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THR 3 years post OP left THR issues

SurreyGirl

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i went diving in St Lucia in January for the first time in five years. Had help with the kit in the water but, apart from that managed fine. I loved it and really felt I had my life back. Was really looking forward to diving again this June but have had to cancel the holiday due to the Covid-19.. Still have some hip issues 1.7 months out from op but so much better. Lovely to see so many divers on here and ladies too!

I can't wait to get back to swimming once pools open again as it was my go-to exercise.

Best of luck with the hip issues and hope you get your wish in September.
 
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okiediver

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@scorow I went about a month feeling great after it was replaced. No pain, walking normal. Then slowly my gait became off, and the pain returned in my lateral hip area and sometimes in the groin. Some days it hurts other days its not so bad. I cannot bear weight at all on the left. I fell again yesterday in my closet lifting my left leg into a slide shoe--apparently I forgot to hold onto something (or thought I could do it) and I remember thinking, "Im going down". Im sore today on the left side and really trendelenberging (is that a word?). SO frustrating. This really concerns me as this is the third fall.

No PT helped me with the gait or pain and Ive done tons of research as well. Surgeon said if 3 months of PT didnt help stop--there is something else going on. I think I may have two issues going on.....one tendon rubbing against something and possible loosening but he tells me its not loose from what he sees....its taken me so long to address this as the right hip decided to go south last fall--very painful, but once in there turns out I had a fractured femur too. Thats why he is opening me up a bit to really check things out which I am grateful for--he did not do the THR originally

Is your gait a problem too?

Im sorry to hear about your setback. Fight for yourself because most of the time that's what you have to do. Who is your surgeon (if thats ok to post)? I have been to two now. Right now Im with Kunapulli and he is awesome and really listens and working with me to fix the issue even though he didnt do the surgery. With our symptoms he tells me that its like putting a puzzle together because its hard to determine what/where the problem is thats causing it.

ALl I know is when my diving starts being affected I have to draw the line lol. I bet we know some of the same people!!!
 
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okiediver

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@SurreyGirl where did you find/get the pool exercises? We also have a pool and its officially open--would love to know!

The Virgin Islands are on my bucket list! So pretty there--I have been to ST Thomas on a cruise but never did any dives there.

Overall both hips are better than they were, but the left side is unacceptable and the walk,,,oh the walk is the worst. I can get a block in and then the pain is too much.

Here is a video of my lovely gait:

lovely gait
 

Jws.

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@okiediver ,@SaraK @Hip4life ...Ok ...it's late and I'm up AGAIN because of groin pain...but I will give you a lot of good info on psoas release and hopefully you will have a great result as sarak...

First of all, my issues with the PR for me were twofold..1. Worried about dislocating 2. worried about weakness.
Saw at least 5 surgeons before choosing, as I knew what I wanted. my gait was screwed up 6 months post RTHR and all the classic symptoms ,groin pain, ROM, couldn't get in car, etc.

I have a very detailed post somewhere back before 8/23/2019 (psoas release), but here are the cliff notes. Saw two surgeons , one said he had just had done a patient for PR and he dislocated, I asked why and he gave me some detailed "thing" about body composition, etc (don't believe it)...second one I saw said it was his second PR and he dislocated patient because he cut too much (idiot)...so began my fear of instability with this surgery...here is the cliff notes on it...If you are having a release by the LESSER TROCANTER you won't have to worry about dislocations, (the problem of having the PR by LT is that they cut all the tendon(maybe more weakness post op) and because its farther away
from groin and implant it may not relieve the groin pain ..

Generally now they all "lengthen" (slight cut in tendon) more up by the groin (by the implant ) as that is where you are having the pain so they figure they are "loosening " closer to the pain and that will resolve it better higher up...My doc was out of HSS and had a "new " procedure where he would raise my operative leg during surgery and never go into the prothesises to get at the psoas and no risk of instability.SO I WAS THRILLED...one problem gone.

BTW...in regards to instability...in all my reviews ...IT GENERALLY IS NOT AN ISSUE...don't let my post frighten you....It was only an issue with the two surgeons I consulted with.

Regarding weakness in the leg...NEVER HAD IT (same as sara). First day out of surgery could not lift leg AT ALL...second day lifted like normal...absolutely no problem.Never looked back!.Second problem gone.

So here are the real issues. Most surgeons don't like doing this surgery because it is only 60-70% successful in all areas... My gait is much better, can get in cars easy now, ROM much better, HOWEVER STILL HAVE GROIN PAIN and that's disconcerting...((the one thing they can't tell you because they have no visibility is if the ball and liner in your implant is impinging too much (too big) and may not be able to be corrected. (they can make an educated guess and see if it's "anteverted" but in actuality that's the shot ...and then you still may need a revision...

Look the surgery as sara will tell you is quick 45 minutes, it is not full of complications ...relatively straightforward..if it works like for sara...you will be "OVER THE MOON"...I would do it all over again given what I know about weakness in leg (don't let them scare you with this one)..and instability not an issue...
If it works you saved yourself a revision.... CHOOSE YOUR DOC CAREFULLY....I would make sure he has done a number of these releases as most orthos dont do them. IMPORTANT!!

feel free to email me or reply if you have any further questions ,...i had researched the hell out of this one ..so ask..good luck...you will be out dancing the same night like sk. BTW, the second day out of surgery I walked up and down manhattan for about 5 hours..with no pain whatsoever (some bandage pain) but all my other gait stuff was GONE. (groin pain came back 3 months later).

Afterthought for you and others...if you have an impingement PT will not help your gait, and other symptoms, it only gets worse...I am not happy about the groin pain...but I am happy my gait is much better..normal..best JWS
 
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Jws.

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@Hip4life [USER=27709]@SaraK ,@okiediver

Hip 4 life....I just read your post...congrats on the PR surgery .!!!!

I would like to know if you had significant groin pain prior to the lesser trocanter psoas release.

I am asking, as I see you posted that the LT release relieved your groin pain. Is that true and did it relieve it completely?.

The reason I am asking is ,I remember asking my surgeon if the groin pain was not eliminated could he do ANOTHER release at the Lesser Trocanter and give me even more room?

I am now thinking after reading your post that I should have that discussion with him as there is little risk cutting the tendon and muscle at the LT and I might just be able to "squeak by" with enough room to cure the groin pain and save myself a revision? ..Thank you in advance.
 
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okiediver

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This is great info thank you. My groin pain is there, but minimal until I start hobbling a ways then it rears its ugly head. If I have a shopping cart to hold onto I can go quite a while. I DO NOT want a revision and will avoid that at all costs after reading about low success rates. I ibuprofen works pretty well if I know I’m going to be doing a lot of walking but I want to be drug free.

Got in the pool yesterday and in 3 ft of water I’m perfect. I could stand on my left leg and I’m straight as an arrow. No pain. Walked and walked around and it was so good to feel normal!

@Jws. if an ortho doesn’t typically do these who does?
 

Jws.

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@okiediver....

Sorry...Orthos do do the arthroscopic surgery...BUT NOT MANY ORTHOS...so you need some ortho thats been trained in it...and you want this done arthroscopically...not as an "Open" surgery.
 
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okiediver

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@okiediver....

Sorry...Orthos do do the arthroscopic surgery...BUT NOT MANY ORTHOS...so you need some ortho thats been trained in it...and you want this done arthroscopically...not as an "Open" surgery.
If it’s done arthroscopicly can the surgeon really look at the area to look for impingement, etc?
 

Jws.

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@okiediver ....If the impingement is coming from the prothesis..it can generally only be seen through an "open" surgery...ask your arthroscopic if he will be able to visualize it...I doubt it...
 
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okiediver

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@Jws. I am having open so he can look around in addition to the lengthening and correct anything that he sees. He is not expecting to find any issues, but feels its a more thorough approach since I have a couple things going on. I know that its not as quick and easy in terms of recovery goes but that makes sense to me unless someone knows something I dont!
 

Hip4life

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I’m certainly no expert here but I think the OS can view the acetabular component either with the open procedure or arthroscopically via a capsulotomy. @okiediver It sounds like your OS has explained it well and you are aware of the differences. Since you already have it scheduled and are comfortable with the doc and the procedure, then by all means proceed. Like always, it comes down to OS specific skills and preferences. Best wishes for relief and healing.
 

Jws.

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If you have other issues going on other than a clear cut tenotomy then you need him to have as much visibility as possible...besides there are a lot of OS'S that do ONLY open tenotomies and have been doing it that way for years.....so you should be fine...
 
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okiediver

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I feel its the right decision just in case something jumps out at him--also he did not do this hip so I feel looking at others work he may see something he doesnt think is right...fingers crossed that I can get a normal gait, bear weight, climb stairs, and quit falling! Prob asking a lot.......

Thanks for all the input!
 

Jws.

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@okiediver @Hip4life @SaraK ..

First of all Okie ...all the things you hoped for in your last post was exactly what I got after my release and I believe so did Sara...so it is definitely not too much to ask!!!!

Sara...hope you are well...with your hip...will try and call you maybe friday if thats ok??
Want to know if you or pat somehow know if you lengthen the psoas near the compartment AND cut it at the LT whether that would make it unstable or very weak.

Pat ...just confirming that you had significant groin pain before your Lesser Trocanter release and after the release you had absolutely NO GROIN PAIN and NO WEAKNESS in your operative leg and could walk free and unhindered with a normal gait.
 

Layla

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Hello and Happy Friday!
Wishing you all the best today with hopes you obtain the best possible result from your Psoas Release procedure.
Please update us as time allows.
Take care. :)
@okiediver
 

Jws.

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@scorow That's the same time period 3 months post op when I started the groin pain and the "twisted" walking and gait. I knew then something was wrong and this wasn't normal healing. That's when I began scouting around for info on the Psoas Release.
 
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okiediver

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Hello everyone! Sorry for the late post, I just haven’t felt up to logging on. No surprises on the open surgery, surgeon did find a large amount of scar tissue in the area and said the tendon was very tight so I got a real clean out and stretching.

The recovery has been more difficult than I expected. I feel like I had my hip replaced all over again pain-wise, and I just graduated to my cane. Today I woke up feeling pretty good (and NOT thinking about Percocet) for once. That has to be good right???? Its too soon to tell any difference however and I’m frustrated about that but I’m prob expecting too much. I’m waiting to get staples out this week and I’m sure I’ll know more. Meanwhile I’m in PT 3 times weekly at home. I cannot lift my left leg hardly at all which has made getting in and out of bed and getting dressed difficult so that hasn’t changed at all. We are working on strength (I’m still so weak) and developing the area. I know it’s only been a week— am I expecting too much?
 

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