Tony and HO

Tony,

When you last posted it seemed as if you had gotten your pain under control with aceteminophen. Is this still working as it did initially?

I ask this because, in another thread, you stated that you were searching for a way to have the HO "excized."

[TXTony]

Paul,

Great question!

Yes, my pain is under control. I still have some breakthrough pain that seems to be caused by swelling/inflammation, but it is minor, mostly tolerable, and manageable without narcotics.

The issue about the possibility of excision of the HO is to restore the joint with the impinged appliance to the ROM that the device was designed to restore. Remember that the value of having ADR (as opposed to fusion) is not just to relieve the discogenic pain--it is also to restore movement of that joint (rather than lock it up in a fixed position). My only hopes for that happening are 1) remission of the HO naturally and 2) excision of the mature bony lesions. Since 1) doesn't seem to be happening, I'd like to have mine excised by an interested, skilled, and experienced surgeon (not by a neophyte using me as a guinea pig).

BTW: I don't truly see this happening anytime soon. It appears to me that HO excision is performed in other arthroplasties, especially in total hip arthroplasties (THAs) where there is fairly high rate of HO and significant morbidity from it (mainly reduced mobility and pain upon movement). In THAs, the huge number of patients, the rate of HO occurrence, and the recognition of their suffering have resulted in doctors performing procedures that frequently work. At this point, US ADR doctors seem to be downplaying the issue of HO, possibly because they are so focused on getting their version of ADR approved by the FDA and avoiding scaring off potential patients ($$$). And, with comparatively few ADR patients worldwide, the demand for HO correction right now is very low. I predict that "some day" (perhaps when hundreds of thousands of ADRs have been performed) enterprising surgeons will be fixing problems associated with HO in ADR because there will be the demand.

Hope springs eternal.

Tony