THR acetabular cup problems

[Mojo333]

@allj
All very unofficial, as my disclaimer states...I'm not a medical professional, just a fairly informed grateful Hippy, who- by the grace of God or the luck of the draw, has been blessed with a noneventful recovery...though I am 2 years post op so there but for the Grace of God go I...
It does seem to me like things didn't seem quite copacetic from the start.
I should hope, even if the surgeon was perturbed, that he would not want , if for no other reason, to screw-up his reputation by doing a sub-par job.
I understand how you could feel like that, I know I most likely would, if it happened to me.
Can you get an opinion from another OS...as I know you have a lot of living you want to do without this hip pain...and I'm sure since any time you have any type of surgery your chance of infection rises...this should also concern me...but I do hope you will consider getting this sorted.
I do remember the wire also...and wonder too if there weren't issues that were "played down"
Healing mojo and sincerest hopes for good things to come your way

 

[allj]

Thanks again for your healing hope Mojo . I'm assuming the surgeon was rushed or/and careless. Either way having the cup not flush is a rare mistake esp. from a surgeon of 20 yrs in a high turnover hip mill like NE Baptist. And then he abandoned me! I was told by Dr. Halawi, another surgeon I recently consulted with, to stretch stretch stretch the psoas. A few months ago he sent me to a PT who showed me some exercises that I do almost daily. If this fails I'll have to seriously contemplate another surgery but only as a last resort. In the meantime I'll keep on living and loving as best I can. Thanks

 

[Mojo333]

Sending healing vibes your way!
Keep the faith @allj

 

[Mojo333]

@allj
Just wondering how the exercises were going and if you had seen any improvement?
Been thinking of you and wishing you well.

 

[allj]

Wow! thanks for your wishes and thoughts.

How am I doing?? I continue to have on and off problems with what feels like the iliopsoas but the most pain is from the rectus femoris. When raising my leg from a supine position I have biting pain at the top of the muscle and shooting pain as I lift the leg up at the end near the knee.

The muscle is much better since not being able to raise my leg at all but continues to be painful and weak. There are several reasons for this that all point to sloppy work by the surgeon. I'm hoping the muscle will fully recover and am going to keep plugging along for a month or so more. If I continue to have issues I'll have to get caught up in the medical system looking for answer.

Hate running to doctors. I'm also dealing with pain from an inguinal hernia mesh replacement and a cut nerve on the opposite side of my body and may end up needing surgery.

Life sure is challenging these days but am still on a mission to live life as well as I can. I just bought an electric bike that takes little effort to use and hoping to do some traveling this summer. Trying to stay positive.

Thanks for thinking of me and wishing you the best. It helps.
Alan

 

[Layla]

Hey there Alan
In catching up on your thread, I'm sorry to read you're still struggling with no relief in sight.
Wondering if you've considered getting another opinion in an attempt to get the hip issue resolved?
I hope you continue enjoying time on your bike and are able to travel a bit this Summer as you mentioned.
Wishing you all the best.
@allj

 

[allj]

Thanks Layla.

I got another opinion in regards to the iliopsoas pain. He said it was related to the cup not being flush. The surgeon thought the pain in the rectus femoris was due to this as well. I'm not sure.

I've read studies indicating it can be caused by the retraction of the muscle, burning, wires or dislocation. If the pain continues I'll go back to the original surgeon and then to others in hopes of finding the answer.

I'm considering legal action if this doesn't resolve. I'm not sure if this will be productive. Anyone have any advice with legal?

Thanks again for your thoughts and well wishes. Alan

 

[Josephine]

He said it was related to the cup not being flush. The surgeon thought the pain in the rectus femoris was due to this as well. I'm not sure.

I've always suspected that. But why are you not sure?

 

[allj]

Because there is rarely pain from iliopsoas near the prosthetic and it's only mild to moderate when it happens. I couldn't raise my leg fully from a supine position until recently.

At 8 weeks out PT wondered if the muscle was cut or damaged. I stretch the iliopsoas by hanging my leg over the side of the kitchen table. Initially, I couldn't raise my leg at all and the pain was at the top of the muscle which was aggravated by twisting or jerking. Eventually, I was able to raise my leg a little but with difficulty - around 1.3 yr out - and then with more time and work was able to raise it all the way with shooting pain down the same muscle toward the knee. This was about 3 months ago. This has gotten better but continues. At 1.5 yrs out I'm fearful this is the best I'm going to get.

I should mention I have worked diligently and almost daily at this.

A new concern is the crunchy sounds I've been hearing for the past months when walking upstairs. I'm not sure if I should be concerned.

The cup was only slightly raised. Do you think the cup problem can cause this much of a problem with the rectus femoris muscle - shooting pain down the muscle, weakness and significant pain at the top of the muscle. Maybe I'm being too impatient?

Josephine, I'm grateful there are fellow travelers like you that are willing and able to help. Thank you again - Alan

 

[allj]

Latest update - As I stated earlier the cup of the prosthetic is slightly raised. I am having pain w the iliopsoas and the top of the rectus femoris and scrunching noises with the prosthetic. I have an appt with the original surgeon.

Is having a redo to get it right very risky i.e. with worse results, or can this usually be successfully done? Thanks Alan

 

[Mojo333]

Hi Alan. Sounds like you are ready to figure out how to get this sorted.
I hope @Josephine has some experience about this and how complicated it might be.
I'm guessing they would be replacing this component vs "repositioning"
I confess I don't know much about this so let's see what the nurse director says.
I know how anxious facing a revision surgery must be...but going on in the way you have has got to be wearying.
Wishing you peace about this.

 

[Josephine]

I should mention I have worked diligently and almost daily at this.

That probably wouldn't have helped and may even have exacerbated your condition.

A new concern is the crunchy sounds I've been hearing for the past months when walking upstairs.

This might be the result of 'working diligently'.

The cup was only slightly raised. Do you think the cup problem can cause this much of a problem - shooting pain down the muscle, weakness and significant pain at the top of the muscle.

It only takes 2-3mm to cause a problem.

Is having a redo to get it right very risky i.e. with worse results, or can this usually be successfully done?

It's actually one of the more common reasons for a revision and such procedures have a very high success rate.

 

[Mojo333]

Hi @allj
Just thinking of you and wondering if you had your consult and if they have you at up to get your hip problem resolved.
Hope you decided to take this leap of faith as you don't seem to be the type to want to slow down or relent to a challenge.
I know this didn't go as planned, but hope there is an end in sight.

 

[allj]

Hello again,
Earlier this year I had a second opinion regarding THR pain. I was told and shown that the prosthetic is stable but "slightly more prominent anteriorly over the bone" causing psoas impingement. I was told there was a 50:50 chance this could get better or even worse. This past spring I could walk but the psoas muscles were so weak I couldn't even lift my leg so after regaining some limited leg lifting abilities I thought it best to give it time. It's several months later now and I continue to have pain from the psoas and pinching. Even though the original surgeon said he would do revision surgery (without any assurances that this would resolve my issues) I do not feel comfortable or trust him enough to have him touch me again. I was told most surgeons are reluctant to do revision surgery (some of that is due to reimbursement) and would be better off going to a teaching hospital. The original post surgery was so debilitating that I can't afford to go from the proverbial "frying pan to the fire". I know there aren't any guarantees in life but is there a general rule of thumb regarding revision surgery i.e. longer recovery, more complications/infections, etc. As Always any help is appreciated.
Thanks again
Alan

 

[Pumpkin]

@allj,
Welcome back!
Sorry to hear you are having continuing problems with your hip.

Often members will report the revision went better than the primary THR, as the components are properly positioned.

If you have not already, recommend you seek a second opinion for your TKR, from 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.

 

[Jamie]

Please use our Joint Surgeon Locator (link at the top of the page) to search out revision surgeons near you. You may need to travel to a larger city to see someone who can help you. Let me know if you need assistance finding someone. Be sure and tag me if you need my help. You do that by typing the "at" sign (@) next to my username in your post - like this .... @Jamie

 

[allj]

Thank you Pumpkin and Jamie,
I found a list of Orthopedic surgeons from the suregeon locator link. Do all of the ones listed do revision surgery?
Alan

 

[Mojo333]

Let's tag @Jamie so she catches this @allj
I think you need a surgeon who feels confident he can get this right and one you can believe in.
I think you have a lot of life you need to be living, so the sooner the better.

 

[Pumpkin]

Do all of the ones listed do revision surgery?

You will have to call or google the surgeons listed to find out if they do revisions or complex joint reconstruction.

Be sure you find someone who does a lot of revisions.

 

[Jamie]

Pumpkln is correct. Once you have the surgeon names, you can Google their website or call them on the phone and ask if they do hip revisions. It may take a little work, but it's so worth it when you find the right doctor to work with.