Guest viewing is limited

THR Arthroscopic hip bursectomy post THR?

Hi,
I was told, due to the fact that two strong corticosteroid injections were totally ineffective, I have recalcitrant trochanter bursitis which is most likely not going to go away. I asked the hip surgeon if, in his opinion, I may have this forever and he said yes. He said I have a severe case and I’ve been dealing with this pain for about 8 months. I had a PT session this morning and she advised me to cut back on walking; perhaps every other day, start slowly and not be so focused on mileage. Again reiterated it’s a marathon, not a sprint. It’s also unfortunate that Medicare has changed their guidelines and criteria for PT and it’s based solely on a dollar amount. I’ve already used 14 visits and have another four or five left for this year. I asked what patients do who really need continuing PT; the answer is, they pay cash! Twenty first century healthcare in the United States!

We discussed what options would be available if there is no improvement and she agrees, it doesn’t hurt to meet with an arthroscopic hip surgeon and discuss what treatments he would recommend at this time. Arthroscopic bursectomy would also release the IT Band which is also causing additional problems,
gluteus Maximus and gluteus minimus. We’re continuing to work on stretching and getting swelling and pain under control; very challenging because this is now a chronic case
of trochanter bursitis. I’m certainly not going to rush into any surgery right now but frustrated that this seems like it will never end.
 
Thanks Helena.
I will do that but my PT explained the new strict guidelines; so different from when I had pt five years ago. At that time, you could get approval to extend treatments, based on submissions from your pt about how you were progressing and continuing progress notes were sent to your physician every several weeks. I was able to have pt for several months for shoulder and cervical spine issues and it was enormously helpful! Now visits are totally based on a yearly monetary amount and once that is used up, you must wait until the following calendar year to continue treatments.
 
Helena,
I just spoke to a supervisor at Medicare and she told me the information my therapist gave me is totally incorrect! I’m glad I listened to you and contacted Medicare. There is no cap on monetary amounts or visits per calendar year as long as the pt documents that continuing care is deemed medically necessary and submits documentation to Medicare and my physician on a regular basis. Perhaps she just doesn’t want to be bothered with additional paperwork; that would be very disappointing, as I trusted her completely. Maybe that’s my biggest problem, trusting drs and therapists and thinking they only put patient’s welfare ahead of their business.

Oh, I had sent her a text after speaking to Medicare and her response was, I’ll have to speak to my biller; I don’t think that’s correct”. She’s not a new business owner and I so wanted to say, c’mon, don’t play this game with me!
 
Hi @Nyc1961

Glad to hear you are now in the hands of a surgeon you have confidence in.
The point i made about ATHR swelling was not to suggest that this approach is a factor in your response post surgery, but to point out that it causes a lot of local swelling ( I've had it as well ) and from what i am lead to believe more swelling than other approaches.
ROM differs from Glute strength,. A lot of active people prior to THR have poor muscle activation / sequencing in this area due to the joint not working as it should. Without working on this area pre and post you will have THR and still have loading through the soft tissues incorrectly placed. Just because you have THR does not mean the soft tissue structures around it are also remedied.

Each hip is different and no one surgery is the same as the other, we all have our journey to better health, some take less time, some take more.
My initial post was to offer some feedback based on my experience in an effort to help you with yours, not to dismiss or offend your current situation.
All the best.
 
Last edited:
Can anyone share their experiences with having arthroscopic hip bursectomy after THR? I am going to schedule an appointment with a surgeon to discuss this procedure for trochanter bursitis and release of IT Band. PT is only aggravating this condition. Also, has anyone achieved success with acupuncture for this condition?
 
@Nyc1961 I changed the title of your thread so that members who have experience with a bursectomy procedure might come and chat with you.

I didn't have acupuncture for bursitis - but it really helped me post LTHR with lower back issues.
 
@Nyc1961 How are you doing? Haven't heard from you for a bit. Hope things are better or at least not worse! I'm also wondering if you tried acupuncture; I've been thinking about that myself.

Things are the same here. Seeing my surgeon tomorrow to push for an expedited MRI.
 
Hello,
Nice to hear from you! I’ve been occupied with recovering from my first cataract surgery and a second one scheduled for August 26. I find it mildly irritating when reminded this is nothing compared to what I endured almost a year ago. Of course, there is no comparison but it’s still surgery and having a year of complications from hip surgery increases the daily stress level.

I am doing better and have been walking almost every day and made the decision to stop pt since I felt much worse after the last session. Some days are better than others and I don’t know if I’m slowly getting better or if this condition is here to stay. I have discovered that Voltaren gel massaged right over the greater trochanter has really helped me. I was reluctant to use it initially since it’s not approved by FDA for use on large muscles like hips but it’s helping me so I am happy about that! The one thing I’m certain about; there will be no more corticosteroid injections in my future!! I’d rather live with GTPS than go through the horrific side effects of those injections again. I realize everyone reacts differently but my body has told me, no more!

I have an appointment next Monday with a sports medicine orthopedic surgeon who performs arthroscopic bursectomy and will discuss all options and hoping he can offer some recommendations other than surgery, which would be the last resort. If not, I am reluctantly coming to terms with the fact that pain and limitations may be my new normal way of living.

I’m glad you have an appointment with your surgeon and really hope the MRI will give you some answers. Please let me know how you’re doing and sending best wishes for you to feel much better soon!
 
Nyc1961 said:
Hello,
Nice to hear from you! I’ve been occupied with recovering from my first cataract surgery and a second one scheduled for August 26. I find it mildly irritating when reminded this is nothing compared to what I endured almost a year ago. Of course, there is no comparison but it’s still surgery and having a year of complications from hip surgery increases the daily stress level.
Click to expand...


@Nyc1961
Your irritation stems from your current situation, not from the advice you have received. Plainly the advice given on surgery for bursitis in comparison to THR is correct, it is minor in comparison. I've had the bursa removed in both elbows. No big deal, no noticeable change in pre and post. Frustration directed at people trying to assist or offer support is ill directed.
Meet with your surgeon, get some great advice and know that if you decide to have the bursa removed that you will be able to tackle that surgery with a lot of confidence knowing you have been through worse.
 
Hi @Nyc1961. I hope the recovery from your cataract surgery is going well. And, I'm glad to hear you are doing better, hip-wise. There sure are a lot of ups and downs with this; one day, I'll be thinking, things are actually improving; then 2 days later, it's just as bad as ever. I should give the Voltaren a try; there's a tube in my drawer but I never thought of it.

Re PT, I hear you..they may not be able to make you better, but they can always make you worse! I look forward to hearing what the sports medicine surgeon has to offer. Meanwhile, wishing you all the best!
 
Good morning,
Just about to get ready for my visit to the sports medicine physician and read your post; what timing! You must have seen me crying and stressed out right now. I really thought this improvement would last but not only am in very bad pain, it’s worse than anything I have experienced so far. For sure, ups and downs is the perfect description. Voltaren is no longer helping; perhaps it wasn’t? Maybe my body decided to give me a brief reprieve from this misery. I’m very apprehensive about my visit this afternoon and in the back of my mind fearful of the dr telling me there is nothing that can be done except surgery. I also always worry about the possibility of the implant loosening, remembering what the second surgeon told me about lack of ingrowth in the hip cup denied my my operating surgeon and the third surgeon I saw in June. I’m at my wits end today. September 22 is the anniversary of this miserable procedure and every day, wishing I never had this done! On a positive note, my cataract surgery went well. Thank you so much for asking about that! I’m having another one scheduled for August 26. My dream right now would be to have one month without seeing any doctor! How are you feeling? Did the MRI give some additional information as to what is causing your pain?
It’s going to be a long day for me! Take care and again, thanks for thinking of me!
 
This was a depressing stressful day. After filling out 15 new patient forms in yet another mega orthopedic practice and waiting patiently once again as all my cds were downloaded, this new doctor listened to my nightmare story, and proceeded to examine me. After reviewing all the discs, he told me that his area of expertise did not include arthroscopic bursectomy and it band release. I was completely shocked and mentioned that he was recommended by the PA of the last surgeon I saw. He was just as surprised as I was and I was angry at driving a long distance and being put through another stressful day with a doctor who couldn’t help me. Now for his recommendation! He said I should see his partner who is the best hip replacement dr in Orange County; sure, no bias there! And if he found there were no problems with the implant and it was trochanter bursitis, then the last surgeon’s diagnosis would be correct. I read the reviews of this hip surgeon and he has only been practicing for a few years. Also his CV was not impressive and there were only a few reviews which were positive. Certainly not someone I would consider seeing for a possible revision surgery if needed. He did suggest having another lab test to rule out the possibility of infection. The last one was done in February and that ruled out infection at that time. I decided to go ahead and do that so it’s back to the lab tomorrow. I’m just dizzy and frustrated from going round and round and feel like a ping pong ball once again with pain now constant and accelerating in so many areas. He didn’t even suggest another X-ray which surprised me. I started thinking once again of the second surgeon I saw who told me there was no ingrowth in my hip cup and questioned the type of implant my surgeon used and the angle of the implant. That obviously didn’t go over well with my operating surgeon and all of that conversation was posted way back in May although it seems like a million years ago. I’m not sure how to proceed or where I should go at this point. I’m so exhausted and still have my second cataract surgery on the 26th plus a test ordered by my cardiologist.
I do have an appointment with the second surgeons’s PA on September 22 for a hip X-ray. I certainly will ask him why he recommended a sports medicine dr that was not trained to do the procedure I had asked him about; frustrated and totally disgusted right now.
The rest of my evening will be spent trying to decide whether to take a cbd gummy bear to sleep or Tramadol for pain which also helps with sleep; such exciting monumental decisions! I never dreamed anything like this would be happening to me for almost an entire year! If I had the financial resources, I would move forward and have a consult with HSS but then what; I couldn’t afford to fly home and have surgery in New York. Time for researching more drs tomorrow after my lab test. And If one more person tells me how great I look, I’ll throw a plate at their head! LOL.
Sending you best wishes and hoping both of us will find some answers and relief from this ongoing pain. As always, many thanks for caring.
 
I'm so sorry to hear this, @Nyc1961. No wonder you are so frustrated; to go through all that rigamarole and then to be told the surgeon doesn't do arthroscopic bursectomy! That's just stupid! But it still seems like if you can just find a surgeon who does do that procedure, it would give you some good information.

My pain has also been significantly worse for the last couple of days; not sure why. Maybe it will ease as it has done before, but in the meantime I just feel completely depressed. As always, best wishes to you....That's all I got today. :-(
 
I’m so grateful for your continued support! I also realize living alone is definitely a contributing factor to my stress level. The one pleasure I loved, walking, which always brought enjoyment and relief of stress is now limited because of pain. Yes, it’s very frustrating and depressing because that was the whole purpose of having hip replacement surgery. I completely understand how you are feeling today and my mood constantly changes from depression one day and real anger the next day! So far, I have not reached the point of acceptance; don’t know if that’s good or bad.

I’m worried about my appointment today with the PA and nervous about another X-ray of my prosthesis. I actually lost count of how many tests I’ve had the past year until I started looking through my volume of reports over the past year.
Maybe he’ll spend than ten minutes with me and offer some new suggestions but not optimistic after his last referral!

I have no idea what the next of action should be but right now, I need to continue taking some deep breaths and somehow try to keep calm and find a glimmer of optimism. I just feel so stuck and mired down by pain and fear that this condition will never improve.

Sending best wishes and hopefully, less pain today!
 
I realized after today’s appointment with the surgeon’s PA there are no answers or an easy fix to what I’ve been left with as a result of surgery.
I really have confidence in my new surgeon and his PA is exceptional. He didn’t feel it was necessary to have another X-ray at this time since the last one was done in April. Another examination just again confirmed recalcitrant trochanter bursitis and psoas bursitis, plus tight IT Band; so much pain and inflammation! I asked him about bursectomy and he said that was a procedure not warranted and explained the reasons why it would not do any good. He also again looked at my surgical report and I asked him if perhaps the two iliac screws, the cerclage cable and the fact that my surgeon had to cement the acetabular because of poor bone quality could have caused the trochanter bursitis. Yes, possibly but there is no way of knowing. There are so many reasons this could have occurred during surgery and I’ll never really have an answer which for me is the most frustrating part! In his opinion, I must go back for PT and he gave me the name of a therapist he feels would be more beneficial than the person I’ve been seeing. I definitely need to work on stretching and strengthening exercises. We talked about PRP injections; sometimes they work but I don’t have the luxury of spending so much money on something that may or may not work. He did suggest CBD oil or cream, also costly but worth trying. Gummies are effective in relieving anxiety but no anti inflammatory benefits. Tylenol doesn’t do much for my pain and I can’t take Aleve because of GERD. He asked if Voltaren was helping and I told him it hasn’t helped much. I’m beyond sad at this moment because the reality of living with this chronic condition forever is too overwhelming to absorb right now. I feel the situation is completely hopeless and I’m exhausted. Of course, I’ll give this new therapist a try. The door has been shut on finding a quick or permanent cure; so sad! I had to fight a strong urge to send my operating surgeon a text and let him know what I thought of him and the callous post op care he gave me. A glass of wine immediately eliminated that bit of absurd and irrational thinking!
 
Oh boy... That is not a happy prognosis. If the bursectomy is not a good idea, that doesn't leave you with a whole lot of options beyond pain management and PT.

When I saw my surgeon last week (and he readily agreed to do what he could to expedite my MRI, btw), he also suggested CBD, but as I think I've mentioned, I didn't find that it helped. Until I get the MRI I'm not at the injection point; that's when I'll have to decide between PRP and cortisone. And you're right about PRP; it's $500 out of my pocket and a complete crapshoot.

However, I've been doing a little research on my own and I'm going to try proteolytic enzymes, which apparently can be effective at reducing inflammation. I ordered them and they're on their way; I will definitely report back on that. To quote a family saying, hope dies last!

And probably just as well you didn't flame your surgeon... You can always write those kind of missives and then not send them, though! Sometimes that helps!

I also want to say that I wouldn't wish this on anyone, so please don't misunderstand me, but it gives me some comfort that there is someone else out there in this world of hurt who understands what I'm going through. So I'm not quite so alone with this. I think maybe it's the same for you.

Wishing you success with the new PT and an end to pain, my friend.
 
@Sashimu@NYC1961
It is hard to compare pain levels for different people, so I can't say that I had as much pain as you do after the same number of months had passed since surgery. I don't think my pain level was too high, but I was disappointed enough to see my OS at 10 and 12 months (he said wait), and to seek out three other opinions (PT recommended, along with time). I can say that at this point today 14 months after surgery, my pain level is down from where it was about 4 months ago, and if I had to rate it, it would be only a 1.
So, since you had your surgeries months after me, I am hopeful that you will recover and that we are all just a little slower to recover that some of the people in the "success stories". One second opinion surgeon actually told me that I am still recovering, and in the third quartile. That surprised me because I thought I was certainly in the bottom quartile.

Maybe I am being too optimistic, but that is what I am hoping for you both unless something more definitive is found. It is a possibility, but everyone is different, so it is so hard to know....and so hard to wait (I can say that from experience.) And, of course, I think it is wise to keep seeking answers.
Best wishes to you both for improvement or answers.
 
Thank you for your best wishes and sending you the same.
I totally understand and it is a source of comfort to know there is another person dealing with the frustration of dealing with ongoing pain and very few answers.
I spent most of the day researching this condition and finally found a dr who performs this procedure and is close to my apartment. I’m reluctant to be hopeful right now but after reading every patient review and his entire background, I scheduled an appointment for September 24. He preferred to wait an entire year after surgery so the timing is perfect.
In the meantime, I’ll meet with the new PT on Monday for an evaluation and see how it goes.

It’s very hot today and I’ve decided to not do much of anything. I’m ecstatic about having one day without seeing a dr. Tomorrow back for a CT calcium heart test and hopefully, nothing more until eye post op appointments and surgery on the 26th.

I hope your MRI will be scheduled soon!
 
You must log in or register to reply here.
Active Antimicrobial Hydrogel
Corganics CBD

Staff online

Members online

Total: 1,260 (members: 2, guests: 1,258)

Latest posts

Back
Top Bottom