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THR acetabular cup problems

@allj Best thing I can do is to ask you to show me the sites of your pain using this chart

[Bonesmart.org] acetabular cup problems
 
I am including a chart of the locations of the pain I'm still experiencing. The dark X's are the most painful and most difficult. Hope this helps your understanding and can lead to a way forward and out of this mess. My leg/body is more painful and debilitating than before the surgery.
[Bonesmart.org] acetabular cup problems

Alan
 
@allj ,
Josephine is away for a few days, and will get back to you when she returns.

Have you obtained a second opinion for your hip? If not you may benefit from having another opinion.
See out a surgeon specializing in Revisions, they have the education and background to determine what is happening with troubled knees. Look for a surgeon specializing in complex joint reconstruction or revisions. They should have no relationship with your present OS, not even golf buddies.

Reading your previous posts you mentioned gluteal weakness, and illiopsosas tightness. Has your PT looked for muscle imbalances? There are gentle exercises you can to strengthen the weaker muscles, your PT should be able to help you with this.
 
Thanks . I'll find another specialist for a consult.
Alan
 
Wishing you the best! Let us know how it goes.
Wishing you comfort in the interim.
A great week to you!
@allj
 
:wave: Boy, what a year, ay?
Really hope you get some relief !
Sending sympathy and best wishes!:yes:
 
Thanks for your kind words. I'm really tired of waiting to get my leg back.
 
Your leg and your life back.
Prayers it happen soon.
I hope you have a nice weekend!
@allj
 
1½ yrs post anterior THR. My iliopsoas catches on the acetabular cup which isn't flush. Is this a surgical error or impossible to get flush with some people?
Thanks for taking the time to answer this.
Alan
 
Hi @allj
Sorry to hear you are having an issue.
Is it very painful?
I'm tagging our Nurse director @Josephine as she would likely be best to answer this question.
 
Last edited:
@allj
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.
How to tag another member; how to answer when someone tags you

Here are the instructions on finding your thread, How can I find my threads and posts? . Many members bookmark their thread, so they can find it when they log on.
 
Thanks for asking Mojo. I had a terrible time lifting my leg via rectus femoris. The first month out the PT commented that maybe it was cut. I have had an awful time with this and the iliopsoas was secondary to this pain. I went to UCONN and the surgeon said the nerve pain would be all the way down the leg if there was palsy and that it was more likely messed up because my iliopsoas was rubbing the cup. He said it wasn't flush.

So still don't know what's going on. I think the surgery was rushed. I live 3 hrs from the hospital so asked not to be called first and reminded them twice. They wanted me there 5:30 so I told them I couldn't make it. The surgeon was ripped and hesitated to shake my hand and didn't look me in the eye then or the next day.

I want to know if the cup protruding is avoidable or am I just looking to blame him. If anyone knows please respond. Thanks
 
I only know enough to be dangerous about the subject but I do know that most cups are pressfit, and it is possible that it could have been misaligned or if bone didn't grow around it properly, scar tissue can form which may or may not make it stable for weight bearing if pelvis shifts.
I know we have had members who have had this issue in the past...let's see if I can hunt them up?
Are they saying the cup is loose, or do you know?
 
Thanks Mojo - It isn't loose but not set flush and causing the iliopsoas to rub on the protruding edge creating pain and difficulty walking up stairs.
 
And also known as acetabular impingement but not the same as this one Femoro-Acetabular Impingement (FAI).

Acetabular impingement is actually not that common but when it occurs, the only answer is to remove the cup and resinsert it.
 
That's what I thought. More pain, more infection??
Even as this is unwelcome thanks for letting me know.
Alan
 
Sorry Alan. I know surgery is not what you wanted to hear.
You didn't have an infection last time, did you?
It would be nice to have this done properly so that you can be out of pain however.
I remember you had some struggles during recovery.
Could this have been the culprit all along , do you think?
Wishing you all the best @allj
 
Thanks for your interest Mojo. I did not have an infection but was told infections are much more common with revision. One article said one could be on antibiotics for the rest of their lives. I believe we live for our guts. If our gut isn't happy we aren't and being on antibiotics for life will be really disruptive to the microbiome in my gut.

To your question about the raised cup being the culprit - maybe all - maybe some. A month out from surgery I couldn't raise my leg at all from a sitting position. The PT said maybe the muscle was cut. I read about paralysis of the rectus femoris by the use of retractors, excessive tension during extremity lengthening, burning the muscle, dislocation of the femoral component or the wire around the femur.

BTW I have a wire around the femur usually used whey there is a bone break. The operation report said the wire around the femur was prophylactic, i.e. just in case. Either the surgeon cracks bones frequently or he had another reason to use a wire. An article I read said 36% of victims regain full muscle strength after 22 months. I am doing better now - not full.

A few months ago I couldn't raise straight my leg from a supine position. So that was part of the problem. The surgeon I recently consulted said he wouldn't have operated on me since my hip bone was only mildly affected and the pain I had usually isn't helped by surgery (great!). He said normally when there is paralysis there is nerve damage hat one can feel all the way down the leg. He also thought the muscle would die if the wire was too tight. However, he did say the cup was raised rubbing on the ilio-psoas and catching sometimes. This is not only involves some pain but also makes it harder to raise the leg.

Forgive my long lament. You probably don't want to hear this but here goes. This surgeon was unhappy with me. I told scheduling I lived 3hrs from the hospital and not to schedule first thing. When they called the night before surgery and said I had to be there I think 5:30-6am. I told them I couldn't get there then. I got a call back from someone who sounded like they were transmitting an irate message saying to come an hour later or don't come at all.

When I saw the surgeon at the hospital he hesitated to even shake my hand and never looked me in the eye - then or the day after surgery. He did apologize at my year visit when I told him how much he screwed me up and ordered an injection of the psoas and told me to call with the results. I left a message a week later stating I was still in lots of pain esp with the rectus femoris. When I didn't get a call back by him or his staff I called again and was basically told I already called and he got the message. This contained an angry reprimand about him being a busy surgeon. I stated that I was still in lots of pain but never got a call by him or his staff.

That's the whole story. Sad but true. The hospital I went to was New England Baptist in Boston - ranked 34 by US News and the surgeon is Carl Talmo. I am going to talk to a lawyer.

Thanks for your kind support. Life can be challenging but with support and love there is a way to go forward. I'm hoping the maxim - "If it doesn't kill you, it will make you stronger" - is true. So sad.

Good Luck and Best Wishes,
Alan
 
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