THR 14 weeks later, UGH!!!

skcoj1

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I'm 14 weeks into my Hip Replacement The recovery started off amazing. I was at the "top of the class". At the 5-6 week mark, I was walking up to 4-5 miles a day and doing all of the PT without any discomfort.
The day after the 6 week mark, I was walking when the repaired leg just scuffed over a dirt mound, no higher than a door threshold between 2 rooms, and bam. Not pain, but a very uncomfortable feeling developed. I went home and iced down, like I normally do after all exercise.
After a couple of days with continued pain and discomfort, I called my surgeon and got an appt for 4 days later. X-Rays showed a perfectly healing hip replacement. Maybe a muscle strain, I was told to slow down. I reduced my walking and PT. Another 2 weeks passed and no improvement.
I saw my primary, he eliminated some things. I made another appt to see my surgeon. More X-Rays, he thought maybe there was a slight fracture and wanted to be sure so he schedules a CT Scan. That next week I saw the surgeon to go over the scan, nothing. He wants me to shut everything down. Back on crutches, ugh!!! 2 days ago I saw the surgeon again, he is perplexed, in 30 years he has never seen anything like this. He scheduled some lab work to rule out an infection.
My other issue is that now my 2 knees that have TKR, Sept 2017/Jan 2018, are feeling discomfort, stiffness, crackling, and my right knee even slightly buckled. ( I did recently see that surgeon, X-Rays showed nothing). I know I need to hear back from the lab before making any determinations.

Just want to say a few things about this process. #1 Does the original pre-op lab work test for these type of infections? #2 My surgeon didn't prescribe antibiotics for after the surgery, is that common? #3 I think 4-6 weeks after the surgery the dr should request lab work to make sure everything is going okay.
I am also wondering if having recovered from Covid, 6 weeks before the surgery, has anything to do with this.
 
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Wow, that's crazy and I have no clue what is going on but it's certainly frustrating.
I am about 14 weeks post op as well.
Hope you get some answers soon, let us know.
 
Your pre op bloodwork might give you a baseline value for WBCs, something to compare with, but I'd bet a front tooth that if your pre op labs showed an indication of infection, your surgery would have been delayed, postponed, or cancelled.
If your op report in posted on tour patient portal, you can check to see if you received antibiotics in the hospital. It might take looking up a lot of drug names, but if your report is like mine, anything administered will be on there. I know I did get abx in the hospital, but not as a prescription for home.
Probably a surgeon who suspected an infection would order bloodwork at a check up, but not for routine patients with no symptoms or problems.

I'm wondering if your PT could do a little hands on checking to see if they can spot something like a muscle injury from your incident. Maybe something strained or tore and is taking a long time to heal? Can your doc say whether the scan shows muscles lower in your leg, or in your butt?

Maybe your knees are feeling it now because your gait has changed due to the pain in your hip/leg. It's crazy how interconnected all those muscles and tendons are, and if one goes wacky, it throws a bunch of others into wacky mode too.

Best wishes for feeling better soon, or at least getting some answers. It has to be frustrating to have been doing so well then getting knocked back.
 
Welcome to BoneSmart, @skcoj1!

I'm sorry to hear you are having so much difficultly and hope your medical team can sort this out soon.

Please give us the date of your surgery and which hip was replaced so we can create a signature for your thread. If you'd like to give us the full dates for your knee replacements, we can add that to your signature as well.
 
Left Hip!!! 2/22/22.
Right Knee 9/26/2017
Left Knee 1/29/2018
 
Huh this is a mystery. Although I am sure that you've heard about the ODIC here on Bone Smart? I felt great at the 6 week mark as well so much that I started doing some crazy stuff at PT and traveling abroad and that hindered my recovery quite a bit. I went back to my surgeon and had xrays done and even though the bone looked as if it had healed I was experiencing lots of pain and swelling. It may be that you need more than a couple of weeks or rest to get back to where you were? Its very difficult to say honestly. Muscle relaxants also helped me quite a bit.
 
I can imagine how frustrated and worried you must feel after doing so well for so long, only to have this pain reaction to that misstep come up. Given that so many of your joints are bothering you at the same time, has your doctor considered a possible immune system reaction to the major surgery? I've heard of people who had fairly widespread inflammation (not infection) following other major surgeries.

It's probably more likely that it's just a reaction to all of the activity and your body is telling you to slow down. I didn't have anything this problematic following my hip replacement, but do know that any time I'd have an increase in pain, or a flare up of symptoms, the best thing for it was to reset---to return to the icing, resting, limited activities from the first couple of weeks, and typically it would resolve itself pretty quickly. Good luck---hope things settle down soon for you.
 
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It’s very possible your muscles are needing more time to heal. I would also request a full spine X-ray. Spine and hips unfortunately mimic each other. It’s the reason I had spinal surgery when I needed hip replacement 2 yrs ago. It’s also common to have both issues. You get relief for a while when one is fixed but then the other acts up.
I’m not a dr it’s just a suggestion from my personal experience. I hope they figure it out soon and you feel better.
 
I feel like 4 to 5 miles a day maybe a bit excessive at 14 weeks. If the Dr can't spot any issues I think the best course of action would be to rehab it by taking a break from all the walking and do plenty of icing for a week or two and then slowly build back up on your walking once you feel better. Remember the recovery from this surgery takes up to a full year and the road to recovery has lots of twist and turns.
 
Hi @skcoj1 and welcome. My sympathies to you, it must be very frustrating and worrying to have this pain at 14 weeks after such a good start to your recovery. I do hope that it is not a sign of infection or anything else serious. But as others have already said, a hip replacement disturbs the soft tissues, which can suddenly produce all sorts of aches and pains as they recover from the surgery and adjust to the change in body alignment. It took a while for mine to settle down after each hip. I had to cut down from lots of enthusiastic exercise to grumpy inactivity for quite a few weeks, but eventually the pain went away and normal life resumed.

I hope your recovery gets back on track soon.
 
Understandably this is very frustrating. I feel this might be just unfortunate timing. At the six week mark, the scuffing of your foot in motion would be enough to pull on those newly healed/healing soft tissues. Its like they have to almost start from scratch to heal again. I caught my leg on a box when cleaning the basement about 3 months out from surgery. I barely thought anything about it until the pain kicked in. Apparently I strained those still healing muscles and I had to cut back on physical activity, ice, and use my cane again for a bit while it healed. I was experiencing tendinitis also at that time and it certainly did not help that, either. Anytime you have to adjust your gait due to pain, it seems to affect the other joints, too. I agree with the above: it could have even jolted your back in the process.

Let's hope that is all there is to it and the labs don't show anything ominous. It would be nice if it was just a case of a little more time and TLC. I'm living with someone who has long-term Covid syndrome. So it makes me think that this would have shown up before your surgery and/or right after if it was Covid related. Keep us posted and we'll send some positive vibes your way.
 
Yes please give us an update! Hopefully you're back at the top of the class again!
 
2 weeks later and no improvement. Had an MRI on Tues. Everything looks good. The Dr has requested an authorization for a MRI of the lower back. Process of elimination, UGH!!! I'm thinking of going to get a 2nd opinion.
 
I know it sounds crazy but it's reality that at 4 mos you're still in recovery. Sounds like you were a superstar in recovery and became very active. That's the way my left hip was. Don't know if there is any scientific connection but I exercised my left and walked a lot, and also overdid it a few times. With my right I took the no exercise or PT route. My right had log leg which my left didn't and the right also had one muscle group that wouldn't release to allow me to tie my shoes. I walked within limits with purpose, not like I was competing. I didn't have any overdids with my right. I'll give everyone 3 guesses at which of my 2 hips has the most pain and weakness years into this. I've had pain with my left that made me think I screwed the implant, but after some rest it went away and proved it to be soft tissue.
 
Second opinion is a great idea! Even if they say the same thing it will put your mind at ease that you've done your due diligence and done what you should have. But speaking from experience and as an active member of the ODIC I think your tenacity for activity (which I totally understand-there's a life to live!) took over too fast and might be hindering your hips recovery. Can you stand to leave it completely alone for 2 weeks and see what happens (unless you've already done that?) in which case you can ignore my useless advice:)
 
Hi @skcoj1, another member of the Overdidit Club here, also dealing with soft tissue issues.

I too, have been impatient to get back up to speed (am 15 weeks out from THR #2), although I haven't been able to walk as far as you did. @Hip4life's story sheds light on something that happened to me a few weeks back, when without warning or precipitant, I suddenly couldn't bear ANY weight on my left hip or even take a step (fortunately, hadn't yet returned my borrowed walker). I had a little meltdown, got very grumpy at my poor husband and shuffled off to bed. SO relived to be able to walk again the next morning . An x-ray showed implant and surrounding bone were doing fine. So, soft tissue. Grrrr.

In hindsight, the signals were clear - discomfort balancing on my left leg while dressing, limping a bit again when tired, legs and hip feeling congested and stiff while walking. Evidently, you can't exercise your way out of soft tissue irritation, you have to rest. Grrrrrrrrr. Maybe I'm not as good at listening to my body as I thought, if it had to yell at me to get my attention!

@Snoopy5made a great point about intentionally continuing to rest for a couple of weeks longer to rule out soft tissue irritation even while you pursue more imaging and a second opinion.

Good luck - let us know the rest of the story!
 
In hindsight, the signals were clear - discomfort balancing on my left leg while dressing, limping a bit again when tired, legs and hip feeling congested and stiff while walking. Evidently, you can't exercise your way out of soft tissue irritation, you have to rest. Grrrrrrrrr. Maybe I'm not as good at listening to my body as I thought, if it had to yell at me to get my attention!

@ScenicRte Wow, how wonderfully articulated!!! I'm 10 weeks and this was me 5 days ago. I was going to bed every night sore from the exercise and waking up pretty much tight and sore and things appeared to be getting worse. Now that I've taken some time to rest, my leg is feeling so much better. I've still soreness and tightness but not to the point it impairs my everyday life and I actually feel like I'm healing again, go figure! My last two nights have been the best sleep I've had since the surgery. No discomfort at all sleeping on both sides. I'm going to take a few more days and see how I feel and then ease back into exercising and hopefully with a bit more awareness. My mind still likes to make promises my body at times no longer is able to keep.... lol.
 

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