How Can The Lower Bulge In My Hip Implants Be Fixed?
Q: Dr. Eppley, I have had two sets of hip implants and both were plagued by bulging on the lower end of the implants. How can this be fixed?
A: I have pulled and looked at both your 1st and current hip implant designs. I would suspect that the first lower bulge occurred because the bottom of the implant developed a bend or fold in it. (thin lower edge) The second hip implant design is much thicker (and also heavier) and this probably occurred for the same reason. My thoughts are as follows:
1) This is not an easy problem to solve mainly because there is no assured outcome based on anything that may be done. Good fixes are those where high confidence is in the knowing the exact problem and having a treatment that is known to work for it.
2) I am not sure a change in implant design/shape is the solution. The profile shape of the bottom half of the implant does not match the shape you see in you externally. (see attached side by side comparison) This still suggests a bending problem at the bottom of the implant.
3) If we knew that the implant shape was the issue I would then just hand modify the bottom of the implant to make it have a lower better taper to it. (this is tempting to do and probably has little downside to doing it…probably can’t make it worse but would it work??)
That being said there are only three options:
1) hand modify the current implants as described above
2) Make new implants of higher durometer (stiffer with with better lower half profile shape)
3) Injection fat grafting around the lower half of the implant to make a more gradual transition.
Dr. Barry Eppley