THR 7 months out

[Mojo333]

I had cementless, which I hear can take longer for the bone to adhere to the prosthetic. Perhaps that’s contributing to my extended swelling? However, cementless is supposedly more advantageous than cemented if a revision is needed.

By now the bone growth into the prosthesis is likely complete and as swelling is attributed to inflammation, this makes soft tissue trauma the more likely culprit. (Hence the discussion about activity)

Any new or extreme swelling should be discussed with your doctor...and the lack of cessation of swelling (especially after resting and icing) may warrant investigation.

I don't remember alot of swelling after the first months, but I was a religious Icer even at 7 months for any aches which might account for the lack of swelling.

 

[Layla]

Maintaining an activity level is important, especially for cardio

Yes, understandable. If you don't agree with whatever doctors are telling you and you're still struggling, I'd dial the activity back, devote some time daily to icing and elevation, along with trying the manual lymph drainage. I'd also refrain from checking whether your thigh is still sensitive by applying pressure and see if you notice a difference after a few weeks. I hope you will give it a try.

 

[Zach65]

Thanks! OK. Here goes: It’s not “new“ swelling. The actual swelling has decreased to almost nothing from surgery. There’s a minor difference (if any), when visually looking at my thighs. But still “feels” swollen. Understandable if you can’t grasp that.

Good mobility and ability to walk. Really no pain when at rest. The best way to describe it is it’s quite noticeable pain when tapped or touched. I hasten to add it doesn’t take a very hard hit to hurt. I’m pretty sure I’m damaging it further because when I tap it it’s quite light. It’s EXACTLY like if you were to have a bruise. When you have a bruise & don’t touch or hit it, there’s no pain at all. However, if the bruise is touched or hit, it hurts when you touch or hit it, but not after.

Dr. said there was no need for me to come back at 3 month follow up because X-rays looked good, I was walking pain free, etc. He did mention possible LFCN damage, which is more prevalent in anterior approach than posterI or. He mentioned this may take a year to come back but may not. Said 85% of patients have it come back. Said it’ll feel tingly when it’s starting to come back. I also didn’t disclose that when I tap my thigh, there’s a tingling sensation.

All of my issues aren’t on the whole thigh, just the middle and outside. You could hit the inside of my thigh with a sledgehammer and all would be good.

 

[Zach65]

Is icing just a band aid? Or permanent fix/help?

 

[Layla]

The best way to describe it is it’s quite noticeable pain when tapped or touched. I hasten to add it doesn’t take a very hard hit to hurt.

Try to leave it alone, as in don't touch it.

I'd like you to read something an old BoneSmart colleague, Sharon, once shared with a member here -

Tightness is a normal occurrence after this kind of major surgery. Your surgeon did major carpentry work and disturbed every millimeter of soft tissue in the area. You aren't tight because your muscle is underused and needs to be stretched and rehabbed. You're tight because your tissue is healing...and complete healing takes a full year OR MORE.

It could be that even with a daily light tap, you're aggravating the soft tissue around your incision. Let your body completely heal without questioning / testing it's timeline in doing so. I remember the area of my incision being tender for months, maybe even a year or longer if I accidentally bumped it.

Another article from the BoneSmart Library. This one on healing -
Healing: how long does it take?

It is hard to say if ICING is just a band aid not knowing what you're doing on a daily basis, or the exact cause of the swelling. You can try other things also along with icing and elevation, such as drinking more water, eliminating inflammatory foods, exercise in moderation, massage and maybe even compression with a nod from your surgeon.

 

[Layla]

Here is a chart that may be of interest to you also. See # 12
Library Index is a link to the BoneSmart Library
Also, don't forget about the SEARCH option top right where you can type in key words and any threads where the key word you typed in was mentioned will pop up for you to read.

 

[Mojo333]

All sounds normal, to me.
I did both at once and the general area around anterior incisions was tender for well over a year.

 

[Zach65]

Not around my incision. It’s my middle/outside thigh (see above). The meaty, muscular, heart of my thigh. My incision is wonderful . Thanks.

 

[Mojo333]

Ever thought about Bursitis?
Can be Fairly common after THR?

Trochanteric Bursitis with THR

To explain about bursas - they are a natural little sac made by a) an extrusion of the joint lining (synovial membrane) in any joint or b) a natural pocket over a bony prominence. The little folds need to be there to allow for movement much like you need pleats in a blouse so it doesn't stop you...

bonesmart.org

 

[subie2021]

@Zach65
I'm 15 months out and my op leg still feels achy or sore at times. For a while at around 6-7 months it felt sore every day all day for no apparent reason. Not painful, nothing that kept me from sleeping or activities, just an ache that was there if I looked for it but was easy to ignore otherwise.
These days the soreness comes back with some activities...most recently the other day because I cleaned the oven. Again, there when aware but not distracting.
Do you know about all the yankin' and crankin' and sawing and pounding that our leg goes through for THR? No wonder they are sore for a long time! It's not just the bone...all the strong muscles, ligaments and tendons are assaulted.
It sounds to me like you're causing yourself some anxiety over your body's normal response to surgical insult and subsequent stress via your activities.
If you don't have pain, your ROM is good, and you're able to participate in somewhat strenuous activities, you're doing well. The lingering aftereffects of surgery will go away in their own time. They don't follow rules or timetables or charts. You can't will them away.
What if you only tapped, smacked, or whacked your leg once a week or every 10 days, or even monthly? Sometimes day to day changes aren't noticeable, but we see a difference week to week or month to month.
As a side note, I've had femoral cutaneous neuropathy for 40 years. It can be bothersome because of the weird sensations, but it doesn't affect strength or mobility. My doctor prescribed Lyrica which relieved it when it was giving me extra grief a while back.
Best wishes for continued improvement and a great recovery.

 

[Zach65]

A tap also causes a tingling/prickly, if you will, sensation down my thigh. The first 3-4 months produced a deep, dull ache at the hip, making lying on my side for sleep impossible (of course my preferred side ). An ache has resurface there, albeit not as bad. But without doubt still noticeable now when lying on that side, challenging sleep now as well. Concerning, worrisome, troubling, angst-causing that it’s reappeared, as opposed to not staying awa.

The outside of my hip is also still swollen (a hump/bump that looks like I have a woman’s hip on the bad side, with my straight/flat, man hip on the good side).

That isn’t as bad as my thigh. I hear of swelling basically being gone in 3-6 months. Not me to be certain. It’s hard to remember, but it MAY be more sensitive, but not more swollen, than before. Hard to explain, but it’s more sensitive to touch & swipe fingers ever so slightly down my thigh when sitting than standing. But VERY sensitive indeed.

Perhaps it’s all the vicissitudes of healing? It sucks mentally because I’m physically fine everywhere else and have a helluva lot more left in the tank (general well-being, virility, etc). If this surgery has a bad outcome (i.e., no further improvements from here out), it would take away from life. Heading back to the the doctor beginning of ‘23, but what sucks is I’m likely going to get the same ol’ company line, song ‘n dance: this is normal, it’ll be fine, needs time. It’s a complain hearing that every visit without seeing progress. Can only hear that for so long until hope is lost.

 

[Layla]

I wish you'd try to stop touching, tapping, hitting the leg from the knee up.

Hard to explain, but it’s more sensitive to touch & swipe fingers ever so slightly down my thigh when sitting than standing. But VERY sensitive indeed.

Have you discussed the frequency with which you are testing the sensitivity level of your post op thigh with your OS, and if so, what was his response?

The outside of my hip is also still swollen (a hump/bump that looks like I have a woman’s hip on the bad side, with my straight/flat, man hip on the good side).

Wondering about his thoughts and advice on this?

Heading back to the the doctor beginning of ‘23, but what sucks is I’m likely going to get the same ol’ company line, song ‘n dance: this is normal, it’ll be fine, needs time. It’s a complain hearing that every visit without seeing progress. Can only hear that for so long until hope is lost.

Again, please remember that it can take a full year, even longer to make a complete recovery. People notice improvement into the second and even third years post op. You are only at seven months post op. I can't help but wonder if you're doing something physically, as in activity, that is irritating your healing leg?

Are you icing, elevating and trying the lymphatic drainage massage, or anything else that's been suggested here, or by your surgeon? Wondering if you notice any difference after dedicating a fair amount of time to any one those suggestions.

Beyond this, I am at a loss, but hope you find the next visit your doctor insightful and reassuring.
Wishing you all the best.

 

[Zach65]

Visited doc today. Pretty sure it’s femoral nerve palsy/neuropathy. No dice on Lyrica or any other meds. PT & time I/he hopes. Stopped by my PT to make appt. on the way home from doc & he was confident in treatmen. We’ll see I reckin’.

 

[Layla]

Well, don't lose hope then. Hopefully the combo of PT and more time will bring the desired result.

Good luck and happy holidays if we don't hear from you again before then.
Stay in touch and let us know how it's going for you at some point.
@Zach65

 

[Zach65]

It’s most assuredly femoral nerve damage. Dr. Google & my PT confirmed that. Major concern on the time though for permanent damage, as the therapist said the sooner it’s treated, the better. I waited 7+ months, though he said that’s still,within the time frame. Apparently most resolve favorably, but some can be permanen.

 

[Zach65]

Revisiting. I’m quite confident (80% confidence level), I have Meralgia Paresthetica (MP, self-diagnosed). Classic symptoms of it. I’m done & quite unhappy with my surgeon as his misinformation & indifference is troubling (to be kind). He referred me to a colleague of his that refers patients to a group that does ablation therapy. Well, this doc is a friend & med school classmate of my surgeon’s colleagu. Hmmm?? Intereating! So Ihad a video consult with another doctor in the referral’s group (not the actual referral doctor), and I was told they can’t help me from the symptoms I described. That’s not professional or acceptable practice, it’s suspect.

I’m leaning on my PCP, who stated experience with diagnosing MP. Have to wait until 3/1 to see him. I fear the MP isn’t permanent because I’ve waited too long. I tried PT, which was fruitless for 7 visits over 3 weeks. There are other procedures/surgeries available for cases that conservative treatment doesn’t cure (which is uncommon). As of this typing it appears I may need more invasive help. I hope 3/1 PCP visit proves helpfu.

 

[Zach65]

Edit correction: “I fear the MP IS permanent“

 

[Zach65]

Anterior THA 5/4/22 (9 months out).

 

[AllieBucks]

I feel so badly about your situation. Do you think that your gait possibly got worse after your THR? I had nerve damage down my thigh and behind my knee for 2 years before my THR. I had my THR 8 weeks ago and my gait is getting straightened out and the insanely annoying nerve pain is going away! As you get this figured out, there are meds that focus on nerve pain, like Tramedol that might help through tough times. A lot of docs won’t prescribe it but it saved me mentally during that tough time. Not trying to promote drugs but when used correctly they can help. Especially since nerve heal so slowly. Perhaps you can get measured by a podiatrist to see if you need leveling out. Just a thought.

 

[Zach65]

Kind thanks Allie! My gait is fine, as is (I think), my leg length. Strength & mobility copacetic. It’s just a pain on the surface of my middle/outside thigh which is extremely sensitive to even a featherweight touch, weight of sheets, putting on clothes, etc.; yet hard, deep pressure has no effect. Really funky (and very annoying), stuff I tell ya! Almost wish I was on 8 weeks like you because the “time” I keep hearing will heal me is running out. I’ll soak in what my PCP says & see how he opines on drugs, but I tend to avoid them like a wet hornets nest, even if they help.