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[HIP ARTHROSCOPY] 14 months on

Discussion in 'Hip Replacement Recovery Area' started by chemflex, Sep 4, 2015.

  1. chemflex

    chemflex Junior Member
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    I had a right hip arthroscopy in July last year (repair of labral tear and osteochondroplasty). Had physio following surgery.

    4 months after I was getting differing sensation in the front of my thigh, also a twisted sensation and pain down the front of my shin bone down to my ankle. Surgeon said it was my adductor tendon and gave me a steroid injection into it - this lasted 5 months.

    After it wore off the pain in my shin was worse. Another steroid injection in June took 2 weeks to work and has only lasted 3 weeks. Pain in my shin is awful. Surgeon says he may have to release my adductor tendon. Does anyone have any experience of my problems or the surgery he says I need?
     
  2. Suzette

    Suzette Graduate

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    Hi @chemflex that sounds really painful. I have no experience with this but will tag some of the forum advisers to see if they can help . @Josephine @sharonslp @Jaycey , sorry to tag you all , am not sure who can help
     
  3. chemflex

    chemflex Junior Member
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  4. sharonslp

    sharonslp Forum Advisor

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    Hi Chemflex. This is way beyond my knowledge or experience base. I have occasionally suffered from shin splints, and it usually means the pair of shoes I am wearing are not good ones for me. You need to wait to hear from Jo on this. In the meantime, it would be helpful to know what your activity level has been like over the last year. What kind of exercises or therapy have you been doing; what recreational activities; what daily work or household activities. (I see two children in your avatar picture, so that answers some of those questions!!)

    And I'm curious....have you consulted any physician other than your surgeon about this?

    Sharon
     
  5. chemflex

    chemflex Junior Member
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    I had approximately 10 physio sessions after my surgert following the exercise programme for post hip arthroscopic surgery. If I put my legs together then draw my feet up to my body then let my legs 'flop' left leg if flat right is pretty sore and restricted. My physio decided that I needed to go back to my consultant because I wasn't recovering as expected and she thought she could still feel an impingement.

    He said my adductor tendon had been overworked and was inflammed I was given a steroid injection into it as a day surgery case.

    After it wore off I was still in a lot of pain so I arranged to see my physio again for a few sessions before I saw him again - didn't help.

    When I saw him again he said it was still inflamed and it may need to be cut and released but with my age 34, he doesn't want to do it unless absolutely necessary as it can't be reversed. Last time he gave me the 2nd steroid injection before he injected me he felt the tendon said it was extremely tight and he thinks he's going to have to cut it.

    He told me to stop exercising as soon as he realised the adductor tendon was inflamed as it would make it worse. If I walk any distance it starts to hurt, same if I run. There's no way on earth is can cycle, in fact I'm selling my bike today. If I drive for long distances it also hurts. If I try to have intimate relations with my husband I'm in agony and near tears.

    He says the pain in my shin bone is because my muscles are tight and not working together properly,

    I'm a dental nurse so am on my feet all day.
     
  6. Jaycey

    Jaycey Moderator

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    Our medical expert @Josephine will need to give you input on this chemflex. She should be along soon.
     
    Last edited: Sep 5, 2015
  7. chemflex

    chemflex Junior Member
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  8. Josephine

    Josephine NURSE DIRECTOR, BONESMART Administrator

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    Thereby confirming his diagnosis!

    I'm going to ask you some questions and it would be very helpful if you would answer each one individually - numbered as I have done - in as much detail as you can then I'll come back as see where you are ....

    1. what are your pain levels right now? (remember the 1-10 scale: 1 = no pain and 10 = the worst you can imagine. And don't compare this with the bone-on-bone pain you had before surgery! aflagsforworship.co.uk_jo_pic_images_nonofisss.gif ) Also don't forget to include other forms of pain such as soreness, burning, stabbing, throbbing, aching, swelling and stiffness

    2. what pain medications have you been prescribed, how much are you taking (in mg please) and how often?

    3. what is your activity level? What do you do in the way of housework, cooking, cleaning, shopping, etc., and

    4. what kind of exercises at home are you doing? How much and how often?

    Can you detail it like this

    Exercises done at home: 3 sessions a day
    Heel slides x10 (reps)
    Strait leg raises x10
    Steps x10

    At PT
    Squats x5 (reps) x2 (sets)
    Wall slides x5 x2
    Clamshells X5 x2
     
  9. chemflex

    chemflex Junior Member
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    Thanks @Josephine

    You have put it confirmed his diagnosis as it lasted for 5 months which I agree with. However if this is the case how come it only lasted 3 weeks the 2nd time?

    1. Generally always a 6 at times raising to a 9. The general pain (6) is around the groin thigh area. When it increases to a 9 it is extreme pain down from below my knee down my shin to my ankle.

    2. 2 x 500mg paracetamol 4 times a day and 400mg ibuprofen 4 times a day. I cannot take codeine or opiates. Pain relief is not really achieved with what I take.

    3. Cooking is shared between me and my husband - I cannot stand up and cook a complete meal. Dusting and polishing it's painful to brush and mop so I don't. I get my shopping by click and collect as it's too painful to push a trolley round a shop.

    4. I am not doing any prescribed exercise at home or a physiotherapy as I have been strongly told by my consultant that I have refrain from any exercise.
     
    Last edited: Sep 5, 2015
  10. Josephine

    Josephine NURSE DIRECTOR, BONESMART Administrator

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    I meant that relief from pain for how ever long confirmed the diagnosis of adductor tendinitis. That it only lasted 3 weeks the second time indicates that it's a pretty severe case.
    On the outer aspect of your leg, I take it? That is sciatica meaning your sciatic nerve is being pressed upon somewhere. Do you have pain in your buttock, like here?

    P site.GIF

    with the pain radiating thusly?

    piriformis sciatica spread.JPG

    Hmm, I see. Have you considered trying a TENS machine?
    I see.
    That's a relief. The last thing you need is exercises!
     
  11. chemflex

    chemflex Junior Member
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    No @Josephine no passion at all in my buttock and nothing down the back of my leg. The pain radiates from my groin along the inside of my leg and front of my thigh. The pain below my knee and my shin is pure agony and feels deep within my bone.

    I have tried a TENS machine but it did not help. Could the pain I'm experiencing be anything to do with my femoral nerve?
     
  12. Josephine

    Josephine NURSE DIRECTOR, BONESMART Administrator

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    umm - no passion? :unsure:


    I think it might well be the femoral nerve. Look at the green area on this image - this is the distribution of pain from that nerve - does it look familiar?
    And oh yes - where is your incision? Front, back, side?

    femoral nerve pathway.jpg
     
  13. chemflex

    chemflex Junior Member
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    Yes it does look familiar. I have 3 incision points at the front.

    Before having the surgery I signed a former like everyone does explaining the risks involved which nerve damage is one of. Ifor my femoral nerve is damaged I fully understand as it was a risk I took.

    My physio said that it could be femoral nerve damage but when I mentioned it to my consultant he said "no, no its your tendon I'll just give you a steroid injection". Maybe he is correct or maybe he doesn't want to admit that something was damaged during his surgery.

    If my femoral nerve is damaged what is the treatment? Also if I need to have a adductor tenotomy what does that procedure entail.

    Thanks @Josephine x
     
  14. Josephine

    Josephine NURSE DIRECTOR, BONESMART Administrator

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    It might be a condition called paresthetica meralgia. It tends to resolve over time but the numbness can persist. Whilst the symptoms are ongoing, they can be treated with things like cortisone injections, gabapentin or amitriptyline. There is a small risk it can develop into Complex Regional Pain Syndrome (CRPS or RSD) so don't dally getting it treated.

    It doesn't sound to me like an adductor issue as it wouldn't be radiating all down your leg. But if it should be, the adductor is a group of ligament that run across the front of the hip. A tenotomy just means snicking the tightest one with a tiny blade through an equally tiny incision. That's the usual way of doing it, anyway.
     
  15. chemflex

    chemflex Junior Member
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    Is the recovery for a tenotomy easy? Are crutches required? How soon after can I drive and return to work? Is it carried out under local or general anaesthetic?

    Sorry for all of the questions @Josephine I'm just really concerned, I thought I would be feeling much better 14 months on.
     
  16. Legin

    Legin Don

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    Hello I am about a month less than you and, well. I suffered nerve damage tho my OS avoids issue at every meeting to date. This in light I had a neural physiological test which detailed exact areas of the nerve not working. Mine is down the back of the leg. I have since been diagnosed with CRPS. There are certain indicators but cut short some nerves are on hyper hyper level so if knocked or pressed it feels like banging your funny bone but to power of five upwards and pain can take an hour to dissipate. My condition was diagnosed by the Chronic Pain Clinic and from there I now receive specialised PT. One of the major possible results of not walking properly is wastage of muscle and movement. Hence I get therapy to move ankle and whole foot, I found those muscles and tendons screamed at me but I did recognise my poor gait and walking style, I called it my Charlie Chaplin walk.
    It sounds like you need help on moving without hurting the main tendon you mention. I would try going back to gp as it is they who make the referral for more specialised assessment, really lay it on the line with them, it was only when I told my gp how bad I was and my life of pain that anything happened.
    Warm healing thoughts for you as I know how bad it feels in the cycle of pain. Re meds BTW Tramadol is a good form of pain relief and my Dr informed me it also helps with the pain from damaged nerves. There is also Gabapentin tho this can give icky side effects, there is also the more costly Pregabalin which is more gentle. One wee tip vitamin C substitute helps boost the body re these issues. Ask if you need more info I will even ignore my fear of dentists and there evil sidekicks

    Legin THR Sep 14
     
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  17. Josephine

    Josephine NURSE DIRECTOR, BONESMART Administrator

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    Well, you have it first hand from someone who knows! Legin has had the worst of it.
    I couldn't say for sure - it depends how the surgeon goes about it, how much cutting he needs to do and such. That also applies to whether or not you will need crutches and when you can drive or return to work. It usually is carried out under a GA as he won't really know until he get in there how much he needs to do. I suggest you discuss these point with him if and when you get to that point. Sorry I can't be more helpful.
     
  18. chemflex

    chemflex Junior Member
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    You've been extremely helpful @Josephine, thanks x
     
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  19. Josephine

    Josephine NURSE DIRECTOR, BONESMART Administrator

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    Very glad to hear it. That's what I'm here for!
     
  20. chemflex

    chemflex Junior Member
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    I have an appointment today to see my consultant so fingers crossed he can hopefully wave a magic wand and ease this pain because I can't take it much longer.
     

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