THR acetabular cup problems

Yes, He claims to do more revision surgeries than anyone in Boston - so here's hoping!
Alan
 
Hi, Alan. I’m really hoping this doc can give you some answers. It is very disheartening to have on-going pain and struggle to find solutions. I’ll be very interested to hear what he has to say. Make sure you take your list of questions and points you’d like to cover. Deep breath. Best wishes and positive vibes for Wednesday. ❤️ Pat
 
Everything is connected...so I'm hoping that the issue that has been plaguing you, once resolved, is likely to resolve all the things that arise from compensation.
Of course I have no direct insight, but I think of your long journey often, and you know I will be on your corner as you search for a resolution.
Virtual hugs for peace of mind after talking to the OS tomorrow, @allj
 
It's just a telehealth appointment and you are still in charge.
I know how wearying this has been and yeah, the timing with the 'we wont mention the dumb ole viris' isnt great...
But you have got alot of life you need to be living.
Hope you like this feller/lady?
Be nice.
 
Hi @allj
Wondering how your virtual appointment went?
:fingersx: it brings you closer to getting a solution.
 
Just had you on my mind @allj and hope you are well.

Hate to think of you being in pain and not being able to resolve it all this time so if you get the time, please do let us know how you are.
 
Thank you so much for your thoughts! I'm doing poorly.

I had another THR for the right hip done on 9/21/20. I had a sharp pain when stretching and was x-rayed for a possible displacement. I may have dislodged a nerve that was cut after being trapped after a hernia operation (or not) but am having allot of pain in the groin during recovery.

But it's only been a month. I tried to do the same exercises on the left side where I had the previous THR and where the cup is raised about 2mm but this made the left leg pain worse walking upstairs, just walking and occasionally giving out at the top of the quad. I'm hoping it will die down again.

This last surgery made me realize I don't want to go through another hip surgery to revise it. I was forewarned about the possibility of multiple complications by the revision surgeon who did this last surgery as well as his nurse practitioner. When I told him that I was having a hard time living with the pain he referred me to a surgeon who could do a tenotomy even though he previously said they were too unpredictable to do. The referred surgeon had limited if any experience doing these and recommended cutting the muscle at the cup rather than at the trochanter saying it may grow back adding that there weren't enough done to say how frequently this happens.

I found a study reporting it grew back in 2 out of 209 cases. I believe he was doing this as a professional courtesy since the revision surgeon operated on his father. Just to complicate my decision, I had buttock pain previous to the left hip surgery (I thought from a torn labrum) but no pain in the groin. I am unsure of the source the continued buttock pain, so had an EMG done suggesting a distal demylenative neuropathy. I don't want to have the muscle cut if the buttock pain is from the prosthetic. So that is how I am. Not good really and confused.

I am looking for an experienced surgeon to do the tenotomy is Massachusetts. Any suggestions? Thanks for listening. I hate complaining!
You're much appreciated!!
Alan
 
Hello @allj - I'm sorry you're still having a bad time. I do hope this second hip replacement recovers more smoothly than your first one.

Here's a copy of our recovery guidelines, just to remind you:
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. Try to follow this

6. Access these pages on the website


Pain management and the pain chart
Healing: how long does it take?
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 the majority of BoneSmart’s forums, we ask that each member have only One Recovery Thread. This policy makes it easier to go back and review the member’s history before providing advice, so please post any updates or questions you have right here in this thread.
 
Would you like us to change your thread title, to reflect that you've now had a second TR? If so, just post what you'd like your new title to be and we'll change it for you.
 
Thanks again
I do have another question in regards the first THR. I am probably going to have a tenotomy and need advice.
I met with a surgeon who is known for doing non-invasive laparoscopic surgery to discuss having a tenotomy. He said it is best to cut the psoas where it rubs the cup because there is a possibility of it growing back and also cutting it at the lower trochanter leaves it dangling possibly causing problems down the road. Is there any consensus on the best place to cut the psoas for a tenotomy?
Thanks
Alan
 
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@allj I am afraid your question about tendon release can only be answered but an experienced surgeon. Perhaps you should get a second opinion on this.
 
Hi @allj
I really was hoping you were doing better and hate to hear number one is still a problem.:sad:
Regarding this recent THR, I know it's hard but try not to compare.
Groin pain, glut pain....all these were normal for me and you really should take it veerrry slow and easy on stretching even.
Lots of ice and rest and some walking....
Yes, a 2nd opinion regarding the tendon as this doc doesn't sound super confident.

@SaraK has had a tendon release...and perhaps she can share what they did and why?
 
Hi @allj ! I did have a tenotomy at the cup. I know @Hip4life had hers at the trochanter and did quite well but my surgeon did mine at the cup - as you say, where the rubbing was occurring. The procedure itself was not difficult. Arthroscopic under general (my surgeon preferred) and released as soon as I was fully awake. There was swelling and stiffness from the fluids pumped in during surgery but the pain wasn't bad. I'm known to overdo things, but I went out to dinner and a little dancing for New Year's Eve that night. There was notable improvement every few hours and I only took a few pain pills.

I had no restrictions at all other than what I felt comfortable doing. PT was optional but I did it because I have a great PT that I knew would accelerate my recovery. I was driving after just a few days and felt better than I had in months within about a week or so. The main issue was retraining the brain and muscle because they needed to adjust to the new length.

I don't think that hip is ever going to be quite the same as the other on the more extreme range of motion but I don't notice any issues in my day to day (including lifting weights). I did experience what might have been a mild subluxation a few months ago when I was very inactive between shoulder surgery and the virus closing gyms. That resolved quickly though, and the pain diminished and I just felt a bit "tender" for the next couple of weeks. I didn't even discuss it with the ortho on follow upson my shoulder.

Be aware - not everyone has the same results. I know others who didn't get the same relief. I don't know it it is because the cup was too poorly misplaced or some issue of their own anatomy. If it's not the tendon rubbing, you'd just be trying to solve the wrong problem. You'd also mentioned a problem with a nerve that may be out of place or unusually placed. Would this solve that issue as well or has that been ruled out?

If you have questions or want a response from me, be sure to tag me. I get those notifications quickly but am not otherwise on the site much these days.
 
@allj

Recommend you ask for Dr. Della Valle at HSS in NYC, he is part of a team that looks at difficult cases. The team will look at your information with out a visit and give you their opinion.
There is a fee involved, be sure to ask about the it.
 
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Hello @allj :wave:
It’s been two months with Righty now, Happy Two Month Anniversary!
I‘m wondering how your right hip is doing since we last heard from you and whether you have a tenotomy scheduled? Hopefully so and it brings you relief soon.
Wishing you comfort as you wait, or speedy healing if you already had the procedure.
 
Happy Three Month Anniversary and a very Merry Christmas to you!
May your day and week be peaceful.
@allj

:merry-xmas-smiley-emoticon:
 
Hi @allj
Sending all the best this season and hope you are doing well.
:fingersx:
 
Hello all!
Since posting it's been about 2 yrs since my right THA. During recovery I tore my adductors and had a terrible time with recovery. I thought I had bursitis but a recent MARS (magnetic artifact reduction software) MRI indicated there is no “bursal collection”. The Mass General surgeon said he hasn’t seen a glute as atrophied as mine so I’m assuming it’s the cause of my painful and weak glute?? BUT, the image showed a protruding acetabular fixation screw extending .34 inches into the gluteus minimus and abutting the gluteus medius and piriformis. He said this is common and to not worry about it. Should I believe him?? Having a screw in a muscle is no doubt painful and worrisome. I'm not sure if the pain is from the torn adductors or the screw. Your thoughts and advice is much appreciated.
Best Wishes,
Alan
 
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@allj
Welcome back to BoneSmart, sorry to hear you are having continuing problems with your THR.

Your surgeon is right most do just fine with a screw producing in to muscles.
There are always exceptions, suggest you seek a second opinion from a surgeon specializing in complex joint reconstruction or revisions, they have the experience and education to find out what is causing your continuing problems.
You will want to seek someone that has no connection to your present surgeon.

You can start your search with our surgeon locator in the blue banner at the top of the page.

Keep us posted on how you are doing.
Chris
 

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