THR Help, my leg feels longer.....

[Doupie]

Thanks Josephine, but I'm not sure what I should or should not be doing. The Doctor's office said I may want to get a lift for my shoe but on the forum it says explicitly not to do this. I love being able to talk to you guys and I feel very competent doing whatever you advise, so I will continue to limp until my body adjusts to the new hip.....

 

[Jaycey]

I waited 4 months to get a lift. Let that pelvis tilt back first. Then if you still feel LLD get a professional to measure you. In most cases these things sort themselves out though. Just a bit of time is needed.

 

[Doupie]

Jaycey, how bad was your discrepancy in the LLD? My PT says that I should feel a difference in a couple of weeks, I sure hope and pray so. I am still going to see my OS tomorrow to find out his opinion of what's going on. I am trying to not let this bother me but you guys know patience is not my forte'. I love you guys and thank you again for giving me an outlet to vent and get questions answered immediately. Josephine your knowledge and expertise is a value beyond measure.....

 

[Josephine]

It's far too soon for you to be franticating about this! Wait, wait, wait. If you start using lifts now, you will arrest and then obstruct any adjustment your body/pelvis will make. Like I said before, this tilt didn't develop in a couple of weeks and it's not going to get back to normal in that time either. More like some months.

 

[Doupie]

So should I try to walk with the limp or compensate for it? I'm not sure what to do.....

 

[alexthecat]

Use a cane or crutch to enable you to walk without limping.

 

[Jaycey]

Jaycey, how bad was your discrepancy in the LLD?

Just post-op my LLD felt like it was about 1 inch. After 4 months it settled and it's now less than half an inch. As Jo says, wait and don't worry. Things will settle. Use a crutch or cane for now. Do some slow heel, toe walking where you plant your foot carefully each step. I don't agree with your OS. It may take more than 2 weeks.

Please let us know how your appointment goes.

 

[Doupie]

Well my OS was shocked to discover that my leg was actually longer than my non-operated leg. He said I was imagining the difference because my hips and pelvic area was corrected and he said that I had been walking with a limp. I told him that I had never walked with a limp. After the first surgery I walked fine, no limp, legs same length. I asked if he took into consideration the difference in my legs based on the fact that one was bone on bone and the other was not. He said that they x-rayed my hips and aligned them perfectly except they used a longer stem on the left hip because they felt that the other implant would be more likely to pop out. So that is where the 3/4" difference comes into play. I pray that Josephine is right, but if you could have seen my OS's face when he saw the length difference, I think he made a huge mistake. He never looked at both my legs during the procedure or after, just the pelvic x-rays. He says that my IT bands are tight and prescribed muscle relaxers, he also gave me a 3/8" lift to put in my shoe. He says this will help me walk correctly until my pelvic alignment is corrected.....
I'm sitting in my bed and my right foot is in front of my left foot, my OS pulled on my right foot but to no avail. He thought they would line up but they didn't, his mouth dropped....what

Josephine told me not to wear the lift but I actually felt normal with the lift in my shoe. My mind is jumbled with all the issues I'm dealing with. I cried today because I was praying that this was all in my head and my OS would show me that.....yeah right.....my hips are even but my legs aren't......

 

[Jaycey]

Gosh, you are stuck in the middle of this aren't you. Yes, your OS is right in that if you wear the lift immediately you won't limp. But on the other side if you do wear the lift your pelvis and the muscles that have shortened will not have the opportunity to balance.

Did your OS mention physio? Ask for it. I certainly don't want to recommend not going with your OS on this but from my experience (and the experience of many other here) giving this a bit of time may ease things. I'm tagging Jo for you so she can comment as well. Take care! This will all work itself out! Josephine

 

[Doupie]

Jaycey, thank you so much for the good thoughts and you are exactly right. My PT finally figured out that she was making my pain worse and the leg difference has exacerbated my back pain. She instructed me to place my legs in a 90 degree angle and use ice on my hip/back and heat on my IT band, this has helped greatly. This is the first day I have not been in a tremendous amount of pain and I am relieved that I am getting to the other side. My PT says that since they had to swap out the implants I probably went through twice the manipulation of the hips and that is why I am hurting so much more this time. It's just good to have some answers. Why couldn't my OS just be honest with me.....

 

[Josephine]

He never looked at both my legs during the procedure

In all the hips I've attended or scrubbed for, I have never known a surgeon NOT compare leg lengths at least 3 times during and after the procedure. It's part of the process.

he also gave me a 3/8" lift to put in my shoe. He says this will help me walk correctly until my pelvic alignment is corrected

Well he's wrong. It's not rocket science to realise that doing that will prevent the pelvic tilt from correcting itself.

PT says that since they had to swap out the implants I probably went through twice the manipulation of the hips and that is why I am hurting so much more this time

She knows not what she is talking about! She's assuming that the hip would have been reduced and then dislocated again and that's not how it goes. For one thing, the theatre staff need to know beforehand what he's going to use so they can get out the appropriate instrument trays. Every implant has its own set of instruments, you see, so very unlikely he'd have made that decision during the op.

 

[ts_nana822]

i was told it is common to be 3/4 taller on a replaced hip. I feel like a segway with a flat tire. Is it really that common? dr. wants to replace R hip too. It has made the recovery process difficult. dr. told me go dancing and laughed... hahahaha

 

[Doupie]

In all the hips I've attended or scrubbed for, I have never known a surgeon NOT compare leg lengths at least 3 times during and after the procedure. It's part of the process.

Like I said and my fiancée can attest to the fact, the look on the doctor's face when he discovered the discrepancy proves they were slack and apparently did not compare my leg length. Josephine I would think they would look at the entire leg and not just the X-rays, but he kept looking at the attached x-ray and he was sure I was imagining the LLD. Since we live in a litigious society I would think that they should have or would have checked it 3 times to be sure. My OS does 3 or 4 of these surgeries a day and they just messed up with me...

Well he's wrong. It's not rocket science to realise that doing that will prevent the pelvic tilt from correcting itself.

I understand about the pelvic tilt correcting itself but the pain in my leg is alleviated when my left leg is not strained from the 3/4" difference when wearing the lift. Don't get me wrong I hate having to wear the lift and which he had taken into consideration the spacing needed for both hips, but he didn't.

She knows not what she is talking about! She's assuming that the hip would have been reduced and then dislocated again and that's not how it goes. For one thing, the theatre staff need to know beforehand what he's going to use so they can get out the appropriate instrument trays. Every implant has its own set of instruments, you see, so very unlikely he'd have made that decision during the op.

Josephine, he stated that the Corin Trinity shell appeared to dislocate to easily when the hip was manipulated, which is why he used the Corin Trifit instead. How do you explain the amount of pain I'm experiencing and how she was able to help me alleviate it today. My PT says that they use a trial prosthesis before setting it, so maybe that's what she was referring to.

Roofmaster in your post you stated that your OS made your first hip 3/4" longer because he knew he would make the other leg the same length with the second surgery. This is what I thought would happen to me....

 

[Josephine]

I understand about the pelvic tilt correcting itself but the pain in my leg is alleviated when my left leg is not strained from the 3/4" difference when wearing the lift.

Of course it will alleviate the pain but that's not the issue. The harm it is causing is, as I said, that it will prevent the pelvic tilt from correcting itself. That is something you do not want to do because you will end up having to use the lift forever more.

My PT says that they use a trial prosthesis before setting it, so maybe that's what she was referring to.

Well, maybe I over did my explanation! Of course they use trial prostheses before they get to using the real one - that's a given. What I am disputing is her assumption that your leg was thereby manipulated a lot in the process which is responsible for your pain.

What you have is simply post-op pain which is most likely being over exercised and under medicated. I believe that is why you have so much pain.

You know, hips really don't need that much in the way of PT. They have this neat way of working things out for themselves if give half a chance. All they really need is some walks in the early days and longer walks in the later days. Nothing more.

 

[Doupie]

Josephine what do I do? I am soooo depressed and confused. It's still hard to believe that my OS could make such a colossal mistake. I tried walking without the lift and I'm limping pretty badly. It actually feels as if my leg is getting longer than growing closer to the other one. How do you deal with the LLD, anybody who has experienced this, please chime in......

 

[Josephine]

Please do bear in mind that you are only one week out from surgery and that most of this pain is simply post-op pain and not entirely due to any LLD.

So I have some questions to ask you:

1. what are your pain levels right now?
(remember the 1-10 scale: 1 = no pain and 10 = the worst you can imagine. And don't forget that 'pain' also includes soreness, burning, stabbing, throbbing, aching, swelling and stiffness)

2. are you still taking any pain medications, if so, what, how much (in mg please) and how often?

3. are you still icing your knee and if so how often and for how long?

4. are you still elevating your knee and if so how high, how often and for how long?

5. what is the detail of your daily activities? What do you do in the way of housework, cooking, cleaning, shopping, etc., and

6. what kind of PT/exercises are you doing? How much and how often? Details would are required!

I'll be back shortly!

 

[fulafoto]

Hi Doupie I have had a LLD since my childhood slipped epiphysis (3cm or about 1 1/2 inches) and did not realise it until my hip started playing up. I had walked on it this way for about 40 years with the pelvic tilt walking between 7-10,000 steps a day with little discomfort. Now have build ups on my shoes which make life a lot easier but to start with it felt really strange and I was getting worse back pain and was about to ditch all the build ups however I did persevere it is a lot better now. It took me about a month to 'come upright' but from then it has been a lot easier on my hip and back.

From what I have read of many members here a lot do have the LLD after the operation (either real or imagined) and it is just a part of the healing process. From my reading and my experience it does take some time for your body to adjust and some days may be better than others.
Hope that helps a little bit and keep your chin up,
Cheers,
Bill

 

[alexthecat]

When I was one week post-op, I felt like I had a huge difference in leg length too. I remember walking with a slipper on one foot and nothing on the other. That felt more comfortable at the time. However, as Josephine says, the perceived difference in leg length began to even out in the following weeks. Now my legs feel exactly the same length and they are. Try not to worry so much about this. It's a normal part of healing and it will be fine in the end.

 

[Doupie]

fulafoto thank you for your kind words. I am trying my best to deal with this and its really hard I find myself crying a lot. I would be perfect and finally pain free from the awful arthritis.

1. what are your pain levels right now?

Right now I have very little pain and can get by with just Tylenol, 1300 mg. Last week I was taking Hyrocodone 10 mg, 2 every 6 hours and sometimes Tylenol PM so I could sleep. When I'm up the LLD is pretty bad and places a severe strain on my IT band on the operated leg as well as my back.

2. are you still taking any pain medications, if so, what, how much (in mg please) and how often?

Tylenol, 1300 mg every six/eight hours
3. are you still icing your hip and if so how often and for how long?[/quote]
Yes it's my hip and every time I lay down, probably 3-4 times a day

4. are you still elevating your hip and if so how high, how often and for how long?

Yes and I have 5 pillows with my legs up way above my heart

5. what is the detail of your daily activities? What do you do in the way of housework, cooking, cleaning, shopping, etc.,

Nothing, from somebody who went back to work almost immediately with the first surgery in June and now I am basically bedridden. All I do is move from the bed to the sofa and back.

6. what kind of PT/exercises are you doing? How much and how often? Details would are required!

They attempted to do PT/exercises but they were to painful, so all I'm doing are heal pumps for blood clots. Everything she attempted made my pain levels go up, so we stopped everything. I walk and now I am going up the stairs once a day to sleep in my bed but that is it. I have been outside once to go back to the doctor and that was it.


alexthecat, I wish my LLD was only perceived, my ankle sits about an inch in front of the other while I'm laying in this bed with my leg elevated. I pray that in six weeks when I return to the doctor and he x-rays that the LLD is better and not worse. My friend who had the surgery did not go through this, he says his hips are perfect and he is happy he had the surgery........
I'm tired of crying and hate having to get through the holidays like this. If I had known this could happen to me I would have lived with the pain and loss of ROM, before I went through with this.....

 

[alexthecat]

Yes, that is what a perceived leg length difference looks like. It is related to how your pelvis is tilted. I understand that it looks and feels like a real difference, but it's not. It is fortunate that your friend did not experience this, but it is still very, very common and it can take months for your pelvis to lose that tilt.