Hemi-Arthroplasty Lateral pelvic tilt and real LLD (7mm)

[spaniel]

Exactly- the X-ray just looking at line of hip, surgeon said 2 mm. PT indicated by anatomical measurement about 2.5 cm. So- I am assuming this is soft tissue issue but I sure am having a dilly a time walking around. Again the PT had me lie down and measured where my heels were … I think

 

[Age28March2022]

Exactly- the X-ray just looking at line of hip, surgeon said 2 mm. PT indicated by anatomical measurement about 2.5 cm. So- I am assuming this is soft tissue issue but I sure am having a dilly a time walking around. Again the PT had me lie down and measured where my heels were … I think

I think your surgeon was right since he/she was using x-ray and that is more accurate. I guess 2mm is nothing and you can live without insole.

I am not sure if the strain on other parts back is due to your leg length discrepancy, but based on what I read I don't think it is because 2mm isn't much and it is probably the complications of the THR and just give it more time to heal and see how it goes

 

[Layla]

Happy Three Month Anniversary!
How are you doing? Leave an update as time allows, we’d love to hear…
@Age28March2022

 

[Age28March2022]

Happy Three Month Anniversary!
How are you doing? Leave an update as time allows, we’d love to hear…
@Age28March2022

Hi @Layla , thanks for checking in!

In 2 days, I will be 16 weeks out from op.

The good news is that I only have minimal pain and I can walk normally right now. I haven't tried running but I think I can if I wanted to. The thigh of my op leg is still slightly smaller than my good leg and I have been doing single leg squat consistently. There's still some swelling on my left hip.

The bad news is that I can still feel my LLD and still think about it everyday, as my op leg is shorter than my good leg. Whenever I am standing I have to bend the knee on my good leg or have my longer leg placed further away from center when standing.

I actually tried 5mm insole once in late May and I had back pain when sitting on that day. I am not sure if it is related but I have since stopped wearing the insole. When standing with 5mm insole I felt comfortable, it's just that I could feel that my feet will be tighter than my good leg since I have insole inserted.

Should I wait a bit more to see if my LLD will improve? I have seen people say it would take 4 to 7 months to resolve.

I would prefer not to wear insole if possible. I just worry that it might cause scoliosis or knee issue (on my good leg) since I exert more force on my longer leg.

 

[Layla]

Good to hear from you! Thanks for the update.
As far as Leg Length Differential goes, many feel this sensation post op. In most cases it eases with time. We advise giving it 3-4 months as it can take that amount of time for things to balance. If at that point, you are still concerned we suggest you visit a reputable podiatrist or PT for a measurement.
Here's an article from our Library Leg length differential - LLD.
Stay in touch and let us know how you’re doing.
@Age28March2022

 

[HipGal2021]

Thank you for posting this! I’m at 6 months post op and I can still feel the leg length discrepancy. Mine measured at 1-1/2 cm. But it feels like more. My hip is still swollen every day.
Thanks for the encouragement!

 

[Age28March2022]

I am almost 6 months out from hip replacement surgery and I still have swelling. I will post the pictures soon.

The swelling is around my incision area

 

[Mojo333]

Hi @Age28March2022

I don't know anything about health system in Japan...and I'm not sure how often follow up appointments are scheduled or when you last saw your Orthopedic Surgeon, but have you let them know about this ongoing swelling?
I had a follow up appointment at 6 months which was reassuring, and though swelling had pretty much settled by that point, it was not localized to the incision site.
I would want to see my surgeon and think you should note any of the following along with the visible swelling:
Unusual or increasing pain
The incision is hot to the touch
Redness or hardening of the surrounding area

If swelling is indeed only localized at the incision site,
Perhaps there could be a seroma that has been forming?
Here is my fellow staffer's good information about a seroma.

The definition of a seroma is "a pocket of clear serous fluid that sometimes develops in the body after surgery. This fluid is composed of blood plasma that has seeped out of ruptured small blood vessels and inflammatory fluid produced by the injured and dying cells." which pretty much describes a bursa!

I hope you can get an appointment with your surgeon, or if that is difficult, at least with a general practitioner to help alleviate concern.

 

[Zoebichon]

I don’t have LLD but I have been using a heel lift in all of my shoes for many years due to scoliosis from a severe degenerative spine. I do have to always wear this heel lift in all of my shoes, including my indoor shoes, or I do get a severe back ache. I very rarely ever go barefoot because of this.

I do have very soft feet however!

 

[Age28March2022]

@Mojo333

I noticed my hip on the left was bulging out quite a bit more than my right side. It's really noticeable and I have uploaded pictures taken at 1 and 5.5 months post OP.

Is this swelling? And is it normal?

When I first had surgery my entire hip was swollen and my thigh looked really big, but now only the swollen part under my scar has subsided, leaving the surrounding area of my scar looks huge and lumpy.

Funny thing is that the part right under my scar is flat, but the surrounding area is huge. It is like muscle won't form under my scar.

FYI, I haven't gone back to jogging yet but last month I traveled overseas and walked several kilometers per day.

I last saw my Ortho in early Aug and all was good on x-ray and I didn't notice the swollen part that much. Since I had no pain whatsoever my next appointment will be in March 2023 which is 6 months away.

 

[Mojo333]

It is clearer to me with the photos that your swelling is not right at your incision site and that is good!

I do remember it seemed like one of my hips seemed like it "stuck out " more prominently and indeed I had divots where my anterior scars are that have since mostly filled back in.

You had two surgeries in the last 2 years and said you had been walking alot but you don't say you are having alot of pain where the swelling is?

The spot I notice looks like it could indicate an inflamed trochanteric bursa.

Friction can build in the bursa during walking if the long tendon on the side of the thigh is tight. It is unclear what causes this tightening of the tendon. The gluteus maximus attaches to this long tendon. As you walk, the gluteus maximus pulls this tendon over the greater trochanter with each step. When the tendon is tight, it rubs against the bursa. The rubbing causes friction to build in the bursa, leading to irritation and inflammation. Friction can also start if the outer hip muscle (gluteus medius) is weak, if one leg is longer than the other, or walking alot on banked (slanted) surfaces.

I know this has been a long recovery with the two surgeries and being patient must be hard, especially as you are young and active.... but swelling can indeed be present at 6 months and maybe a physical therapist could help at this stage.

 

[Mojo333]

If you do have a lot of tenderness where you describe the swelling, you may want to check out this article in our library about
Trochanteric bursitis.

 

[Age28March2022]

@Mojo333

Thanks for your response and it is great to hear that my swelling is not at my incision site which is good!

Yes I have been walking a lot and I don't feel pain generally but sometimes I just feel sharp pain (that lasts 0.1 sec) when I move my leg certain way when I am sitting but I think it isn't related to this swelling stuff.

Right now I could feel that my lump is a bit tight especially when I sleep on my operated side that's why I sleep on my back lately nowadays.

You are right that my gluteus medius is weak, as I haven't been doing those straight leg lift and clamshell exercises for the past 3 months. I also have LLD which may have contributed to it. I just started inserting insole early last month in the shoe of my shorter leg and I walk more comfortably now.

From what I read, basically what I can do is rest (walk less) and ice the area?

 

[Jaycey]

From what I read, basically what I can do is rest (walk less) and ice the area?

Correct - icing the area will help reduce the swelling. Cutting down on activity will let the area rest and recover.

 

[Age28March2022]

From what I read, basically what I can do is rest (walk less) and ice the area?

Correct - icing the area will help reduce the swelling. Cutting down on activity will let the area rest and recover.

Thanks @Jaycey

I was about to start jogging and do more activities and glad I didn't. I actually traveled overseas last month so I had been walking a lot the past month.

Say if the swelling is gone in the next few weeks/months, can I safely go back to those activities without having this lumpy stuff again (inflamed trochanteric bursa)?

 

[Jaycey]

You will be able to return to all the activities you did in the past. Key is to build up activity very slowly and gradually. The excess walking so early out may have contributed to this inflammation.

Slow and steady is the best approach.

 

[Age28March2022]

Hi everyone.

Just had my annual check up last week and all is good judging by the X ray with just a little bit of permanent LLD.

I don't feel pain anymore, it's just that I can feel some tightness around my hip most of the times during walking.
It looks swollen with the scar area being indented (like a hole or lack of muscle?). I took these pictures in early Feb and they still look the same right now.

I asked my doctor about it and he asked me to massage the scar area daily and he says it will improve.

What do you guys think?
Is my doctor correct or should I push for MRI since it looks the same since August last year?