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THR Heterotopic ossification, not what I expected

Mr. Fun, your story is so heartbreaking. I have followed your threads since my surgery on 7.13.23. My recovery has been very difficult but I am starting to see a light at the end of the tunnel. Unfortunately you have not had a similar experience.
Very ironic that your name is Mr. Fun but having a nightmare of an outcome following your THR. My PCP insisted that I get a pneumonia shot prior to surgery.
Within a week of the surgery I had pneumonia and was not able to get the needed antibiotics for another 10 days. My chest felt like it was on fire and my operated leg was swollen to the size of a large watermelon and screaming in pain. I truly felt it was my time to die as I was unable to hold any food down and the pain was unbearable. Somehow my body withstood the ordeal and now I am slowly recovering. Had to use a walker for the first two months. My PCP says I have Meraglia Paraesthia with numbness from my hip down to my knee on my outer thigh. Was off work for 11 weeks and just started back yesterday. Still have pain in the hip joint but it comes and goes and I use Tylenol to manage it.

I have often thought of your predicament over the past 11 weeks and as miserable as I have been it is nothing compared to what you are dealing with. My pain has been acute while yours is chronic and debilitating. My surgeon was recommended by a co-worker who had both hips replaced by him and she was very satisfied with the results. During my pre-op appt with him he asked what my concerns were. I told him I only had one concern - long term post op pain. Exactly what you are dealing with.

Our 3 year old granddaughter lives with us because CPS removed her from her parents due to their drug use. I hobbled around on my walker trying to keep up with her and keep her out of trouble. I know she loves me and her grandpa unconditionally. I am sure your daughters and wife love you unconditionally as well, limping or not. Hopefully you will find your way through this nightmare and get an accurate diagnosis as well as a treatment plan to correct it. Keep posting and let us know how you are doing. Your posts help us all.
 
@Mr.fun just trying to catch up on the forum and was going over your posts. Do you still have an MRI pending and do you still have a second opinion on November? Hoping these can shed some new light on your situation.

The imaging report really kind of caught my attention. And your OS is just down playing it? Definitely time for a second opinion and preferably someone not associated with your current OS. I know you've been trying everything but if you could get some guided injections they might be worth a shot. Like was stated earlier, even if they don't relieve the pain they may give some additional diagnostic information.

I had a pain management doc that did just a lidocaine injection into my back when I was having terrible pains. For about 24 hours I had some sweet relief and then the pain came back! I wanted to ring his neck! :hissy: The good part was it answered the question of whether the pain was coming from my spine or elsewhere as referred pain can show up in strange places. And since he didn't use any steroids it enabled the neurosurgeon to go in sooner to do my surgery. Most surgeons want you to wait 3 months after the steroid injections. Might be worth looking into if you can swing it.
 
To the extent you think it is a cup issue and you need a revision, check out this link. The idea is the CAT scan preop plus this system enables surgeon to get precise cup placement relative to your pelvis and other hip. There are you tube videos too. Something to check out. Wishing you well.

 
@Elf1. MRI is still pending. I have an appointment end of Nov with His co worker. Yes I know it biased. Also waitng for one outside of the systems. 1 referral came back denied. I would assume that doctors has no more vacancies at this time to see more patients. Everything is 6 months to a year wait where I reside. Even Appointments for specialist, xray, mri, cat scans. Our healthcare system is struggling and can not keep up with the work load. @Charlie33 I never had a pre op cat scan. I only had pre op Xrays. Not sure what the protocols are around the world, but no pre op Cat scans here where I Reside.
 
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Mr.Fun, I have been following your story since the beginning because I was operated on around the same time. I had anterolateral LTHR 02/2023. The operation was a success, but the recovery drove me to despair. The operated leg was completely atrophied. I solved that by practicing persistently. The unoperated leg gave me more trouble. Due to a tight iliopsoas, I could not lift my leg an inch off the floor. I exercised with force beyond the pain limit until the muscle got stronger. Now I can step onto the chair with both feet without any problems. It's scary to say, but the situation will not improve on its own. Glutes can be built exclusively through targeted training. Tight muscles are weak muscles. Practice inch by inch every day without stopping and success will not fail.
 
@Klaudia I wish it was a simple as fight through the pain or stop being lazy. I have hired a stretching coach as well as a conditioning coach. All a waist of money. I spent money on message therapy as well. I can put my leg onto a chair and go up stairs with a small pinch and fullness feeling under the hip flexor area.The problem lies in the jam/impingment at the front part of the leg. The crease area, where the leg joins the torso. My strength is fine. It's is the impingment that is causing me so much pain and discomfort. It feels like my hip flexor is being pulled, stretched, cut like someone is holding a torch to it. It feels as though my operated leg is shorter as well and the hip is not tracking properly. My operated hip feels as though it is rolled forward and has a fullness feeling under the hip flexor. especially when I raise my knee up to do stairs or any kind of knee to chest. I am unable to stand upright completely if my heel is on the ground. (operated leg) Interestingly enough walking does not seem to bother my hip.
 
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I exercised with force beyond the pain limit until the muscle got stronger. Now I can step onto the chair with both feet without any problems. It's scary to say, but the situation will not improve on its own. Glutes can be built exclusively through targeted training. Tight muscles are weak muscles. Practice inch by inch every day without stopping and success will not fail.
@Klaudia This has been my experience was well: inch by inch you have to keep at it to see improvement. Agree on glutes too... targeted the way to go, and for me was slow.. started with an fall injury at 20 years old, at 36 was told THR needed in five years to finally at 54 having the operation. Did I wait to long? Yes. Trying to get your brain to 'remember' how to move just takes patience and consistent with guidance here I find has lengthened recovery time. At 10 months out I'm still seeing range increases I never thought possible (ROM I have not had in 10 years) and was told I would not see preop by surgeon(s).....folks here who posted their data and range improvements well after surgery gave me the hope the doctors were wrong and to keep pushing, gratefully bonesmarters were right.

@Mr.fun I suspect has a purely mechanical issue that 3D imaging and a good revisionist could help solve (dr google at work here haha), but sounds like the state of play in canada, access to care unfortunately causing barriers. Cup size and placement 'issues' seem like the most common problems I read about. I had a Depuy Actis system installed using old school 2D xrays but with an excellent surgeon. Likely going to go 3D CAT scan preop for next hip based on what I've learned about the computer aided surgery helps even the most skilled surgeon get a few degrees improvement in placement of cup.
 
@Hippielife Omg reading this has made me :) in my recovery have to say that and so so true too I'm 9 months post op and I still have a dull hip ache but like you said it can take 12-16 months to reach long term recovery and little or no pain but after the 12 month mark everyone starts to feel like they was glad they had it done and the pain and recovery is long forgotten I honestly hope that's how I feel at the magical 12 month mark :)
 
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@Spongebob I have followed your thread. I want to give you reassurance that it sounds to me as though your recovery is difficult but not abnormal. Please don't sweat your hip ache. If you have normal range of motion with some hip ache/pain your well on your way to the pretzel Olympics. You have also have mentioned that you feel better then pre op. sounds like a win win to me fella. My situation however is much worse then how I was before surgery. I am so over this jammed hip in the front and pain pain pain. The fullness feeling and extreme stretching of my hip flexor when I move, I get no relief. In all honesty it feels like my cup has been placed facing more downward then it should and rotated to much forward. My legs do not have the same degree/angle when they exit my pelvis. I can only stand on one leg at a time because my Centre of gravity is off. It is very hard to explain with words. Beyond done with this hip and our awful healthcare system. 8months and I still can not put sock or shoes on. I am still unable to pick things up off the floor. Since the 5 week mark of recovery I can only wash down to my ankle. My range of motion has not improved since week 5 and I have spent thousands a month on stretching coaches, strengthening coaches and messages. In the mean time I get to live groundhog day over and over as I wait to hear from my other referrals that have been sent out over 5 months ago. oh did I mention I'm still waitng for MRI and CT SCANS to be booked as well. 5 months and waiting.
 
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@Spongebob I have followed your thread. I want to give you reassurance that it sounds to me as though your recovery is difficult but not abnormal. Please don't sweat your hip ache. If you have normal range of motion with some hip ache/pain your well on your way to the pretzel Olympics. You have also have mentioned that you feel better then pre op. sounds like a win win to me fella. My situation however is much worse then how I was before surgery. I am so over this jammed hip in the front and pain pain pain. The fullness feeling and extreme stretching of my hip flexor when I move, I get no relief. In all honesty it feels like my cup has been placed facing more downward then it should and rotated to much forward. My legs do not have the same degree/angle when they exit my pelvis. I can only stand on one leg at a time because my Centre of gravity is off. It is very hard to explain with words. Beyond done with this hip and our awful healthcare system. 8months and I still can not put sock or shoes on. I am still unable to pick things up off the floor. Since the 5 week mark of recovery I can only wash down to my ankle. My range of motion has not improved since week 5 and I have spent thousands a month on stretching coaches, strengthening coaches and messages. In the mean time I get to live groundhog day over and over as I wait to hear from my other referrals that have been sent out over 5 months ago. oh did I mention I'm still waitng for MRI and CT SCANS to be booked as well. 5 months and waiting.
Firstly thanks for your advice your probably right I'm well on my way i do have good rom and hopefully the hip ache will fade off in the next few months
I'm terms of your situation I am so sorry you are having it rough are you in the uk?have you had a second opinion ? It seems that your surgery might have had a complication have you seen your surgeon since your operation?
 
@Spongebob I am In CANADA Eh. Waiting for other opinions and I have seen my surgeon numerous times since surgery. Just a heads up, all those questions that you have just asked are in my thread. I'm extremely irritable so please accept my apology if I come across as a Mr.grumpy instead of a Mr.Fun.
 
@Spongebob I am In CANADA Eh. Waiting for other opinions and I have seen my surgeon numerous times since surgery. Just a heads up, all those questions that you have just asked are in my thread. I'm extremely irritable so please accept my apology if I come across as a Mr.grumpy instead of a Mr.Fun.
Your entitled to be whatever you want my friend what did your surgeon say?
 
Dear Mr.Fun,
I am a member of the fb group 'Hip replacement for horse people', which has 1290 members. No one has the problems you describe, and these are people who fall every so often and break something. A certain number of members also underwent hip revision, some more than once, and all of them returned to riding after three to six months. From my personal experience and the experience of the group, it is not normal to have impingement on the operated hip. And it is not normal for doctors to delay a solution for eight months. You don't need new tests, you need a new operation. Good luck!
 
@Spongebob I have followed your thread. I want to give you reassurance that it sounds to me as though your recovery is difficult but not abnormal. Please don't sweat your hip ache. If you have normal range of motion with some hip ache/pain your well on your way to the pretzel Olympics. You have also have mentioned that you feel better then pre op. sounds like a win win to me fella. My situation however is much worse then how I was before surgery. I am so over this jammed hip in the front and pain pain pain. The fullness feeling and extreme stretching of my hip flexor when I move, I get no relief. In all honesty it feels like my cup has been placed facing more downward then it should and rotated to much forward. My legs do not have the same degree/angle when they exit my pelvis. I can only stand on one leg at a time because my Centre of gravity is off. It is very hard to explain with words. Beyond done with this hip and our awful healthcare system. 8months and I still can not put sock or shoes on. I am still unable to pick things up off the floor. Since the 5 week mark of recovery I can only wash down to my ankle. My range of motion has not improved since week 5 and I have spent thousands a month on stretching coaches, strengthening coaches and messages. In the mean time I get to live groundhog day over and over as I wait to hear from my other referrals that have been sent out over 5 months ago. oh did I mention I'm still waitng for MRI and CT SCANS to be booked as well. 5 months and waiting.
When you say we'll on my way to the pretzel Olympics what do you mean ?
 
@Klaudia I wish it was a simple as fight through the pain or stop being lazy. I have hired a stretching coach as well as a conditioning coach. All a waist of money. I spent money on message therapy as well. I can put my leg onto a chair and go up stairs with a small pinch and fullness feeling under the hip flexor area.The problem lies in the jam/impingment at the front part of the leg. The crease area, where the leg joins the torso. My strength is fine. It's is the impingment that is causing me so much pain and discomfort. It feels like my hip flexor is being pulled, stretched, cut like someone is holding a torch to it. It feels as though my operated leg is shorter as well and the hip is not tracking properly. My operated hip feels as though it is rolled forward and has a fullness feeling under the hip flexor. especially when I raise my knee up to do stairs or any kind of knee to chest. I am unable to stand upright completely if my heel is on the ground. (operated leg) Interestingly enough walking does not seem to bother my hip.
Where is the impingement… what area ? Has the surgeon instructed you where and what the issue is and what rehab is available? You have described the front in the crease of the leg where the preference for access was by the surgeon …Anterior ? Mine were both lateral and posterior.
Have you tried gravity free incumbent bike? Very helpful if you have access , aome THR rehab centers have them. You’re only 8 months from surgery… You can hire all the stretch and conditioning coaches to help you during rehab. Sometimes in my experience they do more harm than good. They do not know the connections and how the body responds. Everyone is different and they want to push exercises to help you get better. But that is not always the case in my experience. There’s just one problem …you cannot rush healing. Have you tried walking in water\pool? Walking on sand and work on ole fashioned walking heel to toe in new shoes with good arch supports. Very helpful. And oh those bum squeezes… is the most important exercise of them all as important as core strength. Walking is good and will help the soft tissue while other movements are tricky for a while for most of us .

Our hips are not the same length before THR surgery and after the joint is replaced and the length is placed back by the surgeon for the patient as close as possible. No 2 legs are exactly the same length before or after surgery. But in time it will all fall into place and work out. Believe me you don’t want to go thru revision. Rest, ice, and walking is important from this point foreword. It will get better ….Keep walking … the best way to heal.

I hope you can fully recover in the next few months. 12 to 16 months is generally when most THR patients are back to their ‘New Normal’ . Less pain, better mobility and a better quality of life.

oh I just want to say I ride horses and was never on my horse 3 to 6 moths after THR surgery. Was well over a year. Leg muscles is the driver when riding I needed more strength and time to heal. That comment about THR riders all back on a horse between 3-6 months .. yeah just waking but never trail riding.. was bulling if you ask me.
 
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@Hippielife. My impingment is located on the front upper thigh crease area. I had the TRH Anterior Procedure. Looking down at the scar the impingement feels just to the left of the scar or perhaps just under. I have tried a incumbent bike as well as stationary. I am not able to due a full revolution on ethier do to impingment. I did a lot of beach walking this summer with my children and also a lot of road walking. I am heading back to work this week. I will be on my feet most of the time and will bring lots of soft ice packs and leave them in our work freezer. As for surgeon he feels it is heterotopic ossification. I am not on board with his diagnoses only because xrays at 3 months had three pencil dots. He has yet to prove his case to me. Did not want to do xrays at 6 months and that set off some red flags to me. I am leaning towards malpositioning of the cup. Only Because of my symptoms and how my leg is functioning. I have another opinion from one of his colleague's but have also resourced specialists outside of my surgeons practice. But everything is a waiting game. Ontario Canada's healthcare system moves like a snail. I am in no hurry to push for a revision and my original surgeon would not be selected for that procedure. I would need more definite answer's as to why My hip is behaving this way. Also thank you for the encouragement on 12-16months for recovery. I often say to myself that I am only half way through this ordeal and to give it more time. It is very frustrating to stay positive when you are not getting the results you want. I am on the younger side for this procedure and having a hard time understanding why I did not cost through this. I hope I did not miss any of you questions.
 
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Have you tried ‘Gravity Free‘ incumbent bike is much different than a regular incumbent bike. Gravity free means no pressure on the legs at all from body weight. Your sitting in a sling which is holding your body weight while you rotate the leg. Starting out slowly. Walking slowly in a pool is helpful , very important to ID the issue.

Also anterior approach for THR was touted years ago as less invasive, having a faster recovery, less dislocation and recovery pain. Studies show it has a higher risk due to smaller incision, less area exposed for visuals to the surgeon. Also studies confirm that anterior approach can bring early recovery to patients, but there is no difference in long-term outcomes, including dislocation rates. Anterior approach for hip replacement has become increasingly popular as patient demand for minimally invasive surgical techniques increases. THR has gained a higher number of patience with osteoarthritis in recent years. Modern surgical instruments combined with specially designed operating tables have made it easier for surgeons to use the technique. However…..the learning curve can be steep, requiring hundreds of conditions to become proficient. Anterior approach is supported by many surgeons for THR, but there is a lack of large randomized controlled studies to support this conclusion. Long term recovery is the most difficult for all THR patients. Transitioning the healing phases thru long term healing takes time, rest and patience.

I understand where your pain area is located as you describe is in the femur area - component implant and or component neck area. Ask for X-ray of that area. It bothers me that your surgeon didn’t take x-ray after 6-8 weeks.

Sending healing prayers your way. Remember when returning to work always have a higher chair to sit in ………as well as home. Will take the pressure off and sit for only 20 minute’s at a time then get up and walk.
 
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@Hippielife I tried getting up every 20 minutes this evening and it made an enormous difference! My leg and knee were much happier! Some of the little things make a gigantic difference! I just have to remember to take the time to do them
 
I see that @Hippie Chick just had surgery in August of 2023…due to an invisible slippery fluid on the floor Causing a fall. Very painful way to ID hip issues. However you are still very new in the recovery cycle of healing.

Happy to read your comment above about getting up and walking every 20 minutes has helped you in early recovery . Also a healing tip for your recovery are the air pressure sleeves battery operated on Amazon is also very helpful, by suppling adequate oxygen and blood supply to the hip area while calming swelling and avoiding pain . Very similar to the type hospitals use after THR surgery but so much more affordable.

Pain after surgery is fairly typical after hip replacement . It’s a shame that more surgeons do not take the time or effort to familiarize their patience with the healing phases post surgery.
The body has undergone significant trauma to replace the damaged joint. While this will reduce pain and discomfort in the long term, it can cause acute pain in the short term. Your in the early stages of healing . Most people can expect mild to moderate swelling and pain to subside in 6-8 months . Long term healing continues with several different phases of healing as the new components become accepted by the different biomechanics of each of our bodies yet responses are often similar. As more and more healing speeds up as time passes your new normal will be a blessing.

Most people can expect mild to moderate swelling and pain to subside in short term healing in a few months. While the long term healing journey is up to 18 months will soon find peace, and a better quality of life and improved mobility.
Sending healing blessings your way.
 

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