THR Continuing pain after one week

[FraidyCat]

I had another appointment with the surgeon today and this time the x-ray showed a hairline fracture. He said that is what has been causing my problems. And that I should refrain from weight-bearing or any activity that causes discomfort. My next appointment is in five weeks.

Though it’s good to have an answer finally, I am disappointed, not to mention anxious. Over the last few days, it had seemed that the pain had been decreasing, so I was starting to think that I could gradually start to do more. Now everything has to remain at a standstill.

If anyone has had experience with hairline fracture during the recovery period I’d be grateful if you’d share it with me. Did the fracture resolve on its own or was an additional surgery needed? My impression is that such a surgery would be complicated and the chances of success would be significantly lower than with primary THR.

 

[CricketHip]

Hi Fraidy. While I am sorry you have a hairline fracture, it's got to be a bit reassuring too. At least you know why now. I think if you scroll to the upper right corner, to the blue tool bar and enter hairline fracture post op, you will find recovery threads that pertain to this.
I think I know of a few people so will look for you also.

You WILL get through this, I'm so glad that now you know what has been going on.

 

[CricketHip]

I will post links for you here to read, I hope this helps.

https://bonesmart.org/forum/threads/hip-fracture.46032/#post-1122882

Another good recovery thread would be of our BoneSmart member, @ceezee
She had a fracture with her second THR.

I hope this helps!!

 

[FraidyCat]

Thank you very much, CricketHip. I will take a look, per your suggestions.

 

[CricketHip]

You are so welcome.. I hate that you are worrying. Have a good night's sleep, sleep is so great for our healing..

 

[FraidyCat]

I am confused about how crutches should be used in the setting of a hairline fracture. I’ve gotten conflicting information from the surgeon’s office and from my former PT as well as from watching a video on YouTube. Though all of them say to use two crutches virtually all the time, the video makes it appear as though the “bad”-hip side should never touch the ground, whereas the surgeon’s office—though not a medical person whom I spoke with— the nurse practitioner wasn’t available – said that wasn’t necessary and that weight could be borne on crutches “as tolerated.”

I’ve been using crutches now for about six weeks and assumed I was using them correctly. But the bad-hip side has definitely been touching the ground. I’m unable to even figure out how to maneuver the foot so it won’t have contact with ground. I’m concerned that for a hairline fracture perhaps I should be avoiding weight-bearing 100%. Which would basically mean hardly moving at all since I’m not able to avoid ground contact and some extent of weight-bearing.

This is the beginning of the three day holiday weekend, so trying to get further medical input is going to be hopeless.

 

[Eman85]

Over 50 years ago I had a hip surgery and was non-weight bearing for 3 mos. I had wooden crutches and I would walk with my left leg bent at the knee and support all of my weight on the crutches and swing through to my next step. Granted I was young and a lot more nimble but it's what I did for 3 mos.

 

[FraidyCat]

I’m older and not agile enough to do what you’re describing. And I’m not sure it’s even necessary; I’ve gotten conflicting information regarding the level of non-weight-bearing that’s needed. The surgeon and two PTs have seen me walk with the crutches over the last two months and none of them have said I was using them incorrectly. What I’m unsure about is whether non-weight-bearing for the hairline fracture should be greater than it was for what had been thought to be a normal postop recovery before the fracture was diagnosed.

 

[Jaycey]

I am afraid that only your surgeon can confirm on your NWB. Literally every surgeon is different. Many no longer impose the NWB restriction post THR.

If you can't reach their office over the weekend I would stay off that leg for now.

 

[myglasshalffull]

Fraidy,
After my initial surgery (which was not done where I live, I was on vacation), I flew home after 4 days. Used walker seemed ok. Made appt with my primary to have incision checked, bandage changed, then went back following week to have staples removed, then was referred to orthopedic here for follow up X-Rays and treatment if warranted.
My first visit they discovered I still had a fracture. It was by the femur. Who knows how it occurred. I was put on partial weight bearing for next month, still used walker but I really did a lot of bed rest. Got up a few times a day to walk around the house, I was not in any pain. Doctor said if it didn't begin to heal on its own they would go back in and do more surgery.
Month later I went back and fortunately the small fracture had begun to heal itself.
I can't use crutches, I would do more damage to myself with them!
I'd say take it easy next few days until you can get clearer picture of what is expected from you.
All my best.

 

[ceezee]

i just saw your post and briefly read through it.

I had a femur fracture show up during my one month visit and was put on non weight bearing for as I remember about a month. It was not visible during my initial post surgery X-rays. I used crutches during this time as a walker was just too difficult. I tried to be very conscious about no weight whatsoever on that leg but as my surgeon pointed out it’s really impossible. I had to avoid stairs except to come down at morning and up at night. And then I could use it slightly for balance. Mine healed fine but I was glad when that month was over and the X-ray showed solid bone. So I was on a walker for a month and crutches for NWB for another month.
It healed up all on its own.

 

[FraidyCat]

ceezee, Thank you for your post. Your experience gives me a little hope. My surgeon made it sound as though hairline fracture is an exceedingly rare complication, which was not reassuring to hear. I wonder if it’s less uncommon than he lets on. I’m unable to avoid stairs to the extent you were able to. I asked the surgeon about this specifically and he simply said to use a crutch instead of a cane to ascend/descend, so he didn’t seem to think the more frequent stair use would be decisive to my outcome.

 

[ceezee]

I do think it’s probably pretty rare. My surgeon said when it happens due to installing the rod into the femur they usually can see it when it happens and repair it immediately then. If they do that you’d never know it happened. Mine was likely very slight and hiding behind the bone so didn’t show during the initial post op X-ray and wasn’t apparent at the time. I think something (e.g. landing hard one night on the toilet seat) jolted it during my first month recovery and made it worse. And at the 4 week checkup it did now show on the X-ray. I could tell something was wrong as I just couldn’t get off having to use the walker. He seemed very sure it was going to heal correctly and it did.

 

[Zoebichon]

Also, many hairline fractures simply don’t show on normal X-rays. It takes a CT scan. But after a week or three, the hairline fracture will usually then be big enough to be seen on X-ray.

 

[ceezee]

Also, many hairline fractures simply don’t show on normal X-rays. It takes a CT scan. But after a week or three, the hairline fracture will usually then be big enough to be seen on X-ray.

Thanks. I think this is exactly what happened to me. It really didn’t feel right from the beginning. I couldn’t quite explain what was off. At the time, I attributed it to the fact that if you have two hip replacements they don’t necessarily feel or heal the same.

 

[FraidyCat]

myglasshalffull, I do not think I saw your post until just now. Thanks for sharing your experience. Was your hairline fracture after elective THR? Or did an injury necessitate THR? I have gotten only vague guidelines from the surgeon’s office as to what level of activity would be OK during the next month. I don’t have another postop appointment until October 10. I had just begun to walk in my immediate neighborhood for about 15 minutes each day when I found out I had the fracture. Now I’m not sure if such walks would worsen my situation. I am stuck with an NP who refuses to return my calls or emails, so I’m probably going to have to try and speak directly with the surgeon. The abysmal communication is only adding to my anxiety, which focuses on what will happen if the fracture fails to heal on its own.

 

[myglasshalffull]

My surgery was done on St. Thomas, USVI while I was on vacation.
I had a fall about 2 weeks prior to vacation here at home on some ice. I felt I broke something, went to urgent care, had xrays but doctor said nothing broken just take it easy for a few days, looking back now possibly had a hairline fracture that didn't show up on xray, in any case proceeded with vacation plans, 4 days after arriving on vacation I could no longer walk. Went to clinic on St John (that's where we were and no hospital there), doctor did xrays and couldn't believe my hip was fractured and not discovered here at home, but after that initial fall I could still walk, painful but could walk.
So I was transferred to St. Thomas and had my surgery there.
Flew home 4 days later.
My first ortho appt about a month later revealed a small fracture near the femur. Of course seeing the ortho here didn't do the surgery he told me to be light weight bearing for next month and hopefully it would heal on its own.
I was on walker, I cannot use crutches, tried when I broke ankle and lucky I didn't break something else using them, just not for me. So other than getting up and using bathroom and puttering around house I did a lot of bed rest and watching Netflix. My partner took me out for a few rides just so I wouldn't go stir crazy, even had some friends over for dinner. If fracture didn't heal more surgery, so I did my best to follow light weight bearing, I wasn't perfect by any means, but next visit it did begin to heal and no extra surgery, but he told me stay on walker for another 4-6 weeks.
I had my last ortho in mid July, all new bone growth has formed around implant and no restrictions on my activities. Some days I still am uncomfortable, but I rest and ice.
But I can do just about everything and anything I want to now, almost 7 months post op.

 

[Layla]

My surgeon made it sound as though hairline fracture is an exceedingly rare complication, which was not reassuring to hear. I wonder if it’s less uncommon than he lets on.

I'm sorry this is causing you anxiety, although its understandable. In addition to, ceezee, you will find others that experienced the same by using the SEARCH at the top right of the page and typing in "hairline fracture". All of the posts where its been mentioned will appear if you're interested in reading others accounts. I wish you peace of mind and perfect healing.

 

[Layla]

Hello @FraidyCat
Stopping by on this three month anniversary of your THR with hopes you're doing well.
I wish you only good news at your appointment on October 10th. Please let us know how it goes.
Hoping this special day is a good one for you.

 

[FraidyCat]

My appointment scheduled for 10/10 got moved to today. The new x-ray showed what the surgeon estimated to be approximately 70% healing of the hairline fracture. He felt this represented improvement but said to continue foregoing PT and to keep using crutches. Next follow-up not until 11/3. I hadn't realized that the healing process could occur at such a glacial pace. In another week, I'll be three and a half weeks out from the THR, but still reliant on crutches. He said there's the possibility that the pain will disappear during this one-month interval, in which case crutches will no longer be necessary.

I'm very disappointed. A surgery that was intended to improve mobility has instead taken it away. At the rate things are going, I may still be on crutches when winter begins, which will be treacherous at my location: I wouldn't even be able to clear snow from my tiny front porch while on crutches, as I've always done, since I couldn't maneuver a shovel even with one crutch. I'd never have knowingly scheduled THR that would involve a recovery in the winter months. And it's deprived me of the one activity--photography excursions with a group I've belonged to for many years--that had consistently been an enjoyable diversion during the Covid period. (I've not yet resumed activities such as indoor dining.)

I guess I should apologize for sounding so pessimistic, but my emotional reserves are basically on "empty" at this point.