THR Kevmo's End of stem pain after THR

[Kevmo]

Hi Mike, @NewCreature

Like you I am happy to find this forum. I had right THR one year ago on November 7th 2019. I knew something wasn't right but I kept following doctors orders. I had severe pain in my thigh, I was told it is most likely the IT Band and it will go away. About 4-5 months after surgery I started getting severe thigh pain, what's odd about this is it is mostly when I take the weight off my leg. I never realized how much you lean forward while shaving, brushing your teeth or loading the dishwasher. There are times when I shift my weight I yell out loud in pain.
I was able to walk/hike and golf a bit, but now I'm afraid it will cause more damage.

Fast forward, when I saw my surgeon last week he said I need a bone scan. Of course he ordered lab work to rule out infection. I had a bone scan on Tuesday November 17th, received an email the following day from the doctor saying the bone scan definitely found something and he will do a video chat Monday the 23rd (today). Today he told me I have "end of stem pain" and I have two options. Option 1 is to be on crutches for 3 months and take meds either in a pill form or by injection. Apparently, this helps bone strength? Option 2 is to have surgery. He said they will make an incision in my thigh approximately 8" and attach a cadaver bone along the stem then wrap wire around it. As you can imagine, this is devastating news. I am a snow skier, golfer, motorcycle rider and hiker. He told me if I choose option 1, I need to be committed to the use of crutches 24/7 which I think will be hard to do.

Mike, you are the first person I found online who has the pain while shifting weight. My doctor believes the prosthetic hip is not loose, it's just pain from the stem tip. He said if I choose the surgery which is pretty rare but the success rate is 80-90% in a small sizes case study.

I would love to hear back from you and what you plan on doing, hopefully you check this forum frequently. I'm not of the rules here but let me know and I'll be happy to give you my email address or phone number.

Hang in there...

Kevin

 

[Pumpkln]

@Kevmo
You'll notice that I have copied your newest post, a copy is still in Mike's thread, and started your recovery thread. For several reasons, we prefer that you have your own recovery thread:

• That way, we have all your information in one place. This makes it easier to go back and review your history before providing advice.
• With your own recovery thread, you will see the posts and advice others have left for you.
• Having only one thread will act as a diary of your progress that you can look back on.

So please post any updates, questions or concerns about your recovery here. If you prefer a different thread title, just post what you want and we'll get it changed for you.
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[Pumpkln]

Kevmo,
One of our Forum Advisors, @lovetocookandsew had strut graft surgery on November 19th, for end of stem pain after her knee revision, she will be along to respond when she is feeling better.

Recommend you seek a second opinion for your THR, from a surgeon specializing in Revisions, they have the education and background to determine what is happening with troubled hips. Look for a surgeon specializing in complex joint reconstruction or revisions. They should have no relationship with your present OS, not even golf buddies.

 

[lovetocookandsew]

Hi @Kevmo. @Pumpkln is correct. I have basically the same issue, but mine was in both the thigh bone and the tibia, as I had a total knee revision, not hip. My OS said it's a good idea to wait up to two years as some people are slow to have their bones remodel around the stem. Basicallly, what he told me is the post is solid and doesn't move, but our bones do move and will hit the post (stem tip), then the nerves in that bone will react with pain. Most people (I think he said something like 99.9% will fully heal by two years; if not then they need to address the issue)

I understand the sudden sharp stabbing pain while standing, then shifting my weight-that about did me in whenever I was cooking, doing dishes, and so on.

I had the surgery last Thursday as the pain was unbearable, never stopped upon movement of any kind; woke me at night; it varied in intensity from painful to excruciating, and considering the time frame never would heal. It was stealing my life from me and I had to do it in order to try to get my life back. My bone scan showed what they call uptake, if I'm remembering correctly, which basically means the post is irritating the bone.

You're at one year and my OS said it's better to wait to be certain as this is not an easy surgery nor recovery. I'm finding that out; plus I have other issues that mean I cannot take any kind of pain relief meds, so I have a lengthy in-patient process I have to endure on top of everything else. I'm still in the hospital and may need a day more, or a couple more days here. It's been really painful so far, and no fun. I'm not sugar-coating the process or recovery as that, IMHO, would do you no good. The truth from someone who has had, or currently is having, basically the same thing, is better.

To date, I have not yet taken an actual walking step, all I've been able to do is pivot a bit to use a bedside commode. I don't know if this is more the normal process; I doubt it as most people can take pain meds which would allow them to walk, but I can't.

My advice to you is to take the less invasive option for now. I was using crutches for quite a while in a way that allowed me to use a walking motion but put very little weight on my leg. That was the best way for me to get around, even though in the past I've had issues with using crutches. This way avoided past issues and was much easier to walk around. I'd avoid this surgery until you get to a place where time-wise it's obvious that nothing will change. That would include another bone scan at a later time frame.

I hate the fact that I can't do everything I used to do, or would still like to, but this surgery, if it works, will allow me to at least do some of the things I want to do again. But, I didn't take the decision lightly to go ahead. I agonized about it for a long time until I knew in every fiber of my being that I had no other choice if I want to live. I'd go ahead and curtail my activities for a time, use the crutches, and reevaluate in 3-6 months.

If you have any more questions I'm happy to help. You're also welcome to read my thread, especially any posts after late summer or early fall of 2018 as that was the time frame when I started having this pain, if I'm remembering correctly.

 

[Kevmo]

Thank you for the reply, I hope your recovery goes well. My doctor is sending me to another surgeon for a second opinion. I'll post when I have more info.

 

[Kevmo]

Kevmo,
One of our Forum Advisors, @lovetocookandsew had strut graft surgery on November 19th, for end of stem pain after her knee revision, she will be along to respond when she is feeling better.

Recommend you seek a second opinion for your THR, from a surgeon specializing in Revisions, they have the education and background to determine what is happening with troubled hips. Look for a surgeon specializing in complex joint reconstruction or revisions. They should have no relationship with your present OS, not even golf buddies.

Thank you