THR 7 months Post Op Issues after falling

[Tripplefun]

Layla,
It's been a while since I posted about my right hip replacement. My progress has been ok with some setbacks with pain in the groin/upper thigh area. When I try to do leg lifts the pain is very uncomfortable and the doctor said to avoid exercises that bother me for now. Stretching my leg across my body is also painful. According to my doctor the x-rays look good and the hip is set in well. I still feel like the right leg is longer than the other one! Looks like I won't be having a right knee replacement anytime soon if I can't build up muscles in that leg. Now I'm thinking I should have had a knee replacement first regardless of what my doctor recommended. My knees and back are still bothering me but I try to keep busy and not focus on it too much. I've had some gel shots and cortisone shots that have had minimal effect. I have an appointment with my orthopedic surgeon next month, so I'll see what he has to say. Regardless of all this for the most part I'm staying positive and trying not to complain too much and bore people with my issues!

 

[Layla]

Hi, Thanks for sharing an update.
I guess I agree with your doctor. If the movements you mentioned cause discomfort, or pain, I’d avoid them for now. I don’t really see why you’d need to stretch your leg across your body, unless I’m envisioning something other than what you’re describing. Walking is really the best therapy and you’ll notice little surprises along the way naturally, when you realize you‘re doing something that caused you pain before, but does no longer.

Try to pay attention to what activity causes you groin and upper thigh pain and then avoid it. It’s not to late to ice either once you’re dealing with discomfort from overactivity. I’m sorry your knees and back are bothering you. Let us know how the visit with your OS goes and what he has to say about your knees and the sensation making you feel like you‘re dealing with leg length differential.
Take care and enjoy the weekend!
@Tripplefun

 

[Tripplefun]

Over the weekend I was helping carry a cargo box while walking backwards. I know now that was dumb! I tripped and fell right on my hip on the concrete full force! I was so shocked and the first thing I thought was uh-oh there goes my hip replacement. I called my doctor the next day and he sent me to urgent care for X-rays. Luckily nothing was broken but I’m still in pain. I was still having groin pain from the surgery that seemed to be getting worse and my doctor arranged for me to have an ultrasound guided cortisone shot In the psoas muscle.

Today when I lifted my right leg to get into my car I felt a snap and pop and excruciating pain in the groin area!! Its much worse now than it was before. Has anyone had a similar incident? It’s the weekend and I’m going to have to wait until Monday to call my doctor! I can’t go upstairs or get in the car easily. This has been a very frustrating time for me!

 

[Pumpkin]

@Tripplefun
Sorry to hear about your fall and now a snap and a pop getting into you car.
Suggest you call your surgeons office and talk to the on call surgeon about this new development, they may recommend you go to urgent care or the OR.
If the pain continues to increase or your mobility declines, it would be best if you go to urgent care or the ER for care.

You'll notice that I have merged your newest thread with your original recovery thread. For several reasons, we prefer that you only have one recovery thread:

• That way, we have all your information in one place. This makes it easier to go back and review your history before providing advice.
• If you keep starting new threads, you miss the posts and advice others have left for you in the old threads, and some information may be unnecessarily repeated
• Having only one thread will act as a diary of your progress that you can look back on.

So please post any updates, questions or concerns about your recovery here. If you prefer a different thread title, just post what you want and we'll get it changed for you.
If you need an urgent response to a question, just tag a member of staff.

Many members bookmark their thread in their computer browser, so they can find it when they log on.
How can I find my threads and posts?

Thanks,
Chris

 

[Layla]

I’m sorry you’re struggling with pain.

It’s the weekend and I’m going to have to wait until Monday to call my doctor!

Try rest, ice and OTC meds if your intention is to wait until Monday to contact your OS’s office. It may bring you enough relief to stay comfortable.
I hope you find permanent relief soon.

 

[Hip4life]

I am so sorry you’re still having issues and that you fell. That certainly can aggravate soft tissues that are still healing. It may take a while for them to recover. I would take some comfort in the fact that your X-rays seemed to be okay.

When I had my iliopsoas tendonitis, with certain movements, I experienced what you described getting into the car. This was the tendon sliding over the prosthesis. Even non-THR people can experience a popping and snapping called “snapping hip syndrome.” Then I would experience intense pain and my groin would be more sore for a few days. Icing and OTC pain killers would help but it never went away. Certain movements (like leg lifts) were painful and difficult. Then occasionally I’d have the same sliding and popping again and the cycle would start all over. Since your doctor had you scheduled for a cortisone injection, it sounds like he already was suspecting IP tendonitis. You may have just really irritated the tendon with the fall. The weekend before my injection, I was moving some boxes and pulled my inner thigh muscles. I could hardly walk for a couple of hours and that aggravated the groin area, too.

If you feel you’re okay to wait until Monday, then follow the great advice from everyone and rest, ice, and take whatever OTC pain meds you feel is appropriate and see how you are on Monday. In the meantime, if it gets worse or you can’t weight bear, then you might consider going to an urgent care or ER. I’m hoping that you will be feeling better by Monday and will be able to proceed with your injection in the near future. Just tag me @Hip4life if I can be of further help. Hang in there and keep us posted.
@Tripplefun

 

[Tripplefun]

Hello Hip4life and Layla - Thank you so much for your responses. I'm going to rest, take pain meds and ice this weekend and see how I feel and call my doctor on Monday. It seems I have similar symptoms to you and the pain is very intense! How did you resolve your snapping hip syndrome? I've been reading about a surgery that can help. I did have the cortisone shot already and it didn't help. I had planned to go back to the gym and build up my strength and have a life again and now this! My hip was actually not that bad before surgery. The only reason I had the replacement was because the doctor recommended I have it done before I have my knee replaced, thinking it would interfere with my recovery. Now I can't handle a knee replacement considering the pain I'm experiencing. I followed his advice but now regretting my decision. Thanks again for your support!

 

[Hip4life]

My injection only worked for two weeks. The next step was considering a surgical intervention. They were tendon release (tenotomy) or revision (I had a slight overhang of the cup.) Of the tenotomy, there is a partial release or a complete release. I had the latter. Has the surgeon discussed any of these with you?
@Tripplefun

 

[Tripplefun]

My doctor wants to see me next month to determine if the cortisone shot I got a few days ago worked. The snapping pain occurred a few days after the shot. He stated he wants to try conservative methods before thinking about a release. The pain in my psoas muscle has continued to increase since my AHR 7 months ago. Was tenotomy surgery and recovery difficult? How long after AHR did you have the procedure? I think revision would be a last resort and hopefully can be avoided. Talking to someone who has had the same experience as me has been very helpful! Thank you.

 

[Hip4life]

That’s what we’re here for.
Did you get any relief from the injection, even right after? The injection is also diagnostic: if it doesn’t help at all, it might be something else causing the issue. If you got immediate relief (because an anesthetic is usually included with the steroid) then it’s considered confirmation of tendonitis. You can keep trying injections and other conservative measures which includes the tincture of time. From what I understand, if the injections continue to not last very long, they most likely won’t be curative. The real decisive question is, like with a hip replacement, how is the pain affecting your quality of life?

Mine was affecting me every day, with many of my regular activities. I was done with the pain. I needed to move on with my life. I was at 9 months post op when I had the complete release arthroscopically. The OS detached the tendon from the lesser trochanter. I had a couple of expected sore post op days. I was allowed to go back to work a week later but I took two weeks off. No restrictions just as tolerated exercise. No PT required. The relief was immediate with just the soreness from the incisions. Building back up and strengthening to my regular level of activities took about 3 months to feel completely back to normal. There is still a small deficit in range of motion but it’s nothing that limits me in any way.

The partial release involves some cutting (releasing) of the tendon fibers up by the capsule nearer where the cup prosthesis is. This essentially lengthens the tendon/muscle to allow it to better move without irritation. That option was explained to me as being more involved/longer to recover from and would include PT to allow the tendon to heal properly. I’ll tag my colleague @SaraK as she could answer more specifics about this procedure and its recovery.

I hope this helps. The better informed you are the better questions you can ask and decisions you’ll be able to make. Be completely honest how this is affecting you. All doctors have their own philosophy about these things. There is no one right answer. There is nothing wrong with wanting and finding a solution sooner rather than later. The doc just needs to be aware of where you’re at on the continuum.

 

[Tripplefun]

I didn't feel any effects from the cortisone shot but that could be because I had fallen on my hip a couple of days before and was sore all over and also hurt my back. I may have to repeat the shot when things settle down. Prior to the shot the pain from the psoas was increasing little by little until it snapped/popped.

The pain is definitely affecting my life. Walking upstairs, getting into the car, getting in bed and taking long strides are all painful. Anything that requires me to lift my leg is a reminder that something's not right. I had a meniscus root tear surgery on my other leg about 8 months prior to AHR with a long painful recovery. Too much pain for too long. I'm hoping for relief soon.

I took it easy this weekend and iced off and on. The pain isn't as severe but it's still there! Wasn't able to get an appointment with my OS until March 9. Sending a message to the office today about my symptoms and will wait to see what their response is.

 

[Layla]

Thankfully ice and rest over the weekend helped somewhat. I hope you’re able to get an appointment sooner than March 9th.
Wishing you comfort and relief from the pain you’re struggling with.
@Tripplefun

 

[Tripplefun]

Thank you Layla!

 

[SaraK]

I did have the lengthening procedure. In addition to incision pain, I had pain in the groin where tendon was cut but that pain only lasted a few days and wasn't too bad. I was stiff the first few days (surgeon said it would be due to fluid used in arthroscopic procedure). Surgeon said I didn't have to do PT but that it could be helpful. That hip will never be the same as the other and it takes more effort to raise it high, but the pain is gone and I have great function.

 

[Elf1]

@Tripplefun sorry to hear you're still having pain but happy that it let up some after resting and icing over the weekend. I would keep it up until you get in to see the OS.

I'd like to make a suggestion. Maybe go back to using a leg lifter for a while when you need to lift your leg, into bed, the car, etc it may help a little.

Also when getting in the car revert back to right after surgery, move seat all the way back, sit down sideways on seat and slide around forward, using leg lifter if it helps. You can turn a cane upside down and use the handle to lift your foot/leg. And speaking of cane, maybe try using that until you can get into the OS, may help take some of the pressure off. Hoping you get answers soon.

 

[Tripplefun]

Thank you SaraK for sharing your experience. All the information has been very helpful.

 

[Tripplefun]

Elf1 Thank you for the great suggestions. I have the leg lifter I got for after surgery but didn't think to use it again. Hoping to hear from my OS soon.

 

[Tripplefun]

I was finally able to get in to see my doctor. He isn't convinced it's my psoas muscle because my pain didn't go away after a cortisone shot. Doesn't want to do anything more invasive until at least a year after my hip replacement. So he gave me a prescription for Dyclofenac which is an anti-inflamitory and is sending me to physical therapy. My pain is lessened and I can walk up stairs very slowly now. I'll see how PT goes and hope for the best!

 

[Layla]

Hello @Tripplefun
I hope the PT helps with the pain. I’m sorry you’re still struggling at eight months post op. Hopefully between therapy and the passing of time it eases completely. Please stay in touch and let us know how you’re doing. All the best to you.

 

[Hip4life]

What your doctor suggests is a reasonable course. This is where the patience muscle gets its workout. Time will definitely tell. If the PT causes pain, let them know and have them modify their approach. Hopefully, it will do the trick. It certainly is worth a try. Keep us posted.