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Revision THR Constant pain continuing 1 year after THR<^

Layla

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Hi @Marvy
It's nice to hear from you. Great news on losing the limp. You've been through a lot over the past three years with your left hip so I can fully understand why you're doubting a day will come when you can say "hip, what hip?" But that doesn't mean it won't happen.

Would you consider phoning the office of your OS and through conversation with a member of your surgeon's care team, allow them to make a determination as to whether you need to schedule an appointment? It could give you some peace of mind also, as opposed to wondering what's going on.

Happy Monday....I hope you have a nice week!
 

SaraK

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I was thinking of you over the weekend @Marvy ! I'm glad to know things have improved in certain respects but sorry to hear you're still having problems. You might see if the doctor thinks muscle relaxants or gabapentin would help in the interim. With everything else you've been through, you might be having muscle spasms or misfiring nerves.

I look forward to hearing you say "hip, what hip" someday!
 

Jaycey

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I'm walking a lot (with no limp!).
How much is "a lot"? Sounds like you are using muscles that have not had to work in awhile. They are bound to complain. I agree with SaraK - meds to get those muscles relaxed may be needed short term.
 
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Marvy

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@Jaycey - I typically walk about 10,000 steps a day (4-5 times a week). I've been doing this for a few months now, so it's "nothing new" from an activity level (at least to me!), but the cramps and other pain is. :doh:
 

Trudijane

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I share your sentiments about the way you are feeling.
For awhile, it seemed as if I was able to forget that I even got a new hip, but lately, I have noticed a a few problems and it is hard to pinpoint or describe what I feel - but I'll try,

I'm going on 6 months now, and while I no longer have what you would call 'pain' I definitely feel that my gait may be wrong or maybe one side is higher than the other? This is guesswork.

When I walk, I get this pulling sensation on the top of my hip in the front (the groin area?)- don't know what is is, but it feels like a tendon or muscle. Along with this, my back gets very very stiff to the point both which lead to a feeling of tiredness when I want to continue walking. Then I start wondering if I'm walking correctly given that I have a new hip.

I have scheduled another appointment with Physical Therapy with the hope that maybe some exercises are appropriate for what I feel - I wish I knew but again I ask myself

Will it ever end...so I know what you are feeling.
 

Krista

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Oh, I'm sorry, @Marvy, it's just one thing after the other for you! The cramping is soft tissue-related, but that sharp "pain", that can radiate with too much movement too quickly, may not be. A good orthopedist who knows about soft tissue problems (not just bones) may be able to advise you. I wish you could just "live" instead of always having these conundrums to try to figure out.
 

Ian C

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I had the same after my second hip replacement I had one leg 20mm longer until I got revision surgery on my first one less than 2 years after the first one , 2 years later still in a lot of pain due to scar tissue etc


Sent from my iPhone using BoneSmart Forum
 
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Marvy

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Well, it's been a while since any updates, so here I am. My hip is doing well. Not to the point of saying "hip, what hip" but so much better since the last surgery.

But my right knee/leg is causing me issues. I had a CT scan of my knee and tibia last week. I have a lot of pain in my tibia, but not my knee. So one surgeon said I don't need a knee replacement and gave me a cortisone shot in the Pes Anserine bursa which didn't help at all. The PA I had seen thought it was a stress "reaction". (I had had an MRI of my knee, but not very far down the tibia).

So I went to yet another OS who said I do need a knee replacement. But I kept telling him that it is my tibia that is painful (a few inches down). My right foot also feels "heavy" or tingly. The radiology report from the CT scan (I had it at the same location as the knee MRI) basically was a copy/paste of the MRI report (with only a few words changed). The joint space is really good in my knee.

I'm so frustrated. My actual knee is not painful. It is my tibia. I asked the OS if it was my "knee", why my knee isn't painful but that the pain is farther down my tibia. The pain does not radiate from my knee down my tibia. It's a specific spot on my tibia. He had no explanation other than to say "let's do a cortisone injection in your knee and if that helps, well won't we look smart" (yes, those were his exact words).

So, even though my hip is good, I now can't walk very far because of the pain in my tibia. :bawl:
Icing and pain meds don't help at all.

I've attached an image from the CT scan if anyone can take a look and let me know if they have any ideas... I'm at a loss and just don't know what to do any more. I've had prior leg surgeries that included plate and screws, so I'm not sure if the area I outlined is from that or not.

@Josephine - I know you read mostly x-rays, but do you have any thoughts? Thanks!
tibia.jpg
 

Layla

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Hi Marvy, it's nice to hear from you and it's great to read that your hip is doing so well. At not quite one year post op, hopefully you continue to notice progress in the months to come.

I'm really sorry about your current issue and the pain and uncertainty you're dealing with. It would be easy to assume your right tibia is bothering you due to stress as your left leg has been in healing mode for so long, but the heavy, tingly sensations are also questionable.

Regretfully, Josephine is away from the forum recovering from a knee revision. I'm not sure when she'll be able to look at your x-rays. Have you considered seeking a third opinion? I understand the frustration in the two OS's not agreeing on the issue, I guess that would lead me to want a third set of eyes to look at all you've compiled in your search for an answer and relief. I'm tagging @Jamie from Admin to see if she has any advice for you.
Wishing you comfort and resolution.
@Marvy
 

SaraK

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Can you take that picture to your OS or even your primary doctor and ask them to explain that area? That just looks odd (although maybe less odd with benefit of other pictures from CT). Does the amount of weight you put on it affect the pain level? Maybe it is from old plate and screws but you'd think it wouldn't just start hurting.
 

Jamie

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I'm sorry that Jo won't be available to talk with you about your knee. You're correct, though, that she usually doesn't offer opinions on CT scans. I agree with SaraK that you need to keep looking for a surgeon who can help you explain what is going on. If that's the only place you have pain and your joint space is good (which it looks like from your image), then I can't imagine why anyone would think you need your knee replaced.

Is is possible for your GP to maybe order an MRI from a different diagnostic center? It sounds like the one where you went took the easy way out and just copied from your CT scan paperwork. Sad, really. You need to get some different eyes on your leg.

If you are able to get more information and post it, please tag me so that I see your response quickly.
 
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Marvy

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Good morning all! Thank you @Layla and @SaraK for the replies. I know I need to go to yet another OS, but it is so mentally draining trying to find someone. And now to find someone who isn't "related" to another.

The OS who ordered the CT scan didn't even look at the images. He only read the report (same scenario but different OS when I had the screw in my psoas). Is it that typical that surgeons only read reports and do not look at the images? Or is it just the doctors in my area that take the radiology report as gospel? I'm in an area where we "should" have what some would call world class healthcare (think Duke, Wake Forest and UNC-Chapel Hill and the mega OrthoCarolina) and yet I can't find anyone to actually look at the images (other than the PA who ordered the MRI, but he said he reached his knowledge limit with my case).

the MRI also indicated bowing of the cortex in the anterior medial region medial tibial condyle

The plate and screws in my tibia were removed 9 years ago. It wasn't until that fateful day in April that things went awry. It has been an ongoing issue since then.

Yes, the more I walk, the worse it gets. I can no longer go on a walk around the neighborhood as the pain will start shooting from that spot down the front of my tibia. I have a stand up desk at work and can't use that either because standing for any length of time, the pain will intensify.

I've asked for a CD of the x-rays that were taken a couple weeks ago (from OS #2) so I hope to pick them up today. In the interim, here's a photo of the printout.

@Jamie the reason he suggested a knee replacement was that the MRI report indicated that I had "Grade III to IV chondromalacia of the medial compartment " He said that even if I didn't have pain in my knee, the pain that I am having is referred pain - again the need for a knee replacement. I don't know what the requirements of a knee replacement are, but to me if the joint space is still good, I don't want a replacement - yet anyway!

Sorry for rambling and venting..... and a huge thanks for listening!
 

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