Revision THR Constant pain continuing 1 year after THR<^

[VThereandnow]

When I had my first hip replacement I had a wicked LLD. Then after my revision (for a loose cup) I still had one, though smaller. After a long time I too, as people mentioned above got something added to my shoe and it made all the difference in the world. You really can't notice it much at all. I got running shoes done, my keen sandals etc. There is a site online called American Heelers. Check it out. They do amazing work for large or small lifts across the entire sole of shoe. I had some done in town and they were not as good as this place. Good luck.

 

[Marvy]

I do go up and down stairs about 3 times a day due to where I work - and park. I'm not taking the elevator just because I do want to try and get my leg strengthened. Plus I have stairs at home as well that I have to go up/down every day. If anything, it's now getting harder, not easier to go up the stairs.

Last weekend I was out of town and after walking about 3 blocks, my whole hip ached (is it possible for a metal/plastic joint to ache?) so bad I could barely walk. It is definitely worse than it ever was prior to surgery. I feel as if I'm going backwards in my recovery and am regretting ever having my hip replaced. Tylenol and Tramadol (taking both every 4-6 hours) do not make a difference either.

My surgeon says there is nothing wrong. I am considering getting a second opinion, but I cannot go to anyone in the same practice. How can you find a surgeon that will see someone less than a year out from the original surgery? I've searched alot of the hip surgeons' biographies, but they do not mention anything about being revision specialists.

 

[Jaycey]

Sounds like you are doing anything but strengthening. Your muscles and soft tissues are screaming at you to stop all this stair climbing and give them a break. Are you icing and elevating along with those meds? If you rest does this ease?

 

[Marvy]

Thanks @Jaycey . Resting doesn't help. My hip aches even while lying in bed. It's a "deep" ache - just like before surgery. While lying in bed, it doesn't matter how I lay - my hip can't get comfortable (back, legs elevated, pillow in between legs, etc). Elevating like being in a recliner with (or without) a pillow under my legs doesn't help either. Icing helps very little - it doesn't help the "deep" ache that I'm feeling.

I'll try to back off of the stairs - but where I work, I can't avoid them totally.

 

[Jaycey]

Let's tag @Josephine to get more details from you and perhaps assess what might be going on.

 

[BaldDiva99]

Marvy - I am sorry for the issues you are having. I had a TLHR in February. I am having a similar issue with a bulge swelling near the incision. It's numb as well. I was told this is the last thing to recover, that it will take time. This process is life changing seemingly. I hope you will find resolution to your issues. Keeping you in good thoughts.


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[Lancs Lass]

I have a LLD of around 1cm. I started with shoe lifts but took them out so things could settle for 6 months. I had bade back ache to start with when I had been walking for over half an hour, but that seems to have passed. Ill get x rayed in September, 6 months after the op, and we can see then exactly how different my LL are...

 

[Josephine]

I do go up and down stairs about 3 times a day due to where I work - and park. I'm not taking the elevator just because I do want to try and get my leg strengthened. If anything, it's now getting harder, not easier to go up the stairs.

@Marvy I already told you what this is in this earlier post. Did you read the articles I left you? I think not because doing stairs and such is a jolly good way to make this condition worse! Please read the articles.

 

[PinkOrchid]

My LLD is 1/4" (to measure it my surgeon aligned my ankle bones, not knees). Even this small difference bothered me quite a lot in the beginning. A lift helped immediately. It has now been 17 months since my surgery and I find I rarely notice the LLD, even when I wear shoes without the lift. I don't think there has been any change in the LLD, it's just that I've gotten used to it and no longer notice it. It's more noticeable walking on a flat, hard surface, and not noticeable at all when hiking on uneven ground.

I concluded that THR is part science and part art, and I made peace with the LLD because my previously intolerable pain is gone. LLD is a known risk of THR and I chose to have the THR is spite of the risk. But I think anything 3/8" or more would be harder to get used to.

I did have a sense that people weren't taking my complaints about the LLD seriously. I suspect that recovery nurses at the hospital are trained to not comment on LLDs due to legal liability.

 

[Marvy]

So, I am scheduled for a bone scan next week to see if they can find out what is going on with my hip. After surgery, I was told to walk. I couldn't walk too much. Unfortunately, I cannot walk more than a block or two as the thigh pain is too great. Once the thigh pain starts, it radiates into the groin and eventually the whole hip.

In some ways I hope they don't find anything on the scan, but then again, I hope they do as at least hopefully then I will know what is going on.

 

[Delphi]

Good luck @Marvy with the scan. It is indeed very worrying when your recovery doesn't go to plan and you are still experiencing pain after this amount of time post op. Hope you get some resolution of your problems,
Take care,
Diane

 

[Marvy]

Thank you @Delphi. I have been concerned ever since surgery that "something" isn't quite right. I know that everyone heals at different rates and I shouldn't compare myself to any one else in the recovery process. But I was so active and strong prior to surgery with weights, biking, running, etc. and now can't do any of that. It's really depressing.

 

[Horseshoe]

@Marvy have you considered seeing a revisionist OS not associated with your current dr? Just thinking a fresh set of experienced eyes could help figure this out. There's been a few members with stem loosening or implant issues who went misdiagnosed for many months until they found a different experienced OS.

Joesphine mentioned possible IT band issues. Fwiw, five months on and I still get occasional IT band pain and consequent limping. Was surprised to find my post op pain has all been muscular related.

 

[Marvy]

Hi @Horseshoe, Even though I'm not seeing a revision OS, I figured that at least for now, since my OS has ordered a bone scan, I'll wait and see what it shows and "go from there".....

I've had a sports medicine specialist and a physical therapist both rule out IT band and bursitis. Unfortunately, the pain is always there - whether I try to exercise or sit for days and do nothing. If it was occasional pain, I could live with that (I think!) but the frustrating part is it is constant. Pain meds (including vicodin) and ice provide no relief.

 

[moodybluestoo]

Hi Marvy; I also had difficulty walking after my hip surgery. I had LLD of about 1 inch but also had nerve damage. Finally the doctor ordered an MRI and found out that the muscle was partially torn off of the tendon. I was limping because the abductor muscle was not attached enough to hold my pelvis and hip in place when i walked. Have you been checked out for both nerve damage and muscle tendon attachment.The more i walked the more the thigh muscle hurt. I ended up having a revision where they reattached the muscle, evened off the leg length and had to remove occification that had developed. I am better now but still walk distances and stairs with a cane. Occasionally i get pain in my knee and thigh if I overdo it. I was unable to return to work. Good luck in getting this resolved. Moody

 

[Marvy]

@Moody Thank you for sharing your story. Like you,the more I walk, the more my thigh and hip ache. Yesterday I went to the grocery store and couldn't even lift my leg to get into the car afterwards without using my hands to help lift my leg.

Was your LLD 1 inch too long or too short? (just curious).

I have not been checked for nerve damage or muscle/tendon attachments. Just getting my OS to order the bone scan took mountains as I feel as though he doesn't really believe me/thinks I'm crazy and making this up and/or thinks it is just a muscle ache that I can take Ibuprofen and continue on.

Did you go to a revision specialist or did your original OS do your revision? I am trying to look for a revision specialist. I found a couple, but I am not sure what makes them "revision specialists" as when I read the information on the surgeon, it doesn't specify that they have had any additional/special training. Most just say that they have a clinical interest in hip and knee revisions....

I have called a few OS' and they will not make an appointment since I am less than a year out from replacement. I get the "it can take at least a year to heal". But when I am getting worse and not better, something is going on. The other downside is that where I live, there is one large OS practice. Other doctors aren't going to "go against" one of their colleagues in the same practice. So I guess I find someone a state or two away and travel.

 

[moodybluestoo]

Hi Marvy: My surgical leg was 1 inch too long , so i was trying to push myself to that side and ended up with a bunion and hammer toe on the opposite side. No one believed me either. They suggested that i just didn't want to return to work. I was a nurse at the hospital it was done. People just told me to get rid of the cane as i had become too dependent on it. Without it i couldn't even carry a cup of coffee without spilling it.That was before the second surgery. The doctor admitted that there were problems as described due to the surgery. It also happened to an OR nurse 2 weeks prior but in her case no LLD or nerve damage. The surgeon told me that if i waited to go to another centre that the muscle would retract and would not be able to be reattached and the wait times were 9 months to be seen and another 9 months for surgery if i went there. This was confirmed by my family doctor. So if there is muscle detached there is urgency to get the repair done ASAP. What are they looking for with a bone scan? Do you find it difficult to travel? I become extremely stiff when riding in a car. Will continue to follow your progress. Good luck Moody

 

[Marvy]

Hi @moodybluestoo I think he is looking for any signs of loosening on the scan since the last x-ray looked OK. But he's never said really what he's looking for. I've known from about 2 weeks after surgery that I wasn't progressing, but I kept thinking "I've just had major surgery".

I'm concerned too that if they do find something that needs to be fixed quickly, I won't have the time to seek out a revision specialist or another doctor to get a second opinion.

Yes, it is extremely difficult to travel. I cannot sit for more than an hour (or so) as when I get up, I can hardly walk - and forget about trying to do stairs as I cannot put any weight on my operated leg after sitting that long. So, this has cut out going to movies (of course I guess I could sit in the back row and alternate sitting/standing...)

Thank you for following up!

 

[Marvy]

Just an update. The insurance company will not approve the bone scan. So I think my doctor is going to try and see if they will approve a CT scan or MRI. I've stopped all exercises weeks ago. About the only exercise is going to the store and even then I am in pain to the point I can barely walk. The pain is getting worse instead of better. My doctor thinks I'm either making this up or lying about the pain as he said he doesn't think the tests will show anything but to "make me happy" he is willing to order them. I've tried acupuncture to no relief. You can feel a hard lump in my mid thigh (on the side) that my wife thinks is getting bigger. It is really starting to affect me mentally.

 

[Irish Joe]

Marvy.
Sorry about your continuing issues. Maybe we'll ask @Josephine to revisit your problem for another look at it.
Wishing you the best.
Joe....