessment of you.

@@Lathamhipsurgery can i get your email address?

Thanks for the question. For most people, a bearing made of ceramic on highly cross-linked polyethylene seems to be the best compromise between good function and durability. It's also very safe in terms of biocompatibility. I use metal on metal resurfacing in selected cases - men under the age of 55, with big hard bones. The safest and most successful materials for the cup and stem of the hip replacement are titanium alloy and stainless steel. I did a lot of ceramic on ceramic hips back in the day. The advantage of these is that they have very low rates of wear, but they can squeak. If they break, then revision (re-do) surgery is sometimes difficult because of all the debris that's produced. Hardly anyone is using metal on ceramic hips these days; there's no advantage compared to ceramic on polyethylene.

Thank you very much for your expert opinion. Its good to have the opinion of a very experienced surgeon in a matter as complex as this and who strives to do the the best for his patients. Much appreciated and thanks again.

@@leeindention7493 Thanks! Happy to help.

@@Lathamhipsurgery I had my consultation with my surgeon. He was very impressed when I enquired what type of components and their various constituents he would be using in my surgery. He confirmed he would be using the components you suggested in my surgery. He also recommended that I have a bilateral hip replacement as my other hip is bad as well. I am a bit apprehensive about having both done together as I think I would be very vulnerable and unsteady after the surgery. The reason my surgeon suggested a bilateral is, I would need the other one done in about six months so he suggested doing both as the recovery time would be the same. Anyway, thanks again for your most helpful advice .

@@leeindention7493 Thanks for your feedback. It's good to hear that things are moving along with your treatment. I quite often do bilateral surgery. It makes a lot of sense if both hips are as bad as each other; one anaesthetic, one admission and one period of rehab. Hope it works out well for you.

If a hip dislocates, it will cause a lot of pain, and the leg will be rotated and shortened. You would not be able to walk on it.

@@Lathamhipsurgery thank you

​@@LathamhipsurgeryI have s question then. I had hip replacement surgery almost 2 years ago and I have experienced pain in my groin area. Its kite of a discomfort pain. I can't lift my leg to put my sock and shoes on. I hurt when I walk. I hurt when I try to stand up. But everytime I go to the doctor that did my surgery and he takes a Xray everything looks fine. He never goes further than that. I'm tired of hurting what should I do.

@@RedbirdCountry It could be that the psoas or rectus femoris tendons are catching on the socket. When I see someone with these symptoms I order an ultrasound scan to confirm the diagnosis. An injection of local anaesthetic and steroid often helps. Other causes such as infection and loosening of the components have to be considered as well.

This is a great question. The Charnley hip, which was the first mass produced hip replacement, had a ball diameter of 22.5mm. Charnley understood that to use anything bigger risked causing rapid wear of the polyethylene socket, leading to early failure, particularly in younger patients.. This was orthopaedic dogma for over 20 years. Improvements in bearing materials (ceramic, highly cross linked polyethylene, metal) encouraged engineers and surgeons to use bigger head sizes to reduce the risk of dislocation. The introduction of the Birmingham Hip Resurfacing in 1996 introduced the world to a large diameter, low wear metal bearing. A few years later, we put this large metal head onto a hip replacement stem. This seemed to be the perfect solution for the majority of patients. The heads were impacted onto the tapered neck (trunnion) of the femoral component. Unfortunately, the small trunnions, which were fine with small diameter heads, weren't big enough to withstand the loads transferred to them with the large heads. The heads moved slightly, setting up a corrosion cell. This caused catastrophic damage to bones and soft tissues around the hip. It was a disaster, and they were all withdrawn. The search continues for the ideal implant; low wear, bio-compatible, low risk of dislocation. Bringing new devices to market is very expensive, and there is little if any appetite to do it, given the history of metal on metal hips.

@@Lathamhipsurgery Thank you for such a detailed reply.

It will be painful. The leg will be twisted and shortened. You will struggle to walk.

@Lathamhipsurgery can it partially dislocate? Am i supposed to be able to feel the ball and it clicks when it moves a bit. Appreciate it

@@SuperKoolDude They can. It's called subluxation. Get it looked at!

I understand your concerns Mark. All I would say is that the risk is very small. If you follow all of the precautions it's unlikely that the hip will dislocate. The risk is highest in the first few weeks so take it easy during that time, and wait for the soft tissues to heal before you push it. Your surgeon and physio will be able to give you more advice based on your specific pathology/surgery. My general advice is to rest by lying flat for at least an hour twice a day, and don't sit for more than 30 minutes at a time. Use crutches for as long as you need them - it's not a race. Try your best to surrender to the process and enjoy the feeling of being out of pain, whilst getting stronger and fitter every day.

@@Lathamhipsurgery thanks Jeremy , yes I will mate , cheers

@@Lathamhipsurgery surgery done , was done the old way and I was home the next day , 4 days after surgery walking really good and joint is freeing up well when I wake , amazing procedure and a top surgical team , I stayed awake and had spinal and the anethisist talked me through it all. Surgery never a great experience but if it could be that's what I experienced, for my rite hip they said I can do without the catheter because it was god damn worst than op.

@@markpatterson2811 thanks for the update. It must be a great relief to have had it done without any problems. Your new life starts now!

@@Lathamhipsurgery nearly just the right hip which pain wise is worst , I asked the left first because I'd had pain in it as long as I could remember and it just didn't work anymore but now it does , it's hard with one operated and one bad but the deep throbbing pain I had in the left is gone and it's pain free other than the natural swelling etc etc. Depending on the success of the second hip dr laird said I may well be able to go back to bricklaying but no golden oldies rugby , hahaha

Inbuilt obsolescence? Just like life itself. Everything fails sooner or later. 90% of hip replacements will last 20 years before they wear out and need redoing.