THR Psoas Tendinitis 9 months after THR

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It went very well Kim. He was very thorough. He explained how he would remove the cup, and how he would replace the ball and match it up with the femoral stem component I have now. He said he has done more than 200 revisions because of all the MOM problems. He showed me the X-rays of a revision patient who also had an appointment that day. He does not think my situation will improve much without a revision because mine is a mechanical problem and my soft tissues are continuously irritated. The cup is highly anteverted (I am not sure if I am saying that correctly and I left my notes in my car) and rubbing on a tendon. I can feel it catch whenever I rotate my leg outward which causes pain. My hip always feels achy. The more active I am the worse it is. He said with the components he uses he would place the cup deeper and there would not be an overhang. I really like this doctor and I plan on having him do my left hip when the time comes. I have to think about this one as the pain is manageable with medication.

As an aside, during my appointment I could not stop looking at his hands. He had beautiful hands...LOL! Long tapered fingers. I guess that would help if you are a surgeon.
 
I have to think about this one as the pain is manageable with medication.


You need to consider that having to take medication long term for pain is really not good for you or your body.
 
Hi @calikat Sounds like you have found a competent surgeon who can sort your hip out.I agree with @bottomshollow that it isn't good for your health to take pain killers on a long term basis.I saw my OS recently on a low pain day of course and he explained that my prosthesis which is a ceramic on ceramic contained a metal upper component which is quite rough and is designed to fuse with bone but it can overhang in some people especially those like me with shallow acetabulums.The cup scrapes and irritates the soft tissues leading to Tendonitis.He said that the soft tissues can scar and eventually the inflammation may settle down but it takes a long time.I thought that this was the case with me but the pain has returned over the past few days and I feel it in the whole of the thigh as well as the buttock rather than just the groin and front thigh.I am back on regular paracetamol. I am having an MRI of the left side next month as this is also painful and the X-rays are still showing adequate joint space.

If the pain in the operated side doesn't subside in a day or two I will request another appointment for the cortisone injection.Please keep me informed of how you are managing and any decisions you make.
 
Kim I am sorry that your pain has returned. What your describing sounds a lot like mine. It starts closer in the joint, but when I have been on my feet a lot or very active I feel it in my thigh and buttock as well. The thigh pain has diminished over time though. I have shallow cups also. Good to know about the scarring. Maybe there is hope for my hip? My left is going also. Like yours, my X-Ray shows space, but I am sure it is the same thing that happened on the right. I won't make the mistake of having it scoped.

I don't know what to do about the hip. On a bad pain day (like last night) I think I am going to just do it. On a good day I change my mind. I am thinking I should wait a full year to see if it gets any better.
 
Thinking of you both and hoping your pains ease soon xx


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@calikat I agree with you.There is no way I would consider having another scope which was so very painful ( much worse than the hip replacement ) and seemed to accelerate the bone on bone arthritis.Do you mean that you are considering waiting a full year from your op or from now ?
 
Thank you for your kind thoughts @Hoppy Nanny I hope your recovery is going well without any issues.
 
A full year from my THR which will be in September.

Actually my scope was pretty easy compared to the THR. The pain level for me between the two was not even comparable. I was using crutches right away with partial weight bearing, drove myself to the doctor's office 3 days later, and I used minimal pain medication. Things were great until I hit about the 5 week mark. I remember getting up from a chair and feeling an ache on the outside of my hip. Things then quickly went downhill.

The THR was a different story altogether. The post operative pain was pretty bad.
 
I had so much pain the night after the scope because I was not prescribed adequate pain relief. It was the worse pain I have ever experienced either before of afterwards.However by about 10am it subsided probably did due to the pain killers finally kicking in.I did make a reasonable recovery after that and soon came off the crutches but at about 3 weeks the pain came back and just got worse and worse until I had the THR.I think that the THR was better as the hospital staff were up to speed with pain relief and I followed the advice on here about keeping ahead of the pain.All went well until 7 weeks when I turned awkwardly and strained the groin.I remember the physio saying how unlucky I was as I hadn't done much and most people would have got away with it.With the benefit of hindsight I think the position of the cup was the cause of this.

Are you doing any exercises at the moment ? I haven't a clue now whether to rest or to go back to the exercises including the psoas stretches which did seem to help.The pain got worse after a busy week cleaning my mums new home.I now think all the bending irritated the hip flexors.
 
I think you are right...It is the cup placement not the twist you did at 7 weeks.

I started back to Bikram yoga a few months ago. I am going twice a week. It has actually been helping with my hip. However I can really feel that my leg is off with all of the balancing poses. But my hip does feel better afterwards so I plan to continue.
 
I am considering starting a physio led Pilates class when this current pain settles down as I am sure this will help the muscles around the hip but I don't want to make things worse.I will just have to try it and see what happens and it would be fantastic to attend a regular exercise class again.
 
I started slowly...baby yoga. ;) I need to get back to strength training though.
 
18 month update

I haven't been on the forum for ages so I have decided that an update is well overdue.My recovery so far has been no bed of roses but I know that it could have been a whole lot worse.So to recap :-
All was well until I was 7 weeks when I strained my hip flexors just by twisting awkwardly which delayed my recovery by a few months and forced me to rest.I noticed an improvement after 3 months but found that every time I increased the activity and by that I mean just walking,the pain in the groin returned.Fast forward by a few months when an ultrasound diagnosed psoas tendinitis That was in January of this year.The OS referred me for physio and a cortisone injection.The physio found that the muscles around the hip were very weak and I started a programme of stretching and strengthening.Due to a very long waiting list I waited 5 months for the injection and by the time the appointment came I was a lot better but after a very busy period helping my mother move house the pain was back so I went ahead with the injection.It made no difference at all By this time I had been made aware that due to my very shallow hip socket the surgeon had done his best but the alignment of the prosthesis was not 100% and this was probably a contributing factor to the tendinitis.

At my last visit to the OS I was told that the degree of the misalignment was actually minuscule and that because the injection had brought me no relief it demonstrated that the inflammation had gone and I was left with scar tissue which was causing the discomfort.I was advised to carry on with the exercises.Well this was the turning point in my recovery as I felt that I could move forward without doing more damage.I was so happy as like many of you I was used to an active lifestyle before the hip problem and love walking and exercise.A big concern of mine was the negative impact that years of inactivity was having on my long term health and I had, had high expectations when I set out on this journey of recovery.

I am pleased to say that I am now attending a yoga class as well as a Pilates class which is taught by a very experienced and competent physio.I really enjoy both classes and it goes without saying that I am working at a very low level.Slow but sure.I can walk between 2 and 3 miles including gentle grassy inclines and on firm sand.I just love these walks out in the fresh air especially in my beloved Northumberland.

I still experience intermittent aching discomfort which is more like a sensation of pressure in my upper right thigh which I can live with and have accepted that this may be as good as it gets so any improvement will be a joyful bonus. Sadly, most of my pain comes from the other hip and knee but although it can be intense it is also intermittent and not as bad as the pain I had in the right hip before my replacement.Both X-rays and MRI show that my left hip is quite arthritic but as there is still adequate joint space I don't meet the criteria for a hip replacement at the point in time.

One other issue that I have is poor posture I have the typical bad hip gait of hyper lordosis with an exaggerated anterior tilt of the pelvis and I have to really count my lucky stars that I don't have low back pain as well.Hopefully the Pilates will help me improve this by improving core strength but I am considering signing up for a course of lessons in the Alexander technique and would love to hear from anyone who has tried this.

So to sum up: I am in a much better place and I am grateful for my new hip.I know that my recovery has been a lengthy one and but that doesn't matter as I am so grateful to be exercising and walking again now.I have no intentions of rushing things as one thing this experience has taught me is the art of patience.I felt so blessed earlier this week when I was able to chase my grandson around the garden and walk him to the park and for the first time help him on and off the slide.I am sure some of you will appreciate what a red letter day that was for me.

I hope all my Bonesmart friends are doing well and getting the best out of your new hips.I look back fondly to those early weeks when we had such fun on here. Thank you all for your support, advice and friendship.I don't know how I would have got through this without you.
 
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How wonderful to hear an update. It sounds like you are making progress and that is really good. Not everyone's recovery is a textbook one and it sounds like you have been meeting your challenges head on. Bravo for you!!! You definitely have the right mindset and the fact that you are working on those exercises tells me that you're going to continue to make progress. Please post when you can because you have a great story to tell.
 
Lovely to hear about your progress @Kim22......so pleased for you. A red letter day indeed to be able to run!! You have a great attitude and hope you progress continues...Chrissiexxxx


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Hi @Jamie and @Hoppy Nanny Thank you both for your kind and encouraging replies.I appreciate your comments.I see that you have had your anniversary Chrissie I will catch up with you on your thread.
 
Kim, I love how proactive you've been able to be in bringing about a satisfactory recovery. It does seem that many times, the THR is simply not able to fix everything that is amiss in our bodies. Learning to use the improvements that surgery does bring as a stepping stone to finding more comfort and mobility is key to getting on with life to the best of our abilities. Gaining perspective on the deficits that still exist...and may always exist....is another key. Sounds like you've got the keys to your castle well in hand. I'm so glad for you.

Sharon
 
Wonderful report, @Kim22! I concur with what everyone has said. You are always an inspiration to me.
Enjoy this new turn of events in your recovery, and keep us up to date when you can!
 
@Kim22 That's a great update. Im glad you are finally on the mend -with your op hip at least. It seems a lot of us gets that crampy tight sensation now and then. I wonder if its because our gait has changed after years of walking 'funny' even if we didn't realise we were and its taking a while for our bodies to adjust ?
 
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