THR Failed scope, scheduled THR (33,f)

RalphsMom

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Tldr; arthritis, bursitis, failed hip scope. Tried PT, medications and injections. Scheduled for THR next week. Concerned about the continued bursitis pain after surgery.


First post, thankful for finding this site. I've been dealing with low back and left hip pain since December of 2019, no known injuries. Have been treating on & off with chiro and consistently with PT since late 2020. No long term relief.

May 2021 I saw ortho & after getting x-rays & further imaging showed impingements, labrum tears, bursitis near psoas, and multiple bone spurs. We started with an injection into the joint & continued PT. Injection lasted for about two weeks, PT seemed to make things worse. October 2021, I was referred to a surgeon & we opted to scope the hip.

Hip scope was done December 2021. My leg seemed like it was basically dead in PT. Weeks are going by, I'm not progressing in therapy at all and I'm in more pain than I was prior to surgery. Prescribed a long dose of prednisone, no change. Another injection into the joint, no relief. Tried diclofenac, ketolorac, and Lyrica with no relief. MRI arthrogram shows I have more labrum tears, bone spurs, stage 4 arthritis, bursitis adjacent to iliopsoas.

This brings me to the end of May, I seek another opinion. I have all of my records & imaging sent to another orthopedic surgeon & schedule an appointment. Ultimately we decide the best option is to proceed with the THR. I was scheduled for July but they bumped my surgery date to Monday June 20th. My concern is that I've been working with PT, tried different medications and I'm still having bursitis pain & I'll have that after the THR.
 

Jockette

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consistently with PT since late 2020. No long term relief.

PT seemed to make things worse.

My concern is that I've been working with PT, tried different medications and I'm still having bursitis pain & I'll have that after the THR.

I’m sorry you’ve been through so much with this hip. As you have found, PT does not always help. Hopefully the THR will provide relief for you, once you heal.

I would like to be really radical here and suggest you forgo PT after you have your hip replaced. This is what is in our recovery guidelines:

BIG TIP: Hips actually don't need any exercise to get better. They do a pretty good job of it all on their own if given half a chance. Trouble is, people don't give them a chance and end up with all sorts of aches and pains and sore spots. All they need is the best therapy which is walking and even then not to excess.

I think all this PT has aggravated several areas and it’s time to step back and let your body sort itself out and heal. THR is major surgery which causes a lot of trauma to your body. Afterwards, for a while, you will not be in training, and too many PTs have us in training mode, when our body is in healing mode.

I wish you the very best with this surgery. :flwrysmile:
 

Jockette

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I will leave you our Recovery Guidelines. Each article is short but very informative. Following these guidelines will help you have a less painful recovery.

Just keep in mind all people are different, as are the approaches to this recovery and rehab. The key is, “Find what works for you.“ Your doctors, PTs and BoneSmart are available to help, but you are the final judge as to the recovery approach you choose.

Hip Recovery: The Guidelines
1. Don’t worry: Your body will heal all by itself. Relax, let it, don't try and hurry it, don’t worry about any symptoms now, they are almost certainly temporary

2. Control discomfort:
rest
elevate
ice
take your pain meds by prescription schedule (not when pain starts!)

3. Do what you want to do BUT
a. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you
b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.

4. PT or exercise can be useful BUT take note of these
BoneSmart philosophy for sensible post op therapy

5. Here is a week-by-week guide
Activity progression for THRs

6. Access to these pages on the website
Oral And Intravenous Pain Medications
Wound Closure

Pain management and the pain chart
Healing: how long does it take?
Chart representation of THR recovery

Dislocation risk and 90 degree rule
Energy drain for THRs
Pain and swelling control: elevation is the key
Post op blues is a reality - be prepared for it
Myth busting: on getting addicted to pain meds
Sleep deprivation is pretty much inevitable - but what causes it?

BIG TIP: Hips actually don't need any exercise to get better. They do a pretty good job of it all on their own if given half a chance. Trouble is, people don't give them a chance and end up with all sorts of aches and pains and sore spots. All they need is the best therapy which is walking and even then not to excess.

We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery.

While members may create as many threads as they like in a majority of BoneSmart's forums, we ask the at each member have only one recovery thread. This policy makes it easier to go back and review history before providing advice.
 

Jaycey

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@RalphsMom Welcome to BoneSmart! So sorry you have been through so much with this hip. I agree - THR is your best option.

Please don't assume you will have the bursitis pain post op. You will need to rest, ice and elevate and there is no need for aggressive exercise post THR. Walking is the best exercise for a new hip.

Another tip - PT may want to focus on strength building just post op. You are not in training during recovery. You are healing. There is plenty of time for clamshells, planking and side leg lifts once that hip is healed. Listen to the hip. It will tell you when it is time to strength train.
 
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RalphsMom

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@RalphsMom Welcome to BoneSmart! So sorry you have been through so much with this hip. I agree - THR is your best option.

Please don't assume you will have the bursitis pain post op. You will need to rest, ice and elevate and there is no need for aggressive exercise post THR. Walking is the best exercise for a new hip.

Another tip - PT may want to focus on strength building just post op. You are not in training during recovery. You are healing. There is plenty of time for clamshells, planking and side leg lifts once that hip is healed. Listen to the hip. It will tell you when it is time to strength train.
I had a pre-op PT visit yesterday & failed the straight leg raise. I could barely raise an inch, if that.. and the therapist immediately made a comment that a THR isn't going to help that issue. A little discouraging but it will help the bone on bone pain that I have daily.

Thank you for your responses!
 

Jockette

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I’m sure there are many who can‘t do a straight leg raise while needing a THR. I hope you will not go back to that “therapist.” PTs are not all created equally, and I don’t think that one is going to be of help. And, it’s not a failure, to not be able to do something they want you to do. Your body needs help, and that’s what a THR is for. :console2:
 

Dulcinea14

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For 5 years I suffered with lower back pain and bursitis on the side of my hip. Had an epidural for my back 3 years ago with no relief. Had 3 shots of Cortisone a year in my thigh for bursitis. Very little relief. Finally, I insisted on an MRI. MRI showed severe arthritis degeneration, labrum tears and bone spurs. Saw a new orthopedic surgeon, brought my MRI, he took X-rays and scheduled me for total hip replacement, anterior approach 2 weeks later.
Surgery was done3 weeks ago, no hip pain, no back pain and no bursitis pain. Sorry I waited so long.
Get surgery done ASAP if you can
 

djklaugh

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@RalphsMom I could not do straight leg lifts before my hip replacements! And given the number of problems your poor hip has I would have been surprised if you could do that! Everything you listed above as a finding on the MRI can cause hip to be painful and limit the range of motion you have in the hip. And any of those problems can also cause pain to get to other areas. With so many different aspects of your hip dysfunction it would be difficult to say exactly what is causing the most pain.

Also one of the most frequent causes of bursitis ( besides an injury) is repetitive use. Doing rigorous PT now might actually be making that problem worse.

As the others have said get the hip replaced and most of the other problems fixed and it is likely the bursitis issue will clear up.

I look forward to hearing how you do after the surgery.
 
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RalphsMom

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For 5 years I suffered with lower back pain and bursitis on the side of my hip. Had an epidural for my back 3 years ago with no relief. Had 3 shots of Cortisone a year in my thigh for bursitis. Very little relief. Finally, I insisted on an MRI. MRI showed severe arthritis degeneration, labrum tears and bone spurs. Saw a new orthopedic surgeon, brought my MRI, he took X-rays and scheduled me for total hip replacement, anterior approach 2 weeks later.
Surgery was done3 weeks ago, no hip pain, no back pain and no bursitis pain. Sorry I waited so long.
Get surgery done ASAP if you can
Scheduled for Monday the 20th
 

Klassy

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Good luck for next Monday. Here’s hoping that your pain and loss of mobility will soon be just a memory.
 

Mojo333

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All the best today...will look for you on The Healing Side:flwrysmile:
 
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RalphsMom

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Thank you for the well wishes but they had to reschedule my surgery this morning at 0500 because someone in my OR had tested positive & cases had to be canceled.

I'm now scheduled for June 27th
 

Klassy

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Oh no! So sorry to hear this. But at least the delay is not long. I hope you are bearing up ok.
 

Mojo333

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Oh my...:unsure:
So sorry you have to wait and steel up again in a week.

The upside is it sounds like your OR is following safety protocols closely and that bears well for all their safety protocols.
We will get your surgery date amended @RalphsMom

Get some coffee.:mcoffee: :friends:
 

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InkedMarie

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I’m so sorry it’s been rescheduled but glad it’s not too far away.

Marie
 

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