• REGISTER for Joint Replacement Awareness Day on May 9th, 2020!

    Surgeons, patients, and other medical professionals will talk about topics you've told are important to you. You can ask questions LIVE of the participants. Please "like" and "share" our JRAD notice on your Facebook page too!

    Register and learn more in this announcement:

Watch 2019 JRAD Videos

Revision THR Constant pain continuing 1 year after THR<^

Ausman

junior member
Joined
Sep 16, 2018
Messages
70
Age
60
Gender
Male
Country
United States United States
Also, I still have a lot of pain on the side about 1 inch below my incision. There is a definite "bulge" on my thigh. My physical therapist was quite puzzled over this and really didn't know what it was. My doctor, just like with the LLD, doesn't seem to care. He said the implant looks good and doesn't really care about the tissue/muscle type concerns of mine. I'm thinking that the "bulge" on my thigh is around the bottom of where the stem would be, so XL1B/YL1B area? - not on the back of my leg, but just posterior to what would be the side-center of my thigh. Hope that makes sense? It is not red or discolored, it is just like a fluid-type bulge that is very sore - to the touch and I can't really lie down for very long on my side because of this. Does anyone have any ideas about this?
Marvy-

Wow! I have that exact same painful bulge in the same place on my left THR. I am in a lot of pain at the six-month point. My OS has no idea how to proceed. Like you said, it's soft-tissue pain- apparently "not his department". :headbang:

Ausman
 
Last edited:

Ausman

junior member
Joined
Sep 16, 2018
Messages
70
Age
60
Gender
Male
Country
United States United States
Hello Marvy,

Glad your surgery was successful. As I recall you had a posterior incision. I was in the same boat as you for two years no one could figure out why I was I was still in pain. Well after researching more and more as my pain was increasing, had my local sports medicine give me two injections in the superior gluteal nerve.

This nerve has branches on the glute medius, minimus, and tensor fasciace late. One shot composed of saline and and another substance to break down the scar tissue by the nerve. The other injection was cortizone mixed with lidocaine. This procedure was done on January 07 of this year. I am happy to report I am 80 percent pain free.

My gut feeling is my scar internally grew scar tissue close enough and was nicking that nerve. Once that happened it shut down my hip muscles mentioned above. Amazing this was not in my surgeons protocol for a possible remedy for patients with chronic pain after surgery. I had to research hip anatomy to come to this conclusion. Also, my psoas pain is almost gone as well now that the muscles are firing property.

When you see your OS can you asked where exactly was the bulk of the scar tissue he removed.

Thanks,

Larry
Larry-

Wow that is amazing! Particularly your theory on internal scar tissue. I have always had a tendency to grow dense, keloid scars. For example, a melanoma I had removed from my abdomen in 1997 took years of treatment before it was pain free. I have no reason to suppose that I don't scar similarly internally.

I am in a great deal of soft-tissue pain following my lateral left THR in August. Might I ask, what specialty was your sports medicine doctor? My OS seems to have no idea how to proceed and I feel like I am starting from scratch with regard to a doctor to consult.

Also are you saying Marvy had scar tissue removal- I can't find that in the thread but that sounds very interesting as well.

Thanks!
 
Last edited:

ljpviper

junior member
Joined
May 24, 2014
Messages
70
Age
48
Location
Florida
Gender
Male
Country
United States United States
Austin,

The ortho that injected me is a sports medicine Doctor specialized in soft tissue injury. After the injection I had blood work done two weeks later again to rule out any cobalt/chromium issues with the implant. I have a metal on metal hip resurfacing on the right. To my surprise my SED and CRP went way down they are your main inflammation markers in your blood. I guess the nerve irritation was causing constant inflammation in my hip. Makes sence was when I would bare weight in the am my leg/hip would swell from the adductors and quads as my glutes were not working. Also, my chromium and cobalt levels are >5, which is really low.

I still have some aches in the night but seems very muscle related as they are trying to get back to firing normal. At least I can sleep a full nights sleep with no pain. I suffered for two years. I can't stand the fact all these operating OS's just dismiss the patients that still have pain after surgery. Mine was the same way X-ray looks fine and you can walk, your good. Total BS, I spent thousands in both travel and different pt methods that did nothing.

Good luck,

Larry
 

Mojo333

SENIOR FORUM ADVISOR
Senior Forum Advisor
Joined
Mar 8, 2017
Messages
22,166
Age
56
Location
GA
Gender
Female
Country
United States United States
The surgeon didn't find a tear anywhere. He did clean up a TON of scar tissue, removed the bursa. He also released the IT band as he said it was extremely tight and was almost "stuck" in place - in part due to the amount of scar tissue. He also said he found a "stitch knot" from the previous surgery and removed it.
 

Ausman

junior member
Joined
Sep 16, 2018
Messages
70
Age
60
Gender
Male
Country
United States United States
Hi Marvy-

Following your story closely since your symptoms sound familiar to me (though I did not have the LLD). Did that bulge possibly turn out to be an inflamed bursa in that area? I am hoping to convince my OS to explore that or at least refer me to someone who can.

Wishing you the very best and sending hopeful, healing thoughts.
 
OP
OP
M

Marvy

member
Joined
May 2, 2017
Messages
219
Age
63
Gender
Male
Country
United States United States
I had my first post-op appointment today. He removed the stitches (all 2 of them :loll: ) As a pilot would say on your flight, "you are now free to move about the cabin". My surgeon said I have no restrictions! So I am free to drive, exercise, etc. He actually wants me to move and exercise. The glute medius muscles should be a focus of my exercise as well to get them to wake up and do something. The only stipulation he had at this point is "if it is painful, stop. don't do it". I can live with that! So I came home and the crutches and I went for the longest walk since before surgery, which included 2 hills - one downhill and one uphill. The downhill was actually worse.

The other statement he made sure that I knew and understood was "YOU WILL NOT LIMP". He was ok with me using crutches for another week or so when out walking. Then transferring to a cane or one crutch when the rest of the swelling goes down and I get stronger. He doesn't really care how long I have to use a cane - as long as I do not limp.

My next - and probably final - post-op appointment is March 22.

@Ausman - yes, I definitely had a good case of bursitis and he did remove the bursa. The MRI I had definitely showed the bursitis. Even after 2 cortisone shots, I got no relief whatsoever. Since the IT band runs down the side of the leg, my IT band was extremely tight in that area so he lengthened the IT band as well. Unfortunately, as you are experiencing, I had to search for someone else to help me. I searched Dr. Google for hip/gluteal tendon specialists in my area. There were a couple other surgeons that I would have liked to have gone to, but they were a flight and hotel away and logistics and timing didn't work out. But with what the issue was, I'm not sure if the surgery would have been any different. I am completely satisfied with the surgeon I chose. I do hope you are able to get things figured out.

@ljpviper - I'm not sure if my surgeon is familiar with an injection to help the scar tissue or not. But in my case having the bursitis and IT band tightness and the stitch knot, I'm not sure if he would have recommended an injection or not. My SED rate and CRP wasn't elevated. I do hope the injection works for you so you don't have to have another surgery

@SaraK - the stitch knot that he removed was actually the stitch that is done when reattaching the tendon to the GT at the end of the hip replacement (or revision) surgery. They drill a hole through the GT and run the stitch through that and the tendon to hold everything in place. He did say that typically the stitch(es) are done on the side of the GT and mine was more on the top.

I asked him if the stitch knot could have been the issue or if it was stitched to include something that it shouldn't have. But in typical doctor speak, he talked about it, but never answered the question.

So, if this is deemed a success to resolve the pain and issues that I was having, I will never really know what the true cause is. I guess it really doesn't matter, but I will always wonder. Just who I am.

It is supposed to be a cooler weekend, so I am planning on going to the gym and ride the stationary bike. In the gym, I am usually the "go big or go home" type, so I will have to work hard to dial things down a notch. For now.

He also gave me a prescription of Meloxicam instead of taking Ibuprofen.

I am feeling a bit better everyday. The worst days were Sunday through Wednesday where I felt so tired and had no energy.

Thank you everyone for all of your thoughts, prayers and well wishes - and encouragement! It really helps and means so much! Unless you have been through some of the hip issues and having a replacement, it is hard to explain and sometimes people just don't get it. BoneSmart has been a godsend to be able to chronicle, whine, vent, etc. Sometimes I don't know how I would have kept my sanity if it wasn't for everyone here. :thankyou:
 

Ausman

junior member
Joined
Sep 16, 2018
Messages
70
Age
60
Gender
Male
Country
United States United States
Marvy I am so thrilled to hear all this positive news! I am so glad for you and thanking you for sharing it.

I have asked my OS about an MRI but clearly I need to insist. I am so certain now that I have a majorly inflamed Bursa like yours. Why and what is irritating it I suppose is the question. I'm afraid your wonderful surgeon would be horrified at my lurching limp- I so want it to be gone too!

But you have truly helped me to re-focus a new search. Thank you!
 
OP
OP
M

Marvy

member
Joined
May 2, 2017
Messages
219
Age
63
Gender
Male
Country
United States United States
@Ausman - are you walking with a cane - or crutches. From what little my OS has indicated after I asked if the bursitis, scar tissue, etc can come back, he did say "possible". I think that is one reason why he does not want me to limp. From what I understand, the limping can aggravate the bursa (probably the IT band too, I don't know).

If you aren't walking with a cane or crutches, can you go back to using a walking aid to see if it alleviates the limp at all? I quickly read through your thread and it sounded like the cane was causing shoulder pain? Maybe using one or two crutches may help - especially for longer jaunts.

I think you mentioned that sitting also caused a flare up? That was my case as well. There were days I would sit at my desk feeling as though someone had jammed a hot nail into the side of my thigh...

I would start searching for a hip gluteal/tendon specialist in your area and make an appointment. You can always cancel if your OS decides to order the MRI and diagnose your pain....
 

Ausman

junior member
Joined
Sep 16, 2018
Messages
70
Age
60
Gender
Male
Country
United States United States
I think you mentioned that sitting also caused a flare up? That was my case as well. There were days I would sit at my desk feeling as though someone had jammed a hot nail into the side of my thigh...
Marvy it is uncanny how similar our post-op experiences are! I'm feeling that hot nail right now and I am going to get away from the computer right as soon as I send this.

I would start searching for a hip gluteal/tendon specialist in your area and make an appointment. You can always cancel if your OS decides to order the MRI and diagnose your pain....
I'm doing that as we speak, but yes I promise I am stepping away from the computer for now!

One quick question- was your latest procedure completely arthroscopic? That helps in narrowing the search.

Thank you again Marvy!
 

Mojo333

SENIOR FORUM ADVISOR
Senior Forum Advisor
Joined
Mar 8, 2017
Messages
22,166
Age
56
Location
GA
Gender
Female
Country
United States United States
:wave:I'm so thrilled for you as you sound to be doing so much better!

Hope your weekend is wonderful @Marvy :SUNsmile:
 
OP
OP
M

Marvy

member
Joined
May 2, 2017
Messages
219
Age
63
Gender
Male
Country
United States United States
Went to the gym on Saturday and rode the upright stationary bike for 45 minutes (at the lowest resistance). It felt really good to get the legs moving again! I tried the recumbent bike, but it bothered me from the perspective of where the top incision is and the leg position/movement on that bike. There are still hard lumps under the incisions that the biking motion bothered.

I have to keep telling myself "slow and steady" as boring as it may be..... I have to :walking: when I want to :fasthorse:
 

Layla

SENIOR FORUM ADVISOR
Senior Forum Advisor
Joined
Jun 26, 2017
Messages
20,767
Location
Minnesota
Gender
Female
Country
United States United States
:upright:Good for you!
Do what you're comfortable doing for now, the rest will come.
I hope you have a great week!
@Marvy
 

Mojo333

SENIOR FORUM ADVISOR
Senior Forum Advisor
Joined
Mar 8, 2017
Messages
22,166
Age
56
Location
GA
Gender
Female
Country
United States United States
So glad to read that you sound well and the excruciating pain is gone.:yes!:
Please do take care during rehab...I know I sound like a broken record..but six weeks out from revision...the 45 minutes sounds like too much even with no resistance. We want to get the most out of a trip to the gym but I think shorter sessions of activity several times per day would be less likely to overtax your still healing soft tissue.
Build up slowly and just walking is definitely the way to go for now, in my opinion.
I just worry about that new hip and don't want to see you overdo.:unsure:
Only you know if what you are doing is too much, so listen to your body carefully.
I do So want this to be the end of your hip troubles!:yes:
 
OP
OP
M

Marvy

member
Joined
May 2, 2017
Messages
219
Age
63
Gender
Male
Country
United States United States
:wave: @Mojo333 yes, I am being careful not to over do things. I don't want to become a member of the
ODIC.... :bignono:

It's cold and rainy out, so no walking outside. I thought about running up and down the stairs, but... nah.... might trip over the cat....
 
OP
OP
M

Marvy

member
Joined
May 2, 2017
Messages
219
Age
63
Gender
Male
Country
United States United States
Hi @Layla :hi:
Thanks for checking in! I opted today at lunch instead of going to the gym to have pizza and a salad. Trying not to over-do the biking....so the gym will be there for tomorrow...

Hope you are staying warm and not having to shovel or snow blow.... Not sure where you are in MN, but we were there a few years ago on a biking trip. I am jealous of all the trails! We were in the Redwing, Minneapolis (Chain of Lakes) and Minnetonka area. I remember the Minnetonka drive in and their home made rootbeer! :cheers:
 

Layla

SENIOR FORUM ADVISOR
Senior Forum Advisor
Joined
Jun 26, 2017
Messages
20,767
Location
Minnesota
Gender
Female
Country
United States United States
Pizza, salad and a break from the gym sounds like a good day.
I am staying in today so I'm warm. No shoveling on the agenda.
I'm from the Twin Cities area so you were close to my neck of the woods when you were in the area.
You're doing great! Slow and steady and you'll get there. Just think how great you'll be feeling by Summer.
I'm happy for you! :happydance:
@Marvy
 

Mojo333

SENIOR FORUM ADVISOR
Senior Forum Advisor
Joined
Mar 8, 2017
Messages
22,166
Age
56
Location
GA
Gender
Female
Country
United States United States
Hi @Marvy
Hope Today will be a Good Day.
Hopefully things will continue to get better and better.
Lots of good wishes are coming your way!:ok:
 
Last edited:
OP
OP
M

Marvy

member
Joined
May 2, 2017
Messages
219
Age
63
Gender
Male
Country
United States United States
Yesterday, the hip was a tad sore. Don't really know why, it just was. I think because it is still sore when I lie on my left side and that's how I slept...

Even though I haven't gotten all of the strength back, I can finally walk upstairs without my hip feeling as though it is going to collapse so I am happy about that.

I am using the cane around the house as well as any places where I know I'm not going to be doing alot of walking.. Still using crutches for longer walks, even though I don't put much weight on them. I just want to make sure I don't limp - or start to limp.

Not sure when I will return to work. Right now I am working from home. the surgeon's office put down all 12 weeks for the FMLA time - when it was suspected that I had a tear. I just want to make sure I am not limping or hobbling before going back to my desk.

All in all, things are slowly progressing. I know that you can't take 2 years of issues and expect to be back 100% after a few weeks.

Hope everyone has a great day!
 

Mojo333

SENIOR FORUM ADVISOR
Senior Forum Advisor
Joined
Mar 8, 2017
Messages
22,166
Age
56
Location
GA
Gender
Female
Country
United States United States
Even though I haven't gotten all of the strength back, I can finally walk upstairs without my hip feeling as though it is going to collapse so I am happy about that.
:tada:
That certainly is good news...and you are so right about the time your body needs to retrain and regroup!
Hope your day is equally as Great!:SUNsmile:
 

BoneSmart #1 Best Blog

Staff online

Forum statistics

Threads
50,084
Messages
1,359,711
BoneSmarties
31,510
Latest member
Zolaellie
Recent bookmarks
1

Top Bottom