hip replacement

I've been diagnosed with Borrelia Burgdorferi & Bartonella and have been treated since March 2018. My list of Lyme symptoms has greatly decreased, but I continue to have have hip pain, internal vibrations and tinnitus. I also continue to have a few random symptoms pop up, but the things mentioned are my three major complaints.

Whenever I think my hip's feeling better, I try to get some extra exercise, and the pain increases. My left hip is the biggest issue. Last week, I decided to go to my PCP and see what she thought. I had several X-rays and the radiologist said there is good space between the balls and sockets, but I have some bone spurs. The left (my bad hip) is worse. There was talk about possibly removing the spurs arthroscopically, but that was my doctor's first thought, not the orthopedist.

Today, I saw the orthopedic doctor. After a Q& A session, he asked to see my hip area to check for bug bites, specifically tick bites. I hadn't told him I have Lyme, but I did after he explained what he was looking for. Then, he went on to tell me that I need a full hip replacement. The space between the ball and socket aren't good on the left hip, and I have arthritis in there. The right hip was in good shape, and he didn't think I would ever have to have it replaced. If this was his diagnosis, why do you suppose he looked for tick bites before presenting his decision?

After he told me about the hip replacement, I asked to see the X-rays. He showed me, and insisted that the space on the left hip was tiny, but it appeared to be the same as my healthy hip with a little more cloudiness than the good hip.

My questions:
Will Lyme arthritis clear up with Lyme treatment, or does Lyme cause arthritis that leads to joint replacements?
Will a new hip clear up the Lyme arthritis, or will it linger in the muscles and tendons around the joint?
Should I seek a second opinion?

Right now, I'm thinking I'll start with a cortisone shot then move on to the hip replacement if Lyme treatment won't fix the damage that's been done.

Thank you!

Hi Saraeli

I'm currently being treated by a NPLLMD. I didn't seem to be making progress with my treatment, so my doc took me off of all meds and is doing some new tests to, hopefully, get a better understanding of the Lyme strains I still have. Apparently, I have a rare strain of Bartonella. Ugh! Figures.

So, about 4 weeks ago, I had some blood work sent to Armin labs in Germany. I'll have more blood drawn next Monday, April 29th, to send to NC for the Galaxy Bartonella EPCR test. The EPCR test requires patients to be off meds and supplements for 3-4 week before testing. Perhaps, being off of the meds has caused my hips to flare and the vibration to increase.

Because I was off meds and had some time off from work, I decided I should get my hips checked out to make sure the pain isn't something more serious. My sister-in-law had hip issues and she was diagnosed with cancer. I'm glad I have some X-rays to show what's going on in there. Never did I expect a hip replacement diagnosis.

I'm glad to hear that Lyme joint issues can clear up. I'm assuming your mention of steroids is because Cortisone is a steroid? I didn't know that. So, if Lyme is in the muscles around the replacement, there could still be some pain even after a new hip is in place. Hmmmm.....

Thank you.

WalkingbyFaith said...
I don’t know much about Lyme arthritis, but from what you said, even if you do need hip replacement, I would get a 2nd and maybe even a 3rd opinion from orthopedic surgeons before going down that road. You may very well get different opinions.

Always remember that surgeons make money by operating on people and get rewarded for how many surgeries they do ($$$ they bring in to the hospital). They have a big financial incentive to do surgery. Just my 2 cents.

I liked the doctor, but he appeared to be on a mission. No X-rays were out to discuss his findings. I had to ask to see them. Then, he had me follow him to the nurses station so he could pull them up for me to look at. I was surprised that a sports medicine orthopedic doctor didn't automatically have images out and ready to view with the patient, in the exam room, especially when he says a full hip replacement is necessary. I was a little taken aback by that. My hip problems gradually made its appearance shortly after my Lyme diagnosis. So, it's very likely it's related to the Lyme.

Thanks for your 2¢ worth, WalkingbyFaith.

Girlie said...
I agree about having the X-rays out to show you the area that is degenerating.

My friend has been on a wait list for knee replacement surgery - she saw the surgeon about a month ago and he showed her the imaging - I don’t know if it was X-ray or mri - but the first thing he said was “you must be in a lot of pain!” He then proceeded to point out the area of bone on bone contact. And she was able to see it. And yes she has terrible pain.
This surgeon is known to be the best in our city. He is very busy but she decided to hold out for him. she has had to wait many months to see him and now she waits for surgery which will also be months.

I also think a second maybe even a third opinion is in order - the dr should point out the area on the X-ray so u can see the damage/degradation of that hip.

Yes! And I don't have Bone on Bone contact.

This is the Radiologist's Findings. They don't seem to be reporting a great need for a hip replacement, but I'm not a orthopedic surgeon. My doctor didn't seem to think it was that serious either.

FINDINGS: There is no fracture or dislocation. The hip joint space is
maintained, unremarkable. There is mild to moderate medial superior
joint space narrowing of the left hip. There are marginal osteophytes
of bilateral femoral heads, superiorly on the right, both superiorly and
inferomedially on the left. There is also some spurring at the
superolateral margin of the left acetabulum. The combination of spurs
may be causing some impingement on the left.
SI joints are maintained. Bones well mineralized.

Korissa said...

When I mentioned to my LLMD that I'm a candidate for hip replacement, she said I should ask to have a culture taken during surgery to find out if there was lyme or bart there. I'm not sure I care that much and think it was just slow degeneration.

I'm also considering stem cell therapy.

I saw my Lyme doctor and told her about the hip replacement. She mentioned Prolozone injections, which might regenerate the hip area. She also talked about stem cell therapy, but I think that's even more pricier than Prolozone. However, I don't know much about either of them.

When we discussed the full hip replacement, and when/if I should get it done, she thought I should wait a while to make sure the Lyme had quieted down. She was concerned that some Lyme could get trapped in the replacement parts and come back and cause problems. Hmmmm.... Not sure what to think. Any ideas, comments or suggestion?