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Revision THR Hip and buttock pain'

Hi all. Thank you!! I actually haven’t been in PT for about 2 months now due to insurance issues and cost. I had been in PT Jan through then but still have very little strength in my hip and limp severely. I’m seeing my surgeon for follow up 12/19 and make sure xray is OK. I guess my question is has anyone else have such bad recovery issues i.e., almost a year with little progress and still pain in groin and going down leg.
I hope this may clarify any confusion since I had posted in months until recently. Any thoughts help would be greatly appreciated!!!

Hi again also yes we were working on strengthening and gait training in PT. I continue to just walk for exercise now but limp is getting no better.
Thanks again.
 
Oh my stars...I was so hoping things were better, @zinfandel !
You were such a comfort to me at early days in my recovery...I hate to think that you have ongoing issues.
Feel rather inept at times like these...
Do you think we should tag Josephine and get her prospective?

For what is worth...I really am hoping all gets better soon.
It has happened!
 
@Mojo333 thank you so much. It is so fustrating after all this time. I’m not sure if Josephine has been tagged yet. I see my surgeon in about a month. Just hoping nothing mechanical is wrong. I can barely walk.
Thank you for your kind words. Much appreciated!!!
 
I'm doing that now.
Please @Josephine
If you have any insight to add?


I hate that you are struggling.
I am thinking of you and wishing all will Resolve quickly!
Hugs:console2:
 
Wishing you comfort as you await Jo's response. I'm sorry you've been dealing with this for so long.
Hopefully between Jo's advice and that of your OS on December 19th you will get some direction and be able to finally move forward.
@zinfandel
 
Thank you all. I guess ill see what OS says in Dec. so fustrating what’s worse is it’s making my knee and back hurt. Ugh
 
I do wish you could get in earlier as that seems such a long wait.:sad:

Will be praying things ease up miraculously before then!?
Have you tried some heat for your back? A heating pad might help some!
Hugs:console2:
 
So sorry you have to wait. Wonder if you could get on a cancelation list at the OA's office?
Might be worth a try since your suffering pain, or call to try getting in sooner...
Wishing you comfort and some successful pain management as you wait for your December appt.
@zinfandel
 
Hi all. Just an update. I see OS on the 19th. Pain is still pretty bad even w pain meds four times a day. I am thinking that past X-rays this year were ok that it’s a combination of bad arthritis after 3 surgeries and muscular since I still walk w a horrible limp, can’t do stairs and it’s so weak. I’m curious for what OS will say and now I’m on Medicare and can’t afford PT more than twice a month. I’m way too young for this at 45. It’s crazy. I just wish I could get my life back. Sorry just needed to vent.
 
Please let us know how your appointment goes. So sorry you are still struggling with this pain. Vent anytime - we totally understand.
 
I so wish things were better for you.
I pray things will get better for you, Truly!:beg:
 
Hi all again, I was wondering if anyone heard of anything like what I’m going through almost a year later. I’m just so upset I’m still in pain and can’t walk wo cane almost a year later. Could it really take the muscles that long to recover? I know I’ll know more next week but just wondering if I’m being unrealistic in recovery time. Will the OS be able to tell me it’s muscular if he doesn’t see anything on X-ray? It’s just weird that pain is in groin. Thank you if anyone has any advice or questions since it’s been awhile since I was posting.
 
@SaraK has been struggling also and is due for a procedure first of the year. She may be able to share what imaging is needed...MRI or...to definitively diagnose a particular issue.
The xray, I'm guessing will only assure that the implant is solid.
There are definitely muscle groups that can cause your pain vs some sort of implant problem but I certainly am no doctor.
Iliopsoas syndrome? Nerve impingement?
Did the PT you were working with mention any particular issue they were working on.
I know you are anxious because you have already had to have a revision but it will me good to know if it is a muscle problem vs implant issue, right?
 
I'm sorry you're still struggling. I hope you get answers at your appt next week,
Please let us know how it goes.
Sending a hug and wishing you comfort.
@zinfandel
 
First, I'm no doctor so anything I say should be taken with a grain of salt. Second, my info has been obtained from Dr. Google, who we know has a very high malpractice rate.

When you say you limp, what is your limp like? Is is just a limp or is it Trendelenberg (i.e. the hip dips down on the op side when you put your weight on that leg? What you've described, despite there being groin pain, doesn't sound like the psoas impingement I'm dealing with. It sounds more like a glute issue like @Krista had and @Marvy is currently dealing with. I had a glute tear about 6 weeks out and developed the classic Trendelenberg gait and had pain walking and climbing stairs and doing just about anything. Mine got better with rest and then PT but it wasn't a really bad tear. A really bad tear may not fix itself and may require surgery to repair. With everything being connected, I would expect that a significant tear could impact the piriformis and sciatic nerve, leading to other aches and pains.

A metal artifact reducing MRI may show something, but mine was inconclusive - I have a metal femoral head and between that, the titanium stem and the titanium acetabular shell, the metal artifacts were still too much to really have the MRI be helpful. The other test that may be helpful is an ultrasound of the glutes and piriformis to see if there's a tear or significant fluid in that area.

Again, I leave the diagnosing to your doctor but just give you a couple of possibilities to discuss with the doctor. If you don't get the answer from this doctor, see if you can get referred to someone that specializes in "sports medicine" - they may be more accustomed to diagnosing and fixing muscle or tendon issues.

Best of luck! Tag me if you want to talk further!
 
@SaraK thank you so much. Have never really thought about any tears and surgeon will only do X-ray when I see him. When I walk the opposite side shifts way up. I walk as though my operated leg is shorter then other but they measured it and it was fine. I also think after three surgeries and acetabilar had to heal it’s self that the arthritis may just be so painful. I don’t know. I appreciate your reply and will discuss muscle tears w my dr. I just wish it was this week. But I guess I’ve gone this long. Thanks again. Open to all suggestions!!

@Mojo333 sorry missed your post somehow. I’m pretty sure as early xrays we’re fine that hopefully the implant is fine. Pt never said anything for why I wasn’t progressing but now that I’m on Medicare it’s hard to afford pt weekly. Ugh. But I feel like I wasn’t getting anywhere. I plan to get new script from surgeon and see what they say too if the would know?? Let’s hope when he sees me walk he’ll have any idea or tell me who to go too. Thanks for your thoughts!!!

@Layla thank you as always for your kind words. Let’s see what he says next week it’s been a long three years almost.
 
@zinfandel, you are not getting the expert help that you need. My situation was similar to yours. I hope you can get an accurate diagnosis and treatment.

As SaraK mentioned, I had a THR, and immediately afterwards somehow managed to tear my gluteus medius and minimus tendons on that same side (I had no accident or fall or anything), and they were bad enough that they could not heal on their own. I had gluteal tendon repair surgery 15 months after my THR. X-ray didn't show anything wrong, since it was soft tissue injury. You could see on the X-ray that the THR prostheses were solidly and perfectly in place. However, I had a pronounced Trendelenberg gait and pain in the buttock area. Unlike you, I didn't have any groin pain. I used walking aids of one sort or another for the whole 15 months between surgeries.

My original surgeon could not see anything wrong with the MARS MRI images that I insisted on having, and said I should have steroid injections and do more PT to correct the "weakness". I went for a second opinion to a surgeon experienced in doing gluteal tendon repairs, and he diagnosed me immediately after doing a physical exam and looking at the MRI results. In the images you could clearly see the atrophy and the excessive number of fatty inclusions in my gluteus medius muscle (scan done 6 months post-THR), which wasn't being used at all due to the tendon tear. This second surgeon did my surgery and I have recovered very well, not 100%, but close.

A diagnostic musculoskeletal ultrasound is often used to see problems with soft tissue, but my surgeon preferred to use MARS MRI. I have two threads, and you can see them listed below in my signature. This one describes recovery from the tendon repair surgery:
[REVISION THR] Krista's Gluteus Medius Repair 1 Year post THR

Feel free to ask me any questions!
 
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@Krista thank you so much. I never gave soft tissue issue a thought. But now that it’s brought to my attention I will discuss w surgeon or have me referred. The hard part is being on Medicare now is an MRI will be so expensive but I can’t go on like this. Pain meds four times a day. Ugh. I just want to walk normal and not be in so much pain. I appreciate all your advice. Like right now sitting here my groin is where pain/throbbing is. I used to have it in my butt however that has subsided. Again thank you!!
 
One more thing, @zinfandel...are you able to do single-leg balance on the hurting leg? I was unable to balance alone, even for a second, on the leg with the gluteal tendon tears. When I tried, the leg just collapsed out from under me. We need to be able to hold our hips steady and balance when on only one leg in order to be able to walk correctly, because when we walk normally, each leg must take turns holding our whole body weight. That was the big clue for me when I was researching what my problem might be.
 
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