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Hip Infection* Abductor reconstruction

Billymc

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Hi everyone...I am 53 years old.
Im a long story so I will make the build up as short as possible.
3 years ago I got a serious infection after a total hip revision.
Spent a total of 3 months in hospital and I had many surgeries in a relative short period of time. Infection was down into the bone and I became septic. Had to do a Stage 1 spacer for 8 weeks. Worst pain ever. Eventually things cleared up but all the surgeries really took its toll on my abductor Glute Medius and Minimus muscles.As expected.
In May last year I had reconstruction of the abductor muscles and a Glute Max advancement to help with stability and give me a fighting chance on a normal gait without walking aids. Well it didnt take and after a few months, I knew something didnt feel right. MRI showed no muscle attachment at all at the Greater Trochantor. :( So, 2 weeks ago I had the reconstruction surgery repeated.
Here I am today writing this and feeling scared to death that this "final" surgery will be a success. Not sure what should be considered a success at this point to be honest. All I want is to be able to walk without a cane or crutch. My doc said everything went very well and I need to be very careful and patient. The latter I am unfortunately not right now. I am getting around with 2 crutches and am weigthbearing as tolerated. As per docs orders. Of course the regular hip precautions for 6 weeks are in place as well.
I am curious if anyone else out there has experienced this type of muscle reconstruction surgery and how long it took for recovery.
Thanks for taking the time to read this ......
 

alexthecat

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Wow, you've been through a lot! Over the years, there have been a few members of this forum who experienced detachment of their gluteal muscles. @Krista gave a lot of details in both her first recovery thread and her second recovery thread. She doesn't post much these days, but I tagged her anyway. Maybe she'll see that and stop by.
 

CricketHip

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@Billymc :welome: to BoneSmart and first of all, I am sorry to read about the many issues and surgeries that you've been through. I hope Krista's recovery threads help to give you some perspective on what you are going through with your recovery.

Could you please reply here on your thread and give us the dates of your surgeries and what was done? As in original surgery, which hip and then any other surgery that followed (with dates)
We like to have a signature on each member so when you post and ask anything we can refer to your details. It helps to give a better answer, well at least we hope that's the case!

BoneSmart likes to leave some Guidelines that may help you with your recovery. I will leave them in another post. Glad you found the forum.. I hope it's as helpful to you as it has been for me and many others!
 

CricketHip

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Hip Recovery: The Guidelines
1. Don’t worry: Your body will heal all by itself. Relax, let it, don't try and hurry it, don’t worry about any symptoms now, they are almost certainly temporary
2. Control discomfort:
rest
ice
take your pain meds by prescription schedule (not when pain starts!)​

3. Do what you want to do BUT
a. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you
b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.
4. PT or exercise can be useful BUT take note of these

5. At week 4 and after you should follow this

6. Access to these pages on the website



Chart representation of THR recovery

Dislocation risk and 90 degree rule
Energy drain for THRs
Pain and swelling control: elevation is the key
Post op blues is a reality - be prepared for it
Myth busting: on getting addicted to pain meds
Sleep deprivation is pretty much inevitable - but what causes it?

BIG TIP: Hips actually don't need any exercise to get better. They do a pretty good job of it all on their own if given half a chance. Trouble is, people don't give them a chance and end up with all sorts of aches and pains and sore spots. All they need is the best therapy which is walking and even then not to excess.

We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery.

While members may create as many threads as they like in a majority of BoneSmart's forums, we ask the at each member have only one recovery thread. This policy makes it easier to go back and review history before providing advice.
 
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Layla

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Hello @Billymc
What a struggle you've been through. I'm sorry for your longsuffering and happy that you've joined us here. Whether we can relate to your experience, or not, you'll find abundant support and encouragement here whenever you're feeling the need for company, consolation, compassionate words, or need to be lifted in prayer...we'll be there, the lights never go out here. I wish you comfort and perfect healing as you recover from your latest reconstruction surgery. Please stay in touch.
A great rest of the week to you. :)
 
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Billymc

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Original surgery was Feb. 2011. Left hip.
All surgeries were lateral approach

Revision was Feb. 2017.
Stem was not revised, just acetabular ball and socket.


Infection March 2017.
Heres where I lost count of all procedures. Revisions to remove some parts but at this point the stem was left in place. I and D's.... likely a total of 5 procedures, at least, in a period of 6 weeks
Sometime around this the infection got in my blood as well.

Still infected in May. This is when I was tramsferred to a joint specialist who specialised in infections and complex revisions. He removed everything including the stem and put in the Stage 1 for 8 weeks.


In August 2017 the Stage 1 was removed and a normal hip replacement prosthesis was put in place.
Recovery was very slow. I knew something wasnt right.

In August 2018 I felt a snap. Wasnt the prosthesis but rather a tendon on side of my leg. Had surgery to attempt to re attach to the bone. No glute advance. At this point anyway.


Dec 2018 had a dislocation. Surgery to put the hip back together.
I kept telling doc something wasnt right.

May 2019 had exploratory surgery. At this time I had reconstruction of abductor muscles and a Glute Max and TFL advancement.
Never felt strong and had so much pain.

December 2019 MRI showed no muscular attachment at GT. Again!!!
No idea what happened as to why the reattachment failed. Was told I had a lot of inflammation.

January 2020 had another Glute Max and TFL advancement.
I am seeing my doc this week for first follow up.

Hope this helps guys......
 

Layla

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Hope this helps guys...
Thanks for providing the info. It does help. It's been consolidated a bit, let us know if you spot any inaccuracy.
 

CricketHip

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Thank you Billymc.. I'm sure you patience has worn thin with all of this.
Good luck with your upcoming Dr appt. we will be anxious to hear your update.
 
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Billymc

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I did forget to mention that since my surgery in May 2019, I have a constrained liner to help prevent dislocation.
All else looks pretty good to me.
I will let everyone know what the doc has to say on Friday after my appointment.
 
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Billymc

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So I saw my surgeon today and spent 30 minutes with him going over my latest and "last" surgery.
First, todays x rays were good and showed nothing out of the ordinary.
He was very happy with the look of the incision and certainly shows no sign of infection.
I have a Seroma which he explained wasnt uncommon and sometimes happens when scar tissue is removed and there is a void or "empty space" in the body. Sometimes the trauma of surgery alone can cause a pocket of fluid to form.
It is uncomfortable but the doc assured me it will dissipate in time. Having as many surgeries as I have, the scar tissue being formed wont absorb the fluid as quickly as a primary surgery.
He explained to me that I only have about 30 to 40% left of the Glute Medius muscle left after the infection I had 3 years ago. What was left was re attached to the bone.
He performed a Glute Max and TFL advancement and showed me where the "flaps" of muscle were taken from and explained how they were anchored to the Greater Trochanter.
He was happy with the condition of the muscles and stressed to me there was no more muscle available for further surgery. He couldnt stress enough the importance of not doing too much for 3 months allowing sufficient time for healing to take place. I am allowed to weight bear as tolerated but wants me on crutches for 6 weeks. Even when I feel I am able to walk without them.
As well, he exchanged the metal head for a porcelin one. All 3 surgeons who were involved in the surgery agreed this to be the best option at this point. I am not sure the advantage this head provides over metal and curious if anybody can enlighten.
As far as whats ahead for me, once fully healed and with proper physio thearpy I should be walking without restrictions at all.
Fingers crossed.......:)
 

alexthecat

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As well, he exchanged the metal head for a porcelin one.
I think he probably meant ceramic, not porcelain.
I am not sure the advantage this head provides over metal and curious if anybody can enlighten.
It is supposed to have a lower wear rate. I have a ceramic head too. I'm almost 10 years out and so far, so good.

As far as whats ahead for me, once fully healed and with proper physio thearpy I should be walking without restrictions at all.
Fingers crossed.......:)
Good luck!
 

CricketHip

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As far as whats ahead for me, once fully healed and with proper physio thearpy I should be walking without restrictions at all.
Fingers crossed.......:)
I will keep my fingers crossed for you, too.. and toes!
I also have a ceramic head, and was told it was a very long wearing option.
Sounds like you are going to be very good friends with your crutches and I wish for you the very best in your healing journey. You can do it.. and I can't wait to hear about your progress.
 

Westy

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@Billymc I just read your initial post. You've been through a war with the hip and your body. I had my Gluteus Medius reattached on 12/19/19 after my initial TLHR on 6/27/19. Things were cruising along just fine. Then out of nowhere, I got a very serious infection and just went through surgery #3 on 1/30/20. The OS put in a new ceramic ball and polyethylene receiver. Of course they removed all the infected tissue and bone matter and then irrigated the heck out the entire region with a very strong antibiotic solution. I'm home now with PICC line and doing 6 weeks of daily IV antibiotics. I asked my surgeon about the ceramic and he states it's a better, longer lasting option. I'm hoping my current protocol is successful, but won't know for a few weeks.
More importantly, after all you've endured, I'm sending good vibes and prayers to you. I hope you stay on the road to recovery and can get back to normal over the coming months. Hang in there. You've come to a forum that is packed with a whole lot of very thoughtful, helpful, and wonderful folks. Welcome, and all the best.

Westy
 

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