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THR 2.3 years later developed Tendonitis

AviationGeek777

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Had my left hip replaced back in September of 2018 at the age of 26 due to severe arthritis. Had no issues recovering and it well, until now. The past 3 months I keep having what my surgeon told me tendonitis. He did an x ray and put my mind at ease telling me that it isn't infection, but tendonitis instesd. The symptoms seem to come and go each month. The symptoms include: Pain under the scar tissue (posterior) swelling under the scar tissue (feels like a hard bump) and also redness around the scar and warmth, tingling sensation, cold feeling sensation, very sensetive to the touch. Some of these symptoms are also a symptom of infection, hence why I went to confirm with the doctor. I don't have any discharge or high temperatures. It seems to trigger when i am sitting down for long periods of time. Icing does help keep the swelling down, but once I start walking again it seems to swell back up. It also only hurts when i sit or lay on the operated side. I was wondering if anyone else developed these symptoms 2 years after the surgery? I also have a picture of the scar, that shows redness and swelling around the area. Thank you for your replies in advance everyone! May we all stay healthy.
 

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Jaycey

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@AviationGeek777 Welcome to BoneSmart!

Unfortunately an x-ray really can't confirm an infection. Blood tests and/or cultures grown from fluid removed from the joint area may be needed.

If that red area is sensitive to the touch I would recommend getting a second opinion. The continual swelling is also a concern.

Can you give us your surgery date? We will put the information you your signature for you.
 
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AviationGeek777

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The reason surgeon told me it's not infection is that, if it was infection it will not go away and will get worse. Since mine goes completely away and in a month comes back makes me think something triggers it. I don't have any high temperature or any discharge from the scar. But I will give a blood test just in case. Surgery date was September 18th 2018.
 

Layla

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Hello and welcome to BoneSmart! It sounds like you’ve had a nice recovery until this pesky issue started. I also think the blood test will give you the peace of mind you’re seeking. Please keep us posted.
I hope you have a lovely day! :)
@AviationGeek777
 
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AviationGeek777

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It got worse sadly. It's more looking like an infection than tendonitis at this point. Have a blood test appointment on the 30th to check for infection. Other than that I don't know what other tests or what esle to do.
 

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Layla

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I’m sorry to hear you mention it’s worse. It is good you’re pursuing it to get an answer that leads to resolving the issue. Stay in touch, we’ll be here and we care.
@AviationGeek777
 
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AviationGeek777

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So I just came back from the surgeons office. They poked it with a needle and yellow clear fluid came out. The surgeons assistant was the one performing the procedure. He told me the fluid doesn't look like infection, but is joint fluid. He was surprised as though why it would be joint fluid 2.5 years later. He prescribed me antibiotics just in case for 10 days and wants to see me in two days time. I already feel much more lighter and feel less pain. Thank you guys for your advices and concerns. much love
 

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Mojo333

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So glad you got some good news....please let us know how you are as things go on....:loveshwr:
 

Eman85

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That's interesting, joint fluid from an artificial joint! I had a spot like yours on my incision but it was early on and turned out to be a stitch that worked it's way out, I didn't have any external stitches.
 

Celle

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They poked it with a needle and yellow clear fluid came out. The surgeons assistant was the one performing the procedure. He told me the fluid doesn't look like infection, but is joint fluid.
I sure hope he sent a sample away for testing!

If he's correct and it's joint fluid - I don't think it can be - it would mean there is a communication between the inside of your joint and your skin surface, which shouldn't happen. It's more likely to be lymph fluid..
That's interesting, joint fluid from an artificial joint!
You still get "joint fluid" after a joint replacement, because you still have the synovial membrane surrounding the joint. This membrane secretes synovial fluid, which lubricates the joint.
 

Ric A

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You still get "joint fluid" after a joint replacement, because you still have the synovial membrane surrounding the joint. This membrane secretes synovial fluid, which lubricates the joint.

Amazing, I didnt realise that could happen. I thought the new joint would be fluid less and thats why it was not as mobile as the natural joint.
 

Eman85

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If he's correct and it's joint fluid - I don't think it can be - it would mean there is a communication between the inside of your joint and your skin surface, which shouldn't happen. It's more likely to be lymph fluid..
That's interesting, joint fluid from an artificial joint!
You still get "joint fluid" after a joint replacement, because you still have the synovial membrane surrounding the joint. This membrane secretes synovial fluid, which lubricates the joint.
As you stated I didn't think there would be any signal from the artificial joint that it needs lubrication so I didn't think there would be any fluid. I guess just like all of our recoveries are different our bodies react differently to artificial joints.
 

Ric A

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You still get "joint fluid" after a joint replacement, because you still have the synovial membrane surrounding the joint. This membrane secretes synovial fluid, which lubricates the joint.

I thought that the membrane would have been damaged or removed when the new joint was fixed in place.
 

ljpviper

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Yep, the artificial joint still uses the bodies natural synovial fluid for lubrication. Almost, like oil in your car engine.

No way that can we joint fluid coming out of the excision since its been 2 years. The layers of tissue should be well connected by now.
 

Ric A

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Very interesting. I thought the new artificial hip joint was sealed within the unit and wouldnt allow fluid in.
 

Mojo333

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Yep, the artificial joint still uses the bodies natural synovial fluid for lubrication.
Total hip arthroplasty, a surgical procedure that replaces the unhealthy hip joint with an implant, preserving the synovial capsule, which has a synovial lining and synovial fluid. Some studies have been done to see if there are differences after THR.
The studies found that the cells making up the re-formed synovial lining, as well as the lining of interface membranes, were similar to the typical Type A and B synoviocytes of normal joints. The synovial fluids around joint replacement devices were typically lower in viscosity than pre-arthroplasty fluids but the protein concentration and phospholipid concentrations tended to be comparable, suggesting that the lining tissue function was preserved after arthroplasty. The widespread, long-term success of joint arthroplasty suggests that the lubricant formed is adequate for good clinical performance in the majority of joints.
 

Mojo333

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@AviationGeek777
I would also think that qualifying this drainage as joint fluid is not possible.

I would think they would characterize this as serous (not to be confused with serious) drainage which is mostly clear or slightly yellow thin plasma that is just a bit thicker than water.
I wonder if the bruising I am seeing now has been there for a long time.
It may be a seroma and I would definitely get the doctor to check this out. Sometimes seroma can be the result of a hematoma that is being stubborn to resolve.

The definition of a seroma is "a pocket of clear serous fluid that sometimes develops in the body after surgery. This fluid is composed of blood plasma that has seeped out of ruptured small blood vessels and inflammatory fluid produced by the injured and dying cells."
 

Celle

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The discussion about synovial fluid is taking Aviation Geek777's thread off the subject, which is his recovery and the condition of his incision.

I think enough has been said about synovial fluid and what it does, so please can we return to the main topic - the state of AviationGeek777's incision, 2+ years after his surgery.
Thank you.
 
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AviationGeek777

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I saw the surgeons assistant again today. There was litte of that yellow clear fluid on the bandage. He removed the bandage squeezed more out and placed another bandage and told me to see him next Tuesday. I again asked him today if he should send the fluid for testing, but he said there isn't need to since it doesn't look like an infectious fluid and it doesn't have any puss. They did tell me i have tendonitis 4 months ago, maybe that aggravated something inside my body? They are literally stumped and don't really know why this would be happening almost 3 years after the surgery. He told me it usually happens right after the surgery, not years later. I am still taking amoxicillin twice a day for 10 days.
 

Celle

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I again asked him today if he should send the fluid for testing, but he said there isn't need to since it doesn't look like an infectious fluid and it doesn't have any puss.
You can't tell by looking at it.

I'm glad you are on an antibiotic.

Can you ask if the doctors have considered you might have a seroma?

A seroma is a collection of fluid that builds up under the surface of your skin. Seromas may develop after a surgical procedure, most often at the site of the surgical incision or where tissue was removed. The fluid, called serum, doesn’t always build up right away.
 

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