THR Continuing thigh pain, loose stem?

CafeFan18

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Hi all,

I had THR posterior on May 28. This is my first recovery post. I have been reading all the threads attentively and learned a lot. Most of my questions about recovery issues have been answered by reading others' threads.

But I do have a concern. Prior to my hip issues (fracture with pinning Dec. 2016, AVN leading to THR), I used to commute to work on a bike. This is one of the joys of my life. I'm not one of those speedy lycra-wearing folks. I'm the grey-haired woman with one pantleg rolled up that everyone passes.

Biking is not only fun and healthy, but with the traffic around here it is sometimes the most efficient means of transportation!

Trouble is that riding in the Boston / Cambridge area is somewhat risky even with bike lanes. It is highly likely that at some point over the course of years some car will "door" you or you will have some other mishap.

Is a femur with a prosthetic implant more likely to shatter (in general) than a natural one?

I also have been diagnosed with osteoperosis. So it is most likely that wisdom would say I should put the bike away to avoid an accident.

But I hate to do that. Are there other urban bike commuters out there (or anyone else) who have thoughts on this?

I have not gotten on my bike yet. Still too soon for that. But I am thinking ahead about what this will mean for the future. For now am enjoying walks around the park with my cane.
 
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Welcome to Recovery :welome: and Happy One Month Anniversary!
Please read the Recovery Guidelines below as many will still apply.

I would suggest you talk to your OS about the risks of a biking accident and chances / consequences of a fracture. I believe it would be considered a serious complication most likely involving surgery. Possibly riding your bike in areas that are safer than a commute in traffic could be a consideration. I'm sure you'll receive additional feedback from others.

Please stop back often, you'll find great support and encouragement here as you continue the journey.
Happy Saturday! :wave:

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
elevate
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. At week 4 and after you should follow this
6. Access to 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 a majority of BoneSmart's forums, we ask the at each member have only one recovery thread. This policy makes it easier to go back and review history before providing advice. @CafeFan18
 
I used to commute to work on a bike. This is one of the joys of my life.
Cycling is an excellent form of exercise/activity and is not incompatible with a hip replacement.
Is a femur with a prosthetic implant more likely to shatter (in general) than a natural one?
Not at all. Actually neither is prone to shattering.
I also have been diagnosed with osteoperosis. So it is most likely that wisdom would say I should put the bike away to avoid an accident.
I wouldn't agree with that at all! I think you should read these to get yourself some enthusiasm about what is possible after a hip replacement
Stories of amazing hip recoveries
Great news about Andy Murray!
 
Hi folks,
I'm 6 and half weeks post op posterior RTHR. Everything was going swimmingly but I think I've hit a bump. I've seen that recovery picture with the twisty arrow and I guess I'm in a twist. Hopefully it's only a temporary situation.

Starting yesterday I've developed pain in the side of the hip -- sort of underneath the incision. Unlike previous discomfort that felt like sore and stiff muscles, this is a bit sharper. I'm not on any pain meds and don't plan to start up at this point, as the pain is probably still only like maybe a 3.

But I'm nervous about whatever complications can set in (bursitus, or even something more sinister). I have to admit I'm a bit of a hypochondriac, so am imagining bad things.

Today I cut completely back -- just rested and iced. It's possible I may have aggravated something by "over doing it." I'm hoping the pain will subside and this is just some of the ups and downs. I read Josephine's comment elsewhere that pain can spike around 6-7 weeks because possibly people start to do more.

My "handle" should be "NervousNellie."
 
Hello @CafeFan18! I don’t have a reason for your pain, but I’m having a similar issue at 5 weeks. I was hoping it was a just bump in the road. I see my Dr next week. I’m also from Massachusetts (North Shore) and love riding bikes. I’m hoping to get back on my indoor trainer in a couple weeks. I hope you get some insight to your issue.
 
Hi @bruinsfan. I actually just got the go-ahead from my surgeon to do a stationary bike so looking forward to that. But I don't think I'll try much of anything until this new pain subsides some. I asked my surgeon (Mass General) if low-impact exercise such as walking and biking at low resistance could in any way negatively affect the ability of the bone to adhere to the implant. He was of the opinion that low-impact walking and biking would in no way negatively affect that. That was great to hear because I hope to "up" my walking as well. When you say you have "a similar issue" -- is that some new pain that cropped up? I'll see if you have anything on that in your thread.
 
Hi @bruinsfan. When you say you have "a similar issue" -- is that some new pain that cropped up? I'll see if you have anything on that in your thread.

I actually never started a thread...compared to others, mine seemed uneventful. It is a new pain. I was walking without a cane in the house (I use it when I go out for a walk or elsewhere) however, I’ve had to go back to the cane inside. Dr.sent me to PT for a possible IT band issue and I think I was pushed too far last visit.
 
Yes @bruinsfan, I guess your experience and mine probably just represents the ups and downs of recovery. Good luck on progress toward walking pain free!
 
:hi: Just over one month and lots of healing still happening.
I actually just got the go-ahead from my surgeon to do a stationary bike so looking forward to that. But I don't think I'll try much of anything until this new pain subsides some.
I think this is wise..
Lots of time to strengthen and tone...early days still.

I asked my surgeon (Mass General) if low-impact exercise such as walking and biking at low resistance could in any way negatively affect the ability of the bone to adhere to the implant. He was of the opinion that low-impact walking and biking would in no way negatively affect that.
It might not compromise the stability of the implant but could negatively affect still healing disturbed soft tissue and traumatized muscles and tendons.
We all want to get back to normal but your body is in charge.
Slow and steady will win this race!

Hope you have a restful weekend. :ice:
You will get there
 
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Happy Two Month Anniversary!
Wondering how you're doing over the past couple weeks.
Leave an update, we'd love to hear.
Wishing you a lovely week!
@CafeFan18
 
Hi @Layla,
Thanks for checking in. Yay for 2 months. I have a routine follow-up visit with the OS in two days and he will do an xray. I'm looking forward to seeing if everything looks OK. I believe I will be released at that point for work, starting out part-time. I'm able to drive, to sit at a computer, to walk a mile or so with a cane, and to get around in the house without the cane.

It felt to me like the first 6 weeks were up-up-up. But the last three weeks have been much more up-and-down. For one thing I think I overdid something at my PT and I ended up with a sharp pain on the side similar to inflamed tendon or bursitis. I rested and iced and this has now eased. But as soon as one thing gets better, another thing gets worse. I have pain in both knees and also a pain in my thigh that I'm hoping is muscular, and not a loose stem! The pain is enough to make me want my cane, but not enough to want pain meds.

I'm giving myself a lecture to be patient. But it certainly is a roller coaster.

I'm still reading lots of threads on BoneSmart and getting lots of guidance from that!

Thanks for all you do for everyone!
 
Aww, thanks :)

It sounds like you're doing well. Not sure if you've noticed the little diagram of the reality of recovery on the forum yet. There are ups and downs for sure, especially this early on. I'm guessing the pain in your thigh could also be due to PT. If you're still partaking you may want to scale back and do some more icing. Hopefully the
discomfort will ease soon and you'll receive some reassurance from your OS on Wednesday that all is well. Let us know how your follow up visit goes. I hope you have a wonderful week!
@CafeFan18

rps20171117_054543-jpg.71434
 
:wave:@CafeFan18
It felt to me like the first 6 weeks were up-up-up. But the last three weeks have been much more up-and-down.
:unsure:Layla is right...there can get to be somewhat a recovery stall...and trying to force it along can often froth up some other issues.

But as soon as one thing gets better, another thing gets worse.
If you are like me with my bad hips, I had a pronounced limp and terrible gait, also terrible posture...so just getting all that worked out to the good, caused some other aches and discomfort to muscles that were stressed.
It will be nice to get some reassuring xrays and feedback at your appointment. Do let us know what you hear.:yes:

I'm giving myself a lecture to be patient.
Let me know if you need help with this?:) :-) (:
 
Jeez @Mojo333, I don't know how you always manage to find just the perfect emojis! Adds a sly wink to the message!

My surgeon thinks the xray looked normal -- that is, no indication of problem. He said he could see the bone growth to the cup part but he indicated there isn't a way to actually "see" the bone growth on the stem. Apparently it's only the upper portion of the implant (not the lower stem portion) that has the type of surface that the bone grows in to. While you may see evidence of a loose stem on an xray, there isn't actually something to see for a normal result -- other than "not" seeing a problem. At least that is how I understood it.

Amazingly, he also told me that he has had two hip replacements! The second hip was just done last December. Now I know why he has such a great manner! He says he still bikes and skis! In answer to my questions about resuming street biking he basically said that this is a personal choice as to how much risk you want to take on (but of course that is true whether or not you have an artificial hip). But he certainly didn't want to discourage me.

I'm being released to start back to work part-time and he seemed OK with where I am at even though I'm still using a cane. He said that it's important to use the cane if you still don't have a good gait, as what he called "lurching" can actually contribute to bursitis according to him.

I've still got a long way to go to walk normally, but he didn't seem worried about where I'm at.

Thanks for keeping up with just another straggler on the long list of hippie stragglers!

PS. Unless I'm mis-remembering, I think I noticed in one of your older messages on someone's thread you mentioned "Orange Blossom Special"! Could you be a bluegrass fan, perchance? I am!
 
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My surgeon thinks the xray looked normal -- that is, no indication of problem. He said he could see the bone growth to the cup part but he indicated there isn't a way to actually "see" the bone growth on the stem. Apparently it's only the upper portion of the implant (not the lower stem portion) that has the type of surface that the bone grows in to. While you may see evidence of a loose stem on an xray, there isn't actually something to see for a normal result -- other than "not" seeing a problem. At least that is how I understood it.
That is exactly what my surgeon said. He said they find them patients complaining about pain. The only way the X-ray can help is comparing it to another one taken earlier and maybe find a shift.
 
Interesting conversation, ladies. I'd like to hear @Josephine take on that also.
I was under the impression they could see bone growth around the stem.
Isn't it all fascinating and aren't we blessed that we get this second chance? I sure think so.
Wishing you both continued healing. @CafeFan18 and @ceezee
 
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Jeez @Mojo333, I don't know how you always manage to find just the perfect emojis! Adds a sly wink to the message
You have them too, including the sly wink:wink:
It is up at the top bar above where you begin to type...click on the smiley and they will become available.

he seemed OK with where I am at even though I'm still using a cane. He said that it's important to use the cane if you still don't have a good gait, as what he called "lurching" can actually contribute to bursitis according to him.
I have heard many times best to use the cane if you still have a limp...You Will Get There.
Great report...:friends:
 
@CafeFan18 this imaging discussion is indeed interesting! When I went for followup xrays for each hip, the bone growth on the stem was the only growth that was pointed out. When you say "top part", do you mean the upper portion of the stem but below the ball?

Regardless, I'm very happy that your 8 week OS visit had good news. I found random aches and pains to be part and parcel of both recoveries. On my first hip, while shoe shopping at about 8-10 weeks maybe, I gave myself either a tendonitis or discovered an impingement issue (4 years later the OS PA, on hearing my description, said, "we prefer to call that 'personal anatomy'" Six years later, I find that my recent Barre classes have pretty much cleared up the chronic aspect of it. I can feel it only when the weather is in upheaval and my same-side S-I joint is screaming at me. For the second hip, I did something truly stupid at 8-ish months. I carried a 1/3 share (I had the head end) of a 2'6" high marble statue about 25 feet. Nothing hurt; all's well, Madame du Bonkley Bonkley (a family heirloom) has a new home in my back yard. Two weeks later I carried my half of a fairly commercial-grade treadmill to where it wouldn't fit in the door, and then did some "this is definitely bad for me" lifting as we attempted to get it in without taking off the console, and helping get it in and then around a 180 turn sans console. Then I hurt. It hurt all the way around the top of my thigh, in the crease, when I return to upright from having leaned over to feed the cats on the floor. I'd been "discharged" at my 7-8 month visit to OS with no restrictions, so I called OS. They said, probably soft tissue, call back if it gets worse. It has mostly just stayed the same, although it's maybe a tiny bit better with my 4 months of barre class, currently up to 2-3 times per week. If it only hurts when I straighten from that position, I'll live with it!

Go for the bike! I think if you were comfortable with it pre-hip, nothing much has changed. Running into a suddenly opened car door is scary regardless of what your joints are made of. I was nearly "doored" in my late 20's. It cured me of riding close to the right! We moved across the river and into suburbia not too long after that, so there's no more riding of the bike to work-- too far, and only one bridge with a bike lane anyway. My bike is stored at the house on the Cape, where I can ride the Falmouth bike path. See ya there next summer?
 

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