Osteolysis

[Guest guest]

Mark O'Shea wrote: I've recently been diagnosed with osteolysis, and was

wondering if any

of you had any experience with dealing with this. At the moment surgery isn't

being recommended, and I would prefer to avoid this route if possible.

*** Mark, about a year and a half ago, I had shoulder surgery and part of the

surgery involved the removal of 1-1/2 to 2 cm of my distal right clavicle.

Possibly I can give you some useful information regarding this type of

surgery. Before doing so, and possibly miss the point, would you please post

back and tell what in the world " osteolysis " is? I've done a Net search on it

and found nothing in layman's language to describe it.

Jim Vernon

Venice, CA

[Guest guest]

Mark O'Shea responded with the following quoted definition off list:

" Osteolysis of the distal clavicle is a pathologic process involving

resorption of the distal clavicle and is usually posttraumatic or caused by

the repetitive microtrauma of weight lifting. Pain localized to the

acromioclavicular joint and radiographs or bone scans showing pathology in the

distal clavicle are diagnostic. Modification of activities, such as

curtailment of weight lifting, often alleviates symptoms, but surgery is an

option when conservative measures fail or for patients who cannot limit their

activities. " It comes from the following link:

http://www.physsportsmed.com/issues/2000/12_00/stephens.htm

*** I was going to respond to Mark only but since some Ben Haines has posted

back with the same condition, I will post this to the list.

Mark and Ben -- Following the original trauma (fracture) of my distal clavicle

in 1968, over the years there was some osteolysis. This word was in the

diagnostic notes of doctor who did the surgery. Evidently it was not severe,

but it did contribute to the shattering of the DC when I performed a decline

press with too heavy of a weight. I looked at x-rays with the doctor and he

pointed out an area that was cylindrical in shape (about the diameter of a

pencil) and had a different light value than the rest of the bone. This

cylinder ran diagonally and inward from the end of the clavicle; the

discoloration was the area surrounding the original fracture line from 1968.

It was the distal end of this cylinder that was at the point of the

shattering. When the surgery was performed, the doctor removed the clavicle

containing the entire cylindrical area which extended a little over 1-1/2 cm

up the remaining clavicle.

One would think that you would be somewhat handicapped missing this piece of

bone; that has not been true in my case. You can go back and read about the

entire surgery (if you wish) in the ST archives at:

Supertraining/message/4079

Supertraining/message/4885

Post me privately at Rosemary's address if you would like a jpg picture of

what the shoulder looked like several days post-op.

Today I, don't lift as heavy as I used to and I do make some allowances. I

set a 200# upper body lift limit when using free weights, particularly

dumbbells. If I want to lift more than that, I use machines and with the

machines I have set a 300# limit. I have no problem overhead pressing. I

never lower a bar behind the neck. This is not that constraining considering

I am 60 years old. Normally I would not rely on machines, but in my case,

they are of value in that with my tremor (another story), stability is of

utmost importance. It was the slightest loss of stability at a critical

moment in the original decline press when the clavicle shattered.

I had stopped doing conventional bench presses with weight even before the

distal clavicle shattered. This was due to a spinal injury. I had no

trouble, and still have no trouble, doing decline presses and incline presses,

as long as I make sure my back is well supported and I stay within my weight

limits. There has been no loss in upper body muscle mass overall and the loss

following the surgery was of short duration and very minor. Good rehab was

the key. I would be glad to discuss rehab further off list if you have any

questions in that regard.

The doctor did several things that I think were pure genius. First, he used

no metal parts (or internal metal staples) and he had a great deal of repair

to make during the surgery. This is a lifesaver if you ever have to have an

MRI or other procedures of that type involving the upper body. He also came

as close as possible to completely eliminating the post surgical pain. He did

this by filling the entire wound with a long-acting narcotic prior to closure

as well as implanting a tube attached to a morphine pump. This remained for 4

days. In addition for two days post-op he had me attached to an intervenous

demerol pump under my control. I felt no pain and this went a long way toward

keeping the area calm and uninflamed or irritated following the surgery. On

top of that, I was able to sleep well and relax. Ice packs also helped and we

started them almost immediately. Most helpful was the fact that my weight

lifting partner had me on my feet and walking within 6 hours post-op. I also

lucked out because I had a very enlightened surgeon who understood weight

training and the mentality that goes with it!

In the case of shoulders, my opinion is sooner rather than later when it comes

to surgery for shoulder injuries. Ben, your description of the non-surgical

attempts to fix your shoulder sound all too familiar.

Jim Vernon

Venice, CA

[Guest guest]

Reading Lynette's email about osteolysis brings up a very important

issue. I've said this before but this is a good time to say it

again.

Osteolysis is the destruction of bone near a total joint replacement

implant caused by the body's scavenger cells. Debris from an

implant can cause the cells to eat away at the bone because it

cannot discriminate between debris that is bad and bone, which is

good. This can cause implants to loosen. On Xrays, doctors can

detect space around the implant that means there is not a tight fit

anymore.

Please follow up with your MDs at least once a year and have an Xray

of your total joint replacements. An yearly Xray gives the MDs

something to compare your original Xrays to and they can detect

changes that may not require major revision surgery.

It's like putting a tire on your car and never checking the pressure

or the balancing and then needing major work done when you could

have done regular maintenance.

You all are doing amazing things by helping one another! Keep it up!

Alisa