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Revision THR Constant pain continuing 1 year after THR<^

In my personal experience, the result has been apparent from between a few minutes to a day or so. But I did have one experience where the doctor failed to get into the bursa at all which didn't please me much! I think if you've had no reduction in pain within 2-3 days then it hasn't worked!
 
I'm so sorry that you didn't get done relief from the injection.
Please let us know how you are.
:console2:
 
Hi @Mojo333 - thanks for checking in. I am really the same as before I went to the ortho. I was supposed to go today and get the results from the hip aspiration. But I cancelled the appointment and said that they could call me with the results.

When I was at my ortho appointment last week, I overheard the hallway conversation between the surgeon and his PA about me and my case. The surgeon was telling the PA that he didn't know why I was referred to him and that the sports medicine doctor could have and should have removed the fluid and that I didn't need to go see a surgeon to have that done. He proceeded to tell the PA that I don't need to see a surgeon, that I should have been referred elsewhere (where I don't know) since my only issue was the seroma/fluid and that I was not a surgery case.

The more I thought about that over the weekend, the more frustrated I got. If that is the way he feels, then obviously he is not a good choice of doctor for me. When I called to cancel my appointment, I told them the story of why I was cancelling.

I am sure that doctors talk about us patients all the time, but they don't need to talk about you on the other side of a door where you can hear everything.....

So, I am back to square one (again).

I am glad that I was able to get an MRI done, but am now wondering (hindsight), if it should have been done AFTER they took the fluid. I don't know if the fluid can mask or hide anything on the MRI....

So, I am wondering if I should go back to the sports medicine doctor to see if he can do another ultrasound or find someone else. I know that my insurance company isn't going to approve another MRI or CT...

It is so frustrating... Part of me just wants to say "this is as good as it's going to get" and stop trying to find answers. I was so hoping to get back to at least somewhat of an active life, but now I just don't know if that is possible...

[Bonesmart.org] Constant pain continuing 1 year after THR<^
 
Marvy said:
The surgeon was telling the PA that he didn't know why I was referred to him and that the sports medicine doctor could have and should have removed the fluid and that I didn't need to go see a surgeon to have that done.
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Oh well, at least you're pretty clear what he thinks of your present issue and of sports medicine doctors! (Can't say I don't agree with him about SMD, though!)
Marvy said:
I am glad that I was able to get an MRI done, but am now wondering (hindsight), if it should have been done AFTER they took the fluid. I don't know if the fluid can mask or hide anything on the MRI....
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Absolutely not! They needed to see it in it's full inflamed state! Aspirated, it wouldn't have told them anything like they saw.
Marvy said:
So, I am wondering if I should go back to the sports medicine doctor to see if he can do another ultrasound or find someone else.
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I think you should find another HIP surgeon! One with a bit more common sense and compassion would be nice!
 
I agree...this is not as good as it gets in my opinion.
I'm sorry you got this treatment but I would rather an OS deal with any ongoing issues.
Very frustrating.
Don't get sad...get mad...I think.
Hope there is a way you can get a second opinion with an OS.
Praying all gets resolved
 
@Josephine I received the results from the fluid they removed from the seroma.

The total nucleated cell count was 2662. The reference range is listed as <150 cells/uL It noted that there was "visible clumping present, results of cell count may be compromised"

The Neutrophils % was 57 and the reference range is listed a 0-24%

When they called to give me the results, the physician assistant was not at all concerned with the numbers as he said "it's only because it is bursa type fluid".

The report states that nothing grew and there weren't any organisms seen. The report was written one day after the lab received the sample. I am not sure how long it takes anything to grow.....

I'm still concerned with those numbers and that there is still inflammation and possible infection.

Does this sound right to you?
 
Hello Marvy,

Sorry to hear all the pain that you are in. Trust me I am in same boat seeing countless, surgeons, etc.

My surgery was perfect for the first eleven month, then all down hill from there. It started with pain in the glute.

I am 47 and just tired after 3 surgeries and still dealing with issues(two scopes and one resurfacing. I have began having active release therapy and it's been helping. The therapist is very knowledge. I am so many disfunctions muscle wise in my right hope. We are just trying to get the muscles firing as they should be. I numerous compensating patterns over the years,it's not helping in recovery. I tried injections in my psoas and trachomter bursa no relief

I do feel better after the sessions but I sit a lot at work, so my progress seems to regress. I ordered a kneelin chair it's keeps your hips at like a 45 degree angle which sounds ideal. I done going to surgeons saying the components look great and I bein brushed off. Well there not the one living with chronic pain and a shi__ life.

Keep u posted and hang in there

Larry
 
Thank you for your reply @ljpviper I know what you are going through. It is just mind boggling that a surgeon will look at an x-ray and say everything is fine and send you off. Most of them will not even attempt to help or diagnose past that. With all of the modern technology, etc. it seems like there has to be a better way.

I do have a desk job so most days, by the end of the day my hip (outer thigh) is so painful.

I was able to find an orthopedic surgeon who does deal with glute muscle issues (or so the website says). I have an appointment with him on October 10. It is the earliest I could get in, although it seems forever away. His office is about a 2 1/2 hour drive from me, so I hope he will really look at the MRI and have some suggestions.

I will have to look up to see if there is an active release therapist near me and give that a try. If the surgeon next month has nothing new to say, I'm afraid I will have to give up trying to find answers. I cannot keep taking time off of work and spending what seems like every waking hour trying to find a solution to the pain.

I wish you luck in getting your pain resolved. Together we will all make it through this somehow....
 
Hope all is going well with you?
Hope today is a Good Day @Marvy :angel:
 
I was able to get my MRI reviewed by another surgeon that is out of state. They would like me to get bloodwork done to rule out infection. They would also like me to get a bone scan done. I can't remember exactly what the bone scan would show so I will have to research that. I did tell them that since I "fired" the surgeon who ordered the MRI and did the fluid aspiration, that I will have to ask the new surgeon if he will order it when I have my appointment with him on Wednesday, the 10th.

They agree that what I am going through isn't the way things should be, but nothing glaring stood out to them from the MRI. They did say that from looking at the x-ray that it "appears to be a skirt on the head". I wish that something was found as then I could move on, but not this time or not yet anyway.

So, I hope the surgeon on Wednesday will order the tests. I am going to bring the report from the out of state doctor with me to hopefully make it easier to get the tests.

More details to come.....
 
Marvy said:
They agree that what I am going through isn't the way things should be, but nothing glaring stood out to them from the MRI. They did say that from looking at the x-ray that it "appears to be a skirt on the head"
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:what:
@Josephine .Any clue what this could be and what bone scan will show?

Will be wishing you the best and wearing on update from appointment Wednesday @Marvy
 
@Josephine - here's the latest x-ray. It was taken August 28, 2018. I've tried searching for what a skirt is in relation to a hip replacement, but I keep coming up with things like "what to wear when you have a hip replacement" :heehee: Thank you for taking a look at this!

[Bonesmart.org] Constant pain continuing 1 year after THR<^
 
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Oh LOL! You know, I don't have a clue what they are talking about either!

However, can you tell me where your pain is using this chart?

[Bonesmart.org] Constant pain continuing 1 year after THR<^
 
Thank you @Josephine ! I think from using Google as my best friend, it appears that a skirt refers to the size and/or type of femoral head. But that's about where I've stopped.... It might be that since during my revision, the surgeon did lengthen my leg a tad as he used a larger head/ball... I'm not sure - just a guess...

The pain is along the lateral side of my hip L1F T through Y (or L1B T through Y) It doesn't matter if you use L1F or L1B since the pain is directly along the side. The pain is the worst in the area along the top of W through Y. I thought as you that it may be bursitis, but after they withdrew the fluid and injected the cortisone, I had no relief whatsoever. (The poor MRI image below shows the fluid near the ball/cup in my hip that they attempted to remove).

I also thought about it being IT band related.

The only thing is that it is so painful that I can't lie on my left side. Tylenol does not help (4,000mg/day). Icing doesn't help as once I take the ice off, it's as if I never iced at all. I can't even think about any type of massage or foam roller as it is that painful.


[Bonesmart.org] Constant pain continuing 1 year after THR<^
 
Marvy, I feel for you (and with you)! You've been going through this for so long. I was so hoping that removing the screw would be the answer for you, but that hasn't been the case. I'm dealing with psoas-type symptoms and the pain management doctor (that I finally got my surgeon to refer me to) thinks it's my back causing spasms in the psoas. 4 months of PT, 2½ months of muscle relaxants, NSAIDs and MORE PT (I'm currently on the 4th for the year) and an inconclusive MRI means lots of frustration.

Tell you what - let's you and I have a race to see who can finally get an answer and get some relief. I'm enough of an optimist that I believe you and I will both find a solution and get this resolved as long as we stay in there and be the squeakiest wheels those doctors have ever seen!:console2:
 
Hi @SaraK - yes, those "inconclusive" tests mean more time and more money trying to figure out what is wrong. I feel as if I am "doctor shopping". I guess in a sense I am. I too hoped the screw removal would have solved everything. But it was only to be trading one problem for another... And when the issues point to the muscles and tendons, the water gets murky very quickly.

I'm sorry that you are dealing with all of this too. So many doctors think the answer is PT and pain pills as they don't want to really take the time to investigate. I'm not sure if that is coming from the doctors or insurance companies... :chinstroke:

For probably what seems like the first time, when I said that if the new doctor on Wednesday doesn't say anything I would be giving up. But my family said "NO"! You cannot go through the rest of your life like this - being in pain and unable to be active. So, I really don't know what the future holds or where this road will take me. It has already taken me to places that I never dreamed of - mainly because joint replacements are so "common" these days. However, if I keep firing doctors, there may not be any left!!!

Yes, let's have a race and find a solution! and then we can both celebrate pain free! :cheers:
 
Marvy, have you been checked for a psoas impingement not caused by a screw? From things the latest PT has said, that may be the next step for me - seeing an OS that specializes in snapping hip and arthroscopic (and is what I asked the original OS to check on but he referred me to the pain doc. The one thing MRI did show was that this isn't likely caused by iliopsoas bursitis or trochanteric bursitis - only a small amount of fluid in the bursae. PT said she doesn't think caused by a tight or spasming psoas either. She's trying some things for the back but hinted at psoas impingement. more of a chat with her tomorrow.
 
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