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THR 50 year old male's recovery

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toughstuff

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At my 3 month appointment, the surgeon found calcification where the Psoas meets the femur. He said this is likely the cause of my ongoing soreness especially when doing stairs. He is scheduling me for an ultrasound guided injection. He does this himself so ‘he is sure the injection site is correct’.
The joint looks good and stable at 3 months.
Anyone with personal experience or insight into this injection? Time to relief, permanent ‘fix’, etc?
I have injections in the joint before surgery for years and they worked well. Thank you.
 

Greataa11

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I’m only three weeks out and am sore often just from walking. I’m off the pain killers but I’m not super active, a walk halfway around the block with my walker made my muscles pretty sore. I also recently let both PT and the idea that recovery was going to be any faster than it already is. Frustrating I know - About to go grab some frozen peas! My mantra these days are “hips heal themselves” and “keep calm and carry on”. I feel a little silly for putting all my stock in the doctors’ assertions that being young and fit would somehow get me back to normal at an accelerated rate.
 

Corey W

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Hey brother. I had my femoral stem loosen, but the first action my OS took when i was in pain 3 months after surgery was the PSOAS cortisone injection. Like you I reached out on BS... @Harryn1 (tag bro) had great success with the shot alone. @SaraK had only temp relief and ended up with PSOAS release surgery which fixed her up. If the Dr. put in too large of a cup, the PSAOS tendon will get shredded against the implanted cup. Hopefully the shot gets you right bro. Stay strong!
 

Harryn1

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At my 3 month appointment, the surgeon found calcification where the Psoas meets the femur. He said this is likely the cause of my ongoing soreness especially when doing stairs. He is scheduling me for an ultrasound guided injection. He does this himself so ‘he is sure the injection site is correct’.
The joint looks good and stable at 3 months.
Anyone with personal experience or insight into this injection? Time to relief, permanent ‘fix’, etc?
I have injections in the joint before surgery for years and they worked well. Thank you.

Hi @toughstuff . As @Corey W mentioned, i had the shot at 6 weeks post op, administered together with a high dose of oral anti inflammatories for 7 days, and strict orders for TOTAL rest for 2 weeks which I followed. Almost 18 months have passed,and I have had a great outcome.

Interestingly,my shot was actually done by a radiologist and he obv hit the sweet spot.
 

SaraK

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In my case, the psoas was rubbing against the cup which was a tad too "prominent" . Pain didn't really start for a few months and then kept ramping up. Unlike you and @Harryn1 , it took me several months to get relief because my surgeon just kept chalking it up to "soft tissue issues" and sending me for PT and pain management (where they insisted it was my back causing issues with psoas). (Sometimes I wonder if I would have been taken more seriously sooner if I was a man!). I did eventually have the psoas relief and am now leading the good life. The doctor that did diagnose the issue (or listen to my self-diagnosis) had a radiologist do the psoas injection which was SO WONDERFUL (until it wasn't - about 2 weeks of awesomeness) - the results of the injection confirmed the diagnosis.
 
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toughstuff

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Thank you both for all the information. I’m hoping it works well.
I am still sore after 3 months. It certainly may just need time to heal but it may also be this Psoas diagnosis.
I am likely too aggressive with my activities and may be making healing take longer.
 
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toughstuff

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@SaraK how is the surgery for the Psoas release? Recovery time ? Restrictions? Anything you can share?

I imagine you really have to research the surgeon you choose for that.
 

SaraK

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@toughstuff - I lucked into the surgeon. One of the PTs recommended him because did same for another patient. It was surgeon I'd consulted before THR (when I thought I needed arthroscopy) and then revisionist I saw also recommended him. I got it just in time - he moved back to Montana just after my 6 week follow-up.

Surgery was easy-peasy. Surgeon told me to do anything I wanted as long as it didn't take pain over a 4. I specifically asked about dancing that night (New Year's Eve) and to the gym the next day and was told to go for it.

I had very little pain but movement was restricted in first few days by swelling. It literally got better by the hour! I was driving in just a few days.

It takes some time to get full active range of motion (I'm still improving 10 months later). The pain was gone, except at edge of ROM (wherever that is at the time) but even then, not a sharp pain. The muscle is elongated by the surgery, so it takes some time to retrain the muscle and the brain to get it to move. I did PT a couple times a week for 6 weeks (would probably have done longer but had some unrelated surgery that cut it short). I could have opted to go back or to do more intensive work on my own but decided to just live my life for a few months to see how it went.

Basically, at that point, I could do most anything I wanted to do without pain. Passive ROM was better than active but active has improved (and passive always improves to be one step beyond.

After months of increasing and sharp pain, not sleeping well and reducing activities one by one, the surgery was like a miraclem. No more heavy muscle relaxants, no more constant NSAIDs, no more steroid shots interfering with my blood sugar and back to doing the things I love doing! I've even taken up powerlifting.

Let me know any questions you have. Hopefully the injection works for you one and done or lasts long enough to just do it every few months. Otherwise, this surgery can get you back to where you want to be (and thought you'd be after the THR).
 
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toughstuff

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Yes. I had an ultrasound and then followed by an X-ray that showed some calcification where the Psoas connects to the femur.

I’m hoping the injection really does some good for pain relief. Sounds like I have a good chance of that occurring. The surgeon doing it himself under fluoroscopy gives me some confidence. He acted like this happens quite often to patients who don’t moderate well on their way through recovery.
Although, only two people on here have mentioned it happening to them, but both with great results ultimately.
 

CricketHip

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I hope the injection does the trick. It's a waiting game, isn't it? You need to wait for a while for everything to settle down so the OS can determine what is natural healing and what may be a blip on the screen.
I'm sorry you are still struggling.. Do you have a date for the injection yet?

Please keep us posted.
 
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toughstuff

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My injection is Friday, Nov 15th.

My surgeon actually was a little reluctant to do this injection this ‘early’. He said that 3 months is really pretty early in the healing process. He talked to me about waiting and allowing more soft tissue to settle and stretch before the injection. Then he said I do think it is a tendonitis and this should really help so he scheduled it.
I see on here that it takes some people longer than 3 months to lose the soreness so it makes me wonder as well, but I decided to do it.
 
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toughstuff

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Can anyone else move their hip a certain direction and hear a rubbing sound? In general my hip doesn’t make any sound nor does it catch or anything like that. But if I lay on my back and do a pelvic tilt exercise or stand up and stretch laterally, I can hear the ball rub in the socket. There is no immediate pain felt with this. It is a plastic liner with a metal ball.
Maybe it’s just all the settling down process yet. I walked 7 miles this weekend at the king of Prussia mall with my wife and it just felt weak no pain or soreness until the day or two after. I’m assuming that being able to walk like that rules out a loose implant?
Still being told I have the tendinitis in the hip flexor.
Thanks in advance.
 

Mojo333

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Hi @toughstuff
Good to see you post.
I walked 7 miles this weekend at the king of Prussia mall with my wife and it just felt weak no pain or soreness until the day or two after.
Ya think? You know it never hurts until we stop...which is why we must edit our activity.
Still being told I have the tendinitis in the hip flexor.
My thought is this is still a bit much when you've been diagnosed with tendonitis .
I do hope that you don't have a loose implant and the symptoms you describe don't make me think this...but definitely can be some ongoing inflammation due to the tendinitis that cant be "worked" through.

Hope you are back to icing and resting more.
Healing vibes, friend.
 

Layla

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I've read it can happen from the Psoas tendon rubbing against the new hip while it's healing and during turning the leg from side to side. What was your surgeon's explanation?

My surgeon actually was a little reluctant to do this injection this ‘early’. He said that 3 months is really pretty early in the healing process. He talked to me about waiting and allowing more soft tissue to settle and stretch before the injection. Then he said I do think it is a tendonitis and this should really help so he scheduled it.
I don't understand this. Why aren't you waiting longer then?
 

Corey W

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Hope this helps, when my stem came loose I could feel a clunking and heard a clicking (femur was rubbing on the pelvis). I could not walk 3 miles without excruciating pain...way worse than arthritis. Hope they can figure your pain out brother.
 

SaraK

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After my psoas was inflamed, it seemed like I could feel it rub/grate along the implant. More often, I didn't feel it but could hear it pop when I moved that leg forward in walking. With turning that leg, there was almost a hydroplaning feeling sometimes - almost like the psoas was stretched and should shorten as the leg turned but didn't so there was a detached feeling (sorry, hard to describe but may be easier to recognize).
 

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