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Brimingham Hip Replacement - Groin Pain

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Stefan

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Can anyone help!

I had A BHR on 7th February and all went well. I can now walk unaided for short distances with little or no limp. This part of the operation is a success.

One issue that I do have is that when laid down or sat in a chair, I cannot lift my leg no matter how I try. If my leg is lifted for me I cannot sustain the lift at any point in mid air.

Furthermore, bending movement is very restrictive and while in this position, I cannot lift my leg or foot to put on my socks. In fact in this position I cannot support my weight on my operated hip due to pain in the groin and buttock. I do get periodic pain in the groin when walking, if I catch my foot, or even sneeze!

I have visitied my surgeon who has stated that this "is not right" but was not more forthcoming except to inform me that he would be recommending an ultrasonic scan.

Can anyone help me in determing whether this is normal and if not have you experienced this issue and how was it resolved.

I thank you in advance for your help.

Stefan
 

liz

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I work in Occupaional Therapy and I have not come across this as a complication after a THR. were you given exercises to do by the physio? if so did you do them? when the big muscles are cut they take ages to repair but must be exercised every day at least 5 times. this slowly increases muscle tone. Glad you are having a scan and hope it will be soon. I find it so frustrating that the surgeons do not talk to us properly,as patients, explaining things. It is no good being told that it is not right, you need ideas and options. let us know how the scan goes? liz
 
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Stefan

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Hi Liz,

I have now had an ultrascan but not had the results from my surgeon. However, I do not know what this will show as the only comment at the time of the scan was that the pain was located over the Psoas Tendon.

I have since read a paper on the "web" searching "psoas tendonitis" which has a title "pain related to the psoas muscle after total hip replacement". This seems to suggest that one of the causes is cement which had secreted from the joint and aggrevates the tendon. The most common outcome was to operate and remove the cement.

This is the worst case scenario and as stated I have not had any feedback from my surgeon as yet.

I am now 9 weeks post operation last Wednesday (11th March). Walking is improving each day.....once I get into my stride as I limp for the first few steps. However, back ache is a constant nag.

As to your question; I still complete all of my exercises 4-5 times a day both laying on my back and stood up and have regular short walks.

Unfortunately, the pain in the groin has not improved. If laying on my back, I still cannot lift my leg nor lift my leg when in a sitting position. Also, I cannot lift the leg vertically while stooping to allow me to put on socks nor trousers. Standing vertically, I can lift the leg to climb stairs but it is still rather weak.

I have commenced driving which is no problem once I physically lift my leg into the car.

After going through the operation and putting in a significant amount of work in getting into a position of walking, it is depressing that I have a constant pain in the groin that just does not seem to improve.

I have had 86 "hits" with no other replies other than yours hence this does suggest that these symptons are not common. Hence I very much appreciate your original comment and look forward to any suggestions you may have.

All the best.

Stefan
 

liz

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dear me, wish I had somthing useful to say to you! hope you get results soon. If it does need another op then at least that will fix the problem although this is not what you would want. I do feel for you. I am seeing my surgeon on friday to see if I need a new hip or if it is mending. good luck and let me know the results. liz
 

hamster

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Stefan,

Sorry to hear of all your troubles you're having, you describe all the symptoms I put up with for more than a year before I finally decided to have THR done, I had to physically lift my leg up if sitting in a chair or getting into a vehicle, if laying down it was impossible for me to lift it straight up due the groin pain. I am 6 weeks post-op today and it around the 3-4 week mark that I could lift my leg up if laying down. I hadn't used this muscle in a good year or so, now it has to be rebuilt. Did they go in through the front when they did the surgery? If they irritated this muscle or cut it, maybe it just need time to heal right. Sounds like you did a lot of research already and I hope for your sake they don't have to go back in to remove some glue. I can still feel some groin pain when using this muscle but it seems better all the time. I haven't really caught my foot on anything yet but I'm sure the pain I used get when doing that is gone.

I feel for you, just reading about the pain you're having brings back memories of not that long ago and what life was like, sickening. I certainly hope that you get your test results back soon and get some answers because you should be doing much better at 9 weeks.

Don
 

hatty

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Can anyone help!

I had A BHR on 7th February and all went well. I can now walk unaided for short distances with little or no limp. This part of the operation is a success.

One issue that I do have is that when laid down or sat in a chair, I cannot lift my leg no matter how I try. If my leg is lifted for me I cannot sustain the lift at any point in mid air.

Furthermore, bending movement is very restrictive and while in this position, I cannot lift my leg or foot to put on my socks. In fact in this position I cannot support my weight on my operated hip due to pain in the groin and buttock. I do get periodic pain in the groin when walking, if I catch my foot, or even sneeze!

I have visitied my surgeon who has stated that this "is not right" but was not more forthcoming except to inform me that he would be recommending an ultrasonic scan.

Can anyone help me in determing whether this is normal and if not have you experienced this issue and how was it resolved.

I thank you in advance for your help.

Stefan
hello stefan l had the birmingham hip fitted in feb 2006 ,had nothing but trouble from day one,had the same problem as you in my groin ,all they kept saying was to have more p.t it didn,t work and now fouteen months on l am waiting to go back in to have it redone,l told them last june that things didn,t feel right, after working for seventeen years with erlderly people l have seen alot of people who have had hip ops and they all seemed to come through it fine,l was told after my scan that it had come loose,dont kn ow when that happened l have never been off my two sticks ,when talking to the nurse at the hospital she said l was one of the unlucky ones,l really wanted to hear that, l hope you havn,t got the same problem as me l wouldn,t wish it on anybody
 
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Stefan

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Hello Don,

Sorry for not replying sooner and thanks for the support.

Hello Hattie,

It must be both very disappointing having to go through the operation again. However, on a positive note, at least they have now identified the root cause.

I have now passed 13 weeks. Since the last message I have been having PT twice a week, and personally exercising and taking short walks 3-4 times a day.

I still have the pain in the groin which does not really seem to improve and always seems worse following exertion such as a walk and exercise (I have even tried using a static bycycle but do have to lift the leg from the pedal at the end of the period, which is not the case when getting onto the machine,).

I have discussed this with the PT who keeps telling me that it is because the muscles and especially the glutes (not sure of the spelling) have wasted away as I am tending to use the operated leg due to the groin pain. It seems like a downward spiral I need to change.

However, one of the "tests" the PT completes prior to massaging the tendon and ultrasonic treatment, he requests me to resist when he tries to push against the leg. I must say that I had no resistance at my first session and now there is some resistance.

This is a positive, but then I come down with a bump when I sneeze where the movement causes pain in the groin.

Finally, I still cannot reach down to put on socks, trousers nor shoes.

Oh well, I shall keep trying and will be "challenging " the surgeon in the near future.

Thanks for all your comments, they are comforting.

I hope you are all making good progress, and Hattie, please let me know how it goes

Stefan
 
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Stefan

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It has been some time since I posted an update and thought it appropriate to seek advice forllowing my operation on 7th February.

As I mentioned back in February and March, I have pain in the groin and still cannot lift my leg high enough to put on a sock, the pain is still present and has not improved any further since 8 weeks post op. Exercise seems to exacerbate the pain and no exercise, the pain improves slightly.

I also cannot use my operated leg to take my weight when trying to bend forward and pick something off the ground.

However, I can walk pain free and have completed 7 mile walks recently. Unfortunately, I get terrible back ache later that day and the next.

I have recently visited my surgeon (5th October) who has stated that "it is not right" and believes the problem is the psoras tendon and has recommended I have an injection into the groin/tendon to see if this releives the pain.

He also stated that worst case, then an operation to extend the tendon would be another option.

Can anyone help in providing some details on the course of action recommended by my surgeon; whether I should go for a second opinion; whether back ache is normal.

Thanks

Stefan
 

Josephine

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Helllo, Stephan. You have had a lot of problems! This thing with the psoas tendon is a common feature of back pain. I have this picture here to show how it is a massive structure and emanates from as high up as the thoracic vertebrae in the chest and ends in the upper end of the femur, just below the hip joint.

awww.somatics.com_images_Psoas.jpg


So this could be contracted for some reason since the surgery. I have heard of it before. But I would try the injections first - probably some depomedrone* and local anaesthetic. It's worth a try. You might also try a good chiropractor as well. Sometimes they can get the muscles to lengthen with manipulation and acu-pressure.

However, it is very common for the psoas to get into spasm in the course of back pain in the normal course of events so do not rule out that it just 'might' be coincidental to the hip surgery.


*depomedrone is a steroid
 
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Stefan

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Hello Josephine,

Thanks for the posting. It is comforting to know that the issues I have are not unique. However, it just seems contarary that lengthening the psoras will alleviate the pain in the groin when it is (my perception) contracted when the leg is lifted and the tendon shortens. I do not ge the pain if raising the arms and stretching backwards.

Thanks again and to share my experiences, I will provide an update after the injection.

Stefan
 

Josephine

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I would not disagree with that at all, stefan! Seriously, I would try a chiropractor.
 

Cinhelm

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HI Stefan. I am new to this site...I had THR April 2004. I have had groin pain pretty much the whole time. It got really bad last March...I just live with it and try to ignore it, but pretty difficult to do when you can't even get in a vehicle without lifting your leg....anyway......I finally "bit the bullet" and went to my surgeon in Dec. They did an arthrogram and put a shot in it 12-19-07. After abt 3 days, I had zero hip pain....Well 3 days ago, it's back. Talk about depressing. Anyway, I just want to know how you are doing. Is there anyone out there who can help or give any advices? Needless to say I am at my wits' end. I am 48 years old and can't believe I will have to live with groin pain forever. That's the reason I had the surgery to start with. oh well. I am also having some lower back pain and didn't know if my hip could cause this pain. I would think the back is causing my hip pain, but I have had the groin pain for years now, even after surgery. Any help PLEASE????
 

Josephine

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That's why I suggested a chiropractor. So many people have this problem and it starts like this - your hip gets bad so your posture suffers. Then your back gets bad but because your hip is painful you don't discern one from t'other! You get your hip fixed but the back is still bad. Now you are focussed on the op and figure it must be something to do with the op! Thing is, the hip and the lower back are about 3" apart so it's almost impossible for you to tell the two pains apart.

My suggestion is that you go see a chiropractor, or an osteopath who uses a chiropractic approach, and see what he/she can do for you. However, nothing is for certain but it's an avenue worth exploring.
 

Cinhelm

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Thanks Josephine. I may look into that. I did think since the shot I had helped my hip AND my back that it is the hip, but I'm with you...think it's all tied into the psoas(Sp???) muscle....I see my surgeon Feb. 12....we'll see what he says this time.
 
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Stefan

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Hi Cinhelm,

I can sympathise with you and wish I had some answers, but do not, except to say do not give up!

I am 55.

Well it a few weeks since the injection in the groin, it may have slighly relieved the pain but not really noticable.

I have not been "recalled" to see the surgeon since but prior to this the next resort was to thin out the psoras tendon which would entail another operation. I have not looked into this as I do not see this as an option at this time. I will try Josephine's suggestion.

The other point I note is that when I do try and lift the leg, it does seem as though there is a "lump" in the groin stopping me lifting the leg. However, I cannot feel anything externally.

A colleague of mine has just (9 weeks) had the same operation conducted by Professor McMinn (he has a website which is very interesting) in Birmingham who pioneered the BHR technique, has the same problem. But it is very early days for him.

However, there is one other concern I have and that is the hip still "clicks" when I move the hip into certain positions. This does not hurt as such, but I have noticed that subconsiously I try not to put myself in this position.

I will keep trying different ways of getting around the issues.

Please keep in touch and good luck.

Stefan
 

Cinhelm

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Thanks for trying to encourage me. I have an appt. with my surgeon in Vanderbilt on Feb. 12. I'll try to remember to let you know what he says. I, too, have read about the "thinning" of the psoas.......I don't notice any lumps or clicks; just pain....Thanks!
 

Josephine

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It's not just the psoas, Cinhelm. All muscles loose bulk if they are out of condition. The psoas just happens to be one of the biggest, longest muscles in the body as you can see here.
 
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