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THR Leahs Sloooww but steady recovery

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Leahdp

Leahdp

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Been trying to find info on end of stem pain that is this soon. I found this from another site
  1. "Thigh pain. Patients with cementless hip replacements may have thigh pain for 18 to 24 months after surgery, until the implant is securely locked in place by bone growth. This pain can be expected to be minimal and can be ignored."
Only thing is mine sometimes cannot by no means be ignored.
 

alexthecat

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I had end-of-stem pain after my THR. It lasted a couple of years and it was just a slight, dull ache. It didn't happen all the time. It came and went and was easy to ignore.

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Leahdp

Leahdp

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Mine started as that, but sometimes it can be severe pain. Recently it hurts now every time I step down. Not a lot but I can feel it for sure. Did you have a cementless implant? I see your tag says femoral neck fracture. Was that during surgery?
 

alexthecat

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Yes, I do have a cementless implant.

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Layla

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Leah,
My heart goes out to you, truly. Many of us go into this surgery with anxiety, some hanging onto it afterward,
until we feel it safe to breathe. We worry about blood clots, infection, non-union, revision etc. I couldn't even bring myself to read the threads of those dear members suffering the aforementioned in my early recovery. It frightened me.

Obviously you have concerns, you've expressed them here. I feel you want to believe your OS but through her many years of experience, Josephine, has opened your eyes to the possibility of a loose stem.

Please consider scheduling an appointment for a second opinion with another surgeon, one who comes highly recommended. Do this rather than torment yourself, desperately searching online, holding out hope that you find something to put your mind at ease. Through visiting with another surgeon you may be able to obtain peace of mind, or formulate a plan to resolve an issue...if it's confirmed you have one. Waiting until the end of March is an awfully long time to live in uncertainty over all of this and suffer severe pain at times as you've described. I'm not looking for a response from you....just asking that you give this some serious thought.
@Leahdp
 

prairienut

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@Leahdp , I hope you find some answers soon for the ongoing concerns you are having. I second Layla's advice. It certainly cannot hurt to get a new viewpoint on this vexing problem. I wish I had known years earlier what was really causing my pain and that nothing was going to change that except a revision. The best of luck to you. Your Bonesmart pals are hear to listen to your concerns and support you in your quest for a resolution.
 

Josephine

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Is there any harm in her waiting longer
It depends upon where the stem is loose. If it's towards the top it might be okay but if it's at the bottom of the stem, that could be a problem as the stem might toggle and end up knocking a crack or hole in the side of the bone.
would you advise she seeks a second opinion with a revision specialist who's totally unrelated to the surgeon's group she went through for her THR?
Always
What is the likelihood of a second Orthopedic surgeon advising Leah to give it more time?
Not being gifted with second sight, I cannot possible say!
Been trying to find info on end of stem pain that is this soon.
But yours isn't 'standard' end of stem pain.
What about my xray says loose stem?
Let me give you a more detailed opinion on the xray you gave me.

leah.jpg


This one I've marked where the stem is bonded with the bone at the top (green arrows) and where it is NOT bonded with the bone further down (yellow arrows). I believe that what's happening here is that because the stem is not bonded at te bottom, it is allowed to toggle, or move back and forth at the tip. This is confirmed (in my view) by the as yet, very slight wear that is caused as the tip knocks against the inside of the bone. This is called remodelling and I've attempted to show it by drawing a dotted line around the hockystick shaped depression. I had to enlarge the image to show it so it's made the picture a bit fuzzy but it's there.

remodelling.jpg
 

Mojo333

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:hi:Just popping in to send well wishes and hoping you are hanging in there.
 
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Leahdp

Leahdp

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@Mojo333 I am thanks. Just hoping time will heal. Still having the same issues. I don't know if pain is less or I have just gotten used to it.
 

Layla

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Hi :hi:
Hopefully it's less, rather than you getting used to it.
We're here for you if you need us.
Wishing you a nice Tuesday and great rest of the week!
@Leahdp
 

BionicButt

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Hi @Leahdp, Just got on the forum and saw your thread. Sending a big hug and healing energy your way. It is so hard when a replacement doesn't go the way we hoped/expected and when we are in pain and limping. It's good that your surgeon cabled the femur to support it, though it looks to me like the cable may have some sharp edges.

In my own experience, this does cause muscle pain. As my surgeon explained to me, it is best to leave the cable in place until the femur heals securely around the implant. Mine asked me to wait a year before he removed the cable. But

@NanaKP had a surgeon who was willing to remove hers sooner and she is doing well, though I know she has her ups and downs too! Hopefully, your surgeon is correct and the femur will mend in the next few months and that cable can be removed if it is still bothering you. I was comforted by my exchanges with @prairienut about her revision.

I think we all fear that one day we may have to have one, and it is good to hear a story about a revision that went well and fixed the problems from the first go round. I also have a personal friend that happened to. Her implant was too small and they had to replace it with a larger stem and then it bonded perfectly. She is in her 80's.

Hold on to a vision of your femur healing around your implant and the pain dissolving. I'll hold that candle for you too. In the meantime, be gentle and like @NanaKP says, don't do anything that hurts and ice ice ice Baby!

Big hugs to you!
 

Josephine

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Just hoping time will heal
These things don't heal with time. If the bonding doesn't occur within the usual period of time for bone healing, which is 8-12 weeks, then it's just not going to happen. Sorry
 

Layla

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Hi Leah,
Sending you a hug and best wishes for your comfort. :friends:
I hope you have a peaceful day.
@Leahdp
 
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Leahdp

Leahdp

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These things don't heal with time. If the bonding doesn't occur within the usual period of time for bone healing, which is 8-12 weeks, then it's just not going to happen. Sorry
Is this the same for cement and cementless?
 
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Leahdp

Leahdp

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I am beginning to wonder if some of my issues is my L3-L4 disc issues. I got up from a stuffed chair on my lunch break and was sitting in a not so proper position for my back. When I got up my back, thigh, knee and shin hurt a lot. I thought it was strange for them all to hurt so suddenly in conjunction with my back hurting, which I expected it to hurt or be stiff after sitting how I was. So I googled back pain and found that those pains match pains for L3 & L4 disc issues. I thought sciatica always ran down the back of your leg but not so with those particular discs. Sometimes in the morning when I get up in the morning the top of my foot will hurt also. Of course this does not mean I am not having end of stem pain or bone bonding issues but it might be I have 2 or 3 issues going on. My hip dr does not do backs either so I will have to see another dr in the practice. Does anyone here know if a chiropractor is still allowed after hip replacement?
@BionicButt Thank you for your Sweet reply. I am not having any pain at the top of the femur where the cable is. My pain is at the bottom so not sure if the cable is causing pain issues. I do wonder if it would hinder my muscle healing. I still have quite the limp from weakness and still use a cane 3.5 months post op.

Thanks
 

BionicButt

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Hi @Leahdp, I missed Josephine's detailed analysis of your x-ray last time I looked at your thread. You are describing that your pain is lower down in your femur and not at the top. From the x-ray it looks like that is the place with the least bonding of the femur to the implant. @Josephine has 60 years of experience in orthopedics and she is saying that at 3.5 months post-op, bonding will not happen. It may be very helpful to get a second opinion from another surgeon as @Layla suggested.

I know it is very scary to think about needing another surgery, but living with pain and disability that could be corrected is worse. My biggest regrets have always been not fixing structural problems sooner, hoping they would resolve by other means. Sending you a big hug, 'cause I know this stuff is hard to hear.
 

Jaycey

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I thought sciatica always ran down the back of your leg but not so with those particular discs.
My decompression surgery was on L3/4 due to horrid sciatic pain. Yes indeed, the pain run up and down the leg and down to the top of the foot. Sometimes it felt like someone was trying to rip off my kneecap.
Does anyone here know if a chiropractor is still allowed after hip replacement?
Yes, but you need a very good chiro - mine resulted in needing spinal surgery. I saw an osteopath post LTHR - really helped.
 
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Leahdp

Leahdp

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I am trying to figure out how much is my stem and how much is the sciatica. Did the chiro injure you and cause the spinal surgery? That sounds horrid. What did the osteopath do for you?
 

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