Seeking Psoas Release Information

[Artvandelay]

Hi, has anyone had this problem before getting their THR? I have recurring left side iliopsoas bursitis that gives sharp groin pain that runs down to my knee. I also have moderate-severe arthritis in my left hip and have been recommended for THR by two doctors, one didn't recommend. Had by bursa drained and a steroid injected and it gave me 3 months of dropping pain down from like a 7 to a 3. I will need the THR I feel like but I had been hoping that would take care of the psoas stuff but the more I read it sounds like psoas issues can be a result of the THR! One surgeon said that they try and account for it with placement if you have psoas issues but there's no way to truly guarantee it. The idea of the THR only to have my psoas problems remain is quite distressing!

 

[Mojo333]

Hi @Artvandelay
Welcome to the forum.
There are some members who experience psoas issues after THR...many don't though - and Google is rife with discussion, so I get why this would make you anxious.
OA can cause major changes and damage that mostly only worsens and your bad hip could very well be the cause of the psoas problem.

Abnormal motion of the hip, caused by the head of the femur, rubbing incorrectly against the socket of the hip can also cause a tightening or pinching of the psoas muscle, and soft tissues called psoas impingement.
It sounds like your surgeon is aware of your concerns and though no surgeon is likely to give absolutes...the one given is the OA is only going to worsen.
Sometimes, a leap of faith is required in order to get back to life.
I hope you find some peace in the decision you make.

 

[Artvandelay]

Have my surgery scheduled for May 23rd for anterior THR on left side due to OA with Tri County Orthopedics in NJ. I'm a 52 yr old guy who has always been active, outdoors, sports, gym, etc. and I've seen my functionality decrease and pain increase (especially sleeping) over the past year. An Oct '23 X-ray/MRI confirmed what I'd been feeling on my left side long before that. Waffled on what to do about it since THR was recommended by 2 of the 3 surgeons I saw. Tried more PT, some relief from an injection but nothing close to permanent.

Decided to do it now while I'm in good shape and strong rather than wait until it deteriorates further. I also have iliopsoas bursitis bursitis which surgeon said they will try and smooth out path the tendon slides from bone spurs and the OA which cause friction and that causes the bursitis ( I think that's what he said!)

Nervous but optimistic and hopefully I can stop thinking about this so much every day!

 

[Artvandelay]

thanks for the thoughtful reply and I've basically come to the same conclusion and scheduled surgery for May 23rd. Surgeon did say they will be taking the psoas issue into consideration during the surgery and it could be better but no guarantees and the psoas is a "dumb tendon and will do what it wants to do in a lot cases". ! Leap of faith like you say but feels grounded in a decent probability to get relief beyond the relief from the OA

 

[sistersinhim]

@Artvandelay, I’ve moved your post above out of the Monthly team thread as we reserve that thread for surgery date information, and so members can see who else has surgery the same month. We prefer all other comments and discussions to take place in a pre-op or recovery thread, such as this one. So, I’ve started this Pre-Op Thread for you. Enjoy interacting with others who are on the same journey, here in this thread.

 

[Brandee0275]

I have the same issue on my left side and I've decided to try the bursectomy instead of the THR. My xrays show I still have the joint space maintained so I thought I'd go conservatively. Please let us know how you feel after the surgery. Mine is scheduled for 4/2

 

[Artvandelay]

That makes sense and hopefully that works for you. And yeah I asked my surgeon about the bursectomy as well and I was told that the bursa filling with fluid is the result of the arthritis and bone spurs causing the friction in the psoas sliding in the sheath and that is what inflames the bursa. So I suppose if I had more joint space there, maybe my psoas wouldn't be as inflamed and causing the bursa to fill more. Who knows

 

[Rocksmom]

Have my surgery scheduled for May 23rd for anterior THR on left side due to OA with Tri County Orthopedics in NJ. I'm a 52 yr old guy who has always been active, outdoors, sports, gym, etc. and I've seen my functionality decrease and pain increase (especially sleeping) over the past year. An Oct '23 X-ray/MRI confirmed what I'd been feeling on my left side long before that. Waffled on what to do about it since THR was recommended by 2 of the 3 surgeons I saw. Tried more PT, some relief from an injection but nothing close to permanent.

Decided to do it now while I'm in good shape and strong rather than wait until it deteriorates further. I also have iliopsoas bursitis bursitis which surgeon said they will try and smooth out path the tendon slides from bone spurs and the OA which cause friction and that causes the bursitis ( I think that's what he said!)

Nervous but optimistic and hopefully I can stop thinking about this so much every day!

OMGosh you are talking about my life lately. Only I’m 71 and had to stop exercising due to all this. Don’t know how my body will get through this. Scheduled to see hip replacement surgeon on May 10

 

[Artvandelay]

Good luck! I hope you can find some relief. I'm still very active but have had to really limit what I want to do as a result and combined with consistently poor sleep it felt like the right time while I'm in good shape and hopefully can have a good recovery. I found this site helpful. There's a lot of info- https://www.physio-pedia.com/Iliopsoas_Bursitis

 

[Rocksmom]

Thanks! Good luck with your surgery, I’ll be interested to see how it goes.

 

[Hip4life]

@Artvandelay Most likely, that irritated iliopsoas will be able to calm down once all the osteoarthritis Issues of your hip are fixed. It may take it a bit longer to settle than most. I know it can be frustrating but you'll have to be patient with it and not stress it too much, too early. The good news is that you will have the same options to help post surgery that you did pre if the THR doesn't take care of your tendonitis. The catch, again, is that the surgeon is going to want to give those soft tissues some time to heal and settle. They'll also be relearning how it is to walk with a normal gait again. I think you are choosing wisely to get your THR done now instead of later. Everything you are experiencing now will only get worse if you don't. Best wishes to you going forward.

 

[PolarIce]

I have had some PSOAS issues after my total hip replacement, and I did not know that this was something that could be an issue. Having said all that the pain from the hip was unreal and well worth the trade. I will also say that doing regular stretching can really help decrease some of those tightness issues. I would never withhold getting a new hip if you need it due to the fear of that possible complication. Knowing what I know now, I would still never have not done the surgery. A new hip is truly life changing.