THR Is it normal to feel one leg is shorter than the other?

[Figsktr]

Hi everyone, I am a newbie hipster - had my first surgery on 9/23, unfortunately the prosthesis replacement cup shifted and had to have a revision on 10/9. I know, what a mess. I am now POD 18, from my second surgery. Post op check was 3 days ago - X-rays look good ( there is a spacer now to hold it in place ) . Well, my dilemma is when I stand I feel my operated side feels way shorter. I am scared when I do start to walk I will limp because of the discrepancy I feel in the length of my legs. Does anyone else had this issue? Also my buttock on the right is now flat, they had to use a different approach and partially resect the gluteus medius muscle when they did the revision. How do I prevent my buttock from getting so atrophic? Any thoughts? Scared ex -figrskter


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[Jaycey]

Hello and welcome to BoneSmart. The leg length difference is something nearly every new hippie feels. In most all cases this fades away in around 3-4 months. While you were waiting for your THR you probably carried your weight shifted to the side to stay off that sore hip. Now that it has been replaced your pelvis needs to shift back into balance. Give it time and be sure and use a walking aid until you are feeling steady on your feet. Here's a link to an article on this from our Library Leg length differential - LLD.

I had the same issue with the op side being flat. Over time that faded as well.

 

[Josephine]

Oh dear, it really is rather overwhelming when that happens, isn't it? Welcome to BoneSmart - we'll do our very best to try and help you.

had my first surgery on 9/23, unfortunately the prosthesis replacement cup shifted and had to have a revision on 10/9.

You know, I worked in joint replacement surgery since the start back in the late 60s and can honestly say I have never known or heard of a revision being needed for such a thing only one month later! What ever did your surgeon have to say for himself? I hope he apologised profusely on his knees! Unforgivable! However, you know what they say - if it's going to go bad, it will always happen to a member of staff! (well we say it in the UK anyway! ) I feel for you.

my dilemma is when I stand I feel my operated side feels way shorter.

That is so common it's almost inevitable and your surgeon should have warned you about it. Good news is that invariably it's not an actual leg length differential but an apparent one. Read about that here Leg length differential - LLD.

Also my buttock on the right is now flat, they had to use a different approach and partially resect the gluteus medius muscle when they did the revision. How do I prevent my buttock from getting so atrophic?

If they resected a load of muscle from it - which would be more than somewhat questionable - then there's not a lot you can do about it. But I would be most surprised if they really did do that. Did the doctor tell you he'd done that and if so why?

Either way, there's not a lot you can do about it right now. You are not even 3 weeks post op and this is your second surgery in a very short time so don't think you have to pitch into aggressive PT right now in order to 'make things heal'. Being a medic (I peeked!) you must know that healing and recovery is not something you do, it's something you endure! To explain that, here are our set of recovery articles which I suggest you read carefully!

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
Activity progression for THRs
Home physio (PT)
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?

 

[Figsktr]

Hi, here I am now 14 weeks post op from my second surgery doing better. Still walking with one crutch. I have major weakness of my gluteus medius and abductors. I found Pilates twice a week is helping, but I still have a long way to go yet.

I still get depressed nightly wondering if I should ever have had the surgery in the first place. I know to think positive, but it is hard when I hear stories of fellow hipsters walking without assistance after 6 weeks. Being a previous competitive figure skater and now not even being able to walk gets me down.

Thank you Josephine for your response. Sorry I have been MIA , but I have been reading nightly to everyone's posts.
Denise

 

[Josephine]

Of course you should have had the surgery! The alternative was a life in ever increasing pain and probably ending up in a wheelchair! Also, don't ever compare yourself to other hippies who have had a better recovery than you. You had complications and a revision, they didn't. You're doing okay. It's always a bummer to have to have it done twice. Don't despair, you will get there eventually.

 

[Figsktr]

Thank you for your gracious comment, I know to keep my head up but it is just so frustrating. Any exercises you can recommend to concentrate on the abductors and gluteus muscles? I have been doing clam exercises and now I can finally lift my right leg about 4 inches. I am doing Pilates with a private trainer twice weekly and I see a little improvement. Should I do it more frequently? Is it uncommon to be still taking narcotics. ( I hate to admit it, but I still take hydrocodone 25 mg a day) I feel like such a drama queen.

 

[alexthecat]

It sounds like you're doing everything that you can. Sometimes things take a little longer than we'd like. How often do you go to PT? Do you do PT exercises on your own at home too? Are you doing Pilates on the mat or the Reformer or both?

 

[Figsktr]

I did only one PT session, I did not like the therapist, so I decided to do Pilates instead (since I am I key west Florida there is not much down here to begin with). My Pilates instructor was a physical therapist in the UK so I decided to just work with her. She takes me through all the same exercises anyway.

 

[Figsktr]

Sorry, Pilates on reformer and mat. She is really working to try and get my pelvis stable since it is so shifted since the second surgery since I was not able to put any pressure on my right leg for 6 weeks.

 

[alexthecat]

Where did I get the idea that you were doing PT? I must have been thinking of someone else, because you never said that. Sorry.

I think Pilates is a great choice, actually. I started out in PT after my THR and then switched to Pilates when I ran out of PT. The PT was just for my hip, but Pilates really got my whole body working together again. It felt like the next step after PT.

I think you're moving in the right direction, even if it's slower than you'd like. Do you keep a journal of your progress? That might make it easier to see how things are changing weekly or monthly.

About pain meds... if you need them, you need them. There are plenty of people who still need medication at your stage of recovery, especially after revision.

 

[Figsktr]

Your right, I should keep a journal. Good suggestion. Thanks,
Denise

 

[Jaycey]

@Figsktr , plenty of us had to take pain meds for quite awhile. As Jo says, every recovery is different. Just some take more patience than others. Hang in there!

 

[elliemom]

Personally, I think you need to rest! I too am recovering from revision, after nine months. The second time around, I knew this time that all I had to to was everything the forum advocates. So I'm post op 7 weeks and finally getting back into the swing of things, like driving, work, and some household stuff. I would give your body more time to physically heal, then worry about range of motion and strength. I know it is rough not being active, but I think in the long run, it really is the best thing to do. There will be time to regain cardio and muscle.
I thought my operative leg was longer. My OS did measure and I'm about 1/2" off. Maybe in time, it will get better. So...just take it easy and keep reading and heeding.

 

[Figsktr]

Thank you for your comment. I really appreciate it. I get depressed everyday wondering if I will ever be able to walk normal again. I know being a physician ( I am an obgyn) i should know normal recovery, but it seems it is taking forever. I wish you an awesome recovery, (it seems I was doing the same stuff you are now when I was seven weeks). Thank you, to everyone who posts a comment on my thread, how little things makes me excited and gives me hope to press on!!!

 

[elliemom]

Hi Fig....as a physician, you know every body acts differently, so the same is true with recovering from hips.
Yeah, our OS want us to move around minimally and not abduct the abductors ....so just follow that very basic PT leg movement to keep blood circulating.....then lay down and read a book, watch tv, or go to sleep. I've slept SO much during revision where I was an insomniac during first hip. Let those pieces parts get used to you before you feel the need to overuse them...that's the polite thing it do!

 

[Jaycey]

Press on indeed @Figsktr ! I remember getting very discouraged at about your stage. You read how others are getting back to doing all the normal things and then begin to doubt yourself. Don't! For some of us this takes awhile. But consider it a short time for a lifetime of activity. You'll get there!

 

[Nannyannie]

Welcome @Figsktr You have got years ahead of you so listen to Jaycey and Jo - you will get there! How bad was your hip before surgery? I bet it had got really bad as you knew you would need time off work and your ladies would miss you!
So recovery time is probably going to be longer than you want but what you need - and take those pain meds "as needed". Us women can so easily play the martyr, grit our teeth and carry on as if nothing is wrong, so what if they might be addictive? Deal with that later because pain is very draining and does affect recovery. Feel the love and hugs coming from this side of the Atlanticto encourage you to get better!
We will be watching to see how you get on.
Regards Anne
P.S. I had the opposite trouble to your flat cheek - it took weeks for the swelling on the operated side to disappear, looked very odd from behind!

 

[Figsktr]

Thanks for the comment Nannie, to answer your question on how bad my right hip was before the surgery, I will share with you how I reached the final decision to proceed with the surgery. One year ago we went to Las Vegas for New Years, everyone was walking from casino to casino, while I could barely keep up. I struggled to walk short distances, I was so frustrated. I finally came to the conclusion at 46 years of age I could not handle it any more. Walking through airports became a dreadful task. So I threw in the towel, and of course had a complication and a revision 15 days later. I am now 16 weeks post op still on pain meds and struggle every day to walk with assistance) (so I wonder why I even did the surgery)
Denise - figskter