THR Leahs Sloooww but steady recovery

[Leahdp]

I had left THR Nov 27 2018. I still have quite a bit of pain in my thigh on the front side.

I'm still taking Tramadol and Meloxicam. I don't go a day without this thigh pain and the heating pad is my best friend. Some times the pain is worse when I walk but sometimes it is not.

I had a slight fracture in my femur during surgery and it was cabled with a wire. I am going to see the surgeon tomorrow to make sure the fracture is not the issue. I have not been xrayed since week 2.

I was seeming to be on the right track although slow till I tried straight leg lifts while laying on my side at 7 weeks post op. I could barely lift my leg but I tried repeatedly. One day later I was in terrible pain and have been having issues ever since. I still have a limp at 12 weeks also.

Has anyone had theses issues with a femur fracture during surgery? I haven't found much info on the topic so I wondered if there is a connection.

 

[Layla]

Hi, Welcome to BoneSmart. Thanks for joining the forum.

To answer the question in your thread title - Yes, there have been others here who've experienced a femur fracture during surgery. Possibly some will stop by.

Your concerns raise questions such as whether your meds need adjusting, whether you've ever iced, whether you've been participating in PT, whether the origin of your pain has to do with the fracture, or hardware?

Since it's been almost three months since your surgery and your dealing with pain, I'm tagging the forum Nurse @Josephine to weigh in on your issues. Please check back in case she has questions.

I'll leave the Recovery Guidelines as some may still apply.
Please pay special attention to the article on ICING and the Big Tip -

BIG TIP: Hips actually don't need any exercise to get better. They do a pretty good job of it all on their own if given half a chance. Trouble is, people don't give them a chance and end up with all sorts of aches and pains and sore spots. All they need is the best therapy which is walking and even then not to excess.

Stop back often, we'd love to follow your Recovery and offer support along the way.
A peaceful evening to you!

Hip Recovery: The Guidelines
1. Don’t worry: Your body will heal all by itself. Relax, let it, don't try and hurry it, don’t worry about any symptoms now, they are almost certainly temporary
2. Control discomfo

rest
elevate
ice
take your pain meds by prescription schedule (not when pain starts!)​

3. Do what you want to do BUT
a. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you
b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.
4. PT or exercise can be useful BUT take note of these

BoneSmart philosophy for sensible post op therapy​

5. At week 4 and after you should follow this

Activity progression for THRs​

6. Access to these pages on the website

Oral And Intravenous Pain Medications
Wound Closure​

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

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?

BIG TIP: Hips actually don't need any exercise to get better. They do a pretty good job of it all on their own if given half a chance. Trouble is, people don't give them a chance and end up with all sorts of aches and pains and sore spots. All they need is the best therapy which is walking and even then not to excess.

We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery.

While members may create as many threads as they like in a majority of BoneSmart's forums, we ask that each member have only one recovery thread. This policy makes it easier to go back and review history before providing advice. @Leahdp

 

[Leahdp]

Hi, thanks for the reply. I have an ice machine but I am not longer using it. I used it for about 2 months. I have found for my thigh the heat feels better. Is ice a better option?

As far as my meds I am taking 200mg extended release a day and meloxicam I am not sure of the dose but I think it is the maximum. I was hoping to ween off the Tramadol as I have been taking it for a long time. It is what I took before surgery but with the pain I have not visited my primary Dr to do that.

For about a month I took Hydrocodone & Meloxicam and then switched back to the Tramadol & Meloxicam. I did about 7 PT visits and had my last visit January 3rd as after December my insurance rolled over and it was no longer free. I was actually gradually doing better up to that point.

The legs lifts is something PT had me try once to see if I could do it so I thought I should work on it and that is when my thigh pain really started. I have not been doing any exercises since then because I hurt and want the all clear from the Dr first.

I am relieved to read that it is the site's belief that PT is not necessary. I would like to get back to my walking but for the moment with the limp and the pain I can not go very far. I have a full time desk job and I try to get up from time to time.

 

[Layla]

Let's wait for the forum Nurse to weigh in. She may be able to advise on a better pain regimen.
It is recommended that you use an assistive device until you're no longer limping. In addition, not sure if your PT explained heel-toe walking but it really helps with a limp.

A tip -
Try heel-toe walking when / if you're limping. Let your heel hit the ground first followed by toes.
It takes a concentrated effort but I believe you'll notice a difference. Give it a try.

Ice not only relieves swelling, but also pain. I'd suggest you try icing several times per day.
Target 4x daily and ice for 40-60 minutes each session, no less.

 

[Leahdp]

Thank you for the tips, I use a cane when outside but wing it inside. I will go back to using the cane all the time. I have done the heal toe when I want to concentrate. If you think it helps I will slow down and work on that also. No one told me to do it I just noticed it on my own but didn't know if it was helpful to my recovery. I will make some of the alcohol ice packs, the ice machine was eating me alive in buying ice, and start icing again. I look forward to hearing from the Nurse but you have been helpful also.

 

[Josephine]

Hi there. What a hard time you've been having. It was ill-advised of the PT to get you doing leg lifts because, with the fracture, that would certainly cause you pain and long lasting pain at that.

Did you read the articles Layla left you in the second post of your thread? You do need to read them carefully because they contain a lot of good advice!

I'd really like to offer you some structured advice but in order to do that, I also need to ask you some questions. Are you willing for me to do that?

 

[Leahdp]

Yes I did thank you. I just made my alcohol ice pack and I am using my cane all the time. I'm also glad to hear I made the right decision to quit exercising when the pain started. I jumped to the conclusion on my own to do the leg lifts after he had me try one during pt.
I'm glad to answer some questions.

Also the Dr gave me no restrictions for the fracture and treated it as no big deal.

 

[Leahdp]

I had an apt with my surgeon today. First let me say I am so glad I have a surgeon that is not only a great surgeon but he has great bedside manner. I know others are not as fortunate.

I went in with concerns of thigh pain, my fracture, and my limp. Xrays were taken. He also had me walk for him. He believes my pain in my thigh is end of stem pain. Because of the fracture, in the trochanter at the level of the femoral neck cut, the bone is taking a while to heal and form around the top of the implant.

This is causing movement in the bottom of the stem and with the stem being stronger than the bone it is causing me pain. Where he said the end of the stem is, is where my pain is. The fracture is healing but slowing down the sealing of the bone around the top of the implant. The good news is he believes it will resolve itself in about 6-9 months. I can deal with the pain if I know it will end eventually.

Onto my limp. He said it is difficult to access the resolution of the limp. My muscles around my hip are weak and also working to protect me from my fracture. He explained it, it was complicated. He also agreed with me that the fact that I had SCFE at the age of ten and pins for 40 yrs from it could change my anatomy. I am different than someone who had a hip replacement just from normal wear and tear. He said to continue to use my cane and to work on strengthening those muscles. Nothing extreme though.

I will go back again in 3 months for a follow up and to access how I am doing. He said to use ice or heat, which ever works. I have noticed since switching to ice last night the pain seems less. I will share my xrays.

 

[alexthecat]

That's quite an xray! I'm going to tag @Josephine to take a look at it. She's an expert on such things.

 

[Debru4]

Thanks for the update---your story is pretty complicated, for sure. I am glad you feel reassured by your visit with your surgeon.

I always hated using ice before I had my hip replaced. Now I am a believer---wish I'd used it sooner for back pain and other issues. I always preferred heat, like in a hot bubble bath or a heating pad.

Are you looking at a return to work anytime soon, or is that not an issue?

 

[LdnFizz]

I really can't assist much on the fracture element- but I wanted to reassure you regarding limping- and also some physics. I continued using my crutch(es) for months after my first hip replacement - as my physio advised and as many have found here- it can take time to re-build muscles and changing gait and some many other elements- and using them and just one- you can't hurry losing the limp- and using them makes the difference. I see so many people local to where I live who were so proud that they'd got off their crutches or sticks really quickly- but they are still limping/ waddling months later. Patience- particularly when you don't have anyone to reassure you is hard. And I imagine the fracture might have added a time element.

I did find going to the pool (as well as hydrotherapy) really positive for reassurance- as well as helping- especially with the first one which took so long to improve enough to make me feel more normal- I wonder if just being in the water might help with some pain and allow you to move bit and feel more positive when you are able.

But I really wanted to reassure you that the limping will improve- but it may take more time than you'd thought or other people expect.

I had my second one done just before your op- and my first one still hurts as I am having to reset how I walk etc.. but the amazing thing is how little I am (finally) limping.

 

[Leahdp]

Are you looking at a return to work anytime soon, or is that not an issue?

I went back to work at 9 weeks. The first week was tough because I worked my full shifts so the second week I cut back. I am now back to full time. I have a desk job and sitting in an office chair hurts more than you would think. Plus I exhausted myself and stayed in my recliner that following weekend all the 2 days.

@LdnFizz Thank you. I am hoping to fit a membership to a gym with a pool into my budget this summer. I went on vacation to visit my mom the 7th & 8th week of recovery and she had a pool and a jacuzzi and it was wonderful. I am back to using my cane as much as possible.

@Debru4 Since I have switched back to ice from heat my thigh feels better.

 

[Layla]

Hi there
@Josephine should be around soon to look at your x-ray. I'm sure she'll decide whether to post the questions she asked if you'd be willing to answer, since you've met with your OS in the interim.

Consider bringing some gel ice packs to work to store in a community freezer, or a small cooler under your desk. It may bring you some relief from the office chairs when you're feeling uncomfortable.
I hope you have a nice weekend. Stay in touch, we'd love to follow your journey
@Leahdp

 

[Leahdp]

Consider bringing some gel ice packs to work to store in a community freezer, or a small cooler under your desk.

I already have one in our fridge/freezer. You have a nice weekend too!

 

[Josephine]

He believes my pain in my thigh is end of stem pain. This is causing movement in the bottom of the stem. The good news is he believes it will resolve itself in about 6-9 months.

I hope he's right. As you can see, I edited your picture before I read your post and immediately discerned that your stem is loose! In my experience, if the bone hasn't bonded onto the device within 8-12 weeks, it doesn't usually do so after the fact. But I could be wrong! I'd LOVE to be wrong! Do keep us up to date on it, won't you?

 

[Leahdp]

Oh man I hope you are wrong too. I am hoping maybe the fracture at the top has slowed that timeline. He said he only had one patient where it did not resolve itself and she was a special case. Of course he did not state how long before their issue resolved. It could have been early on, before 12 weeks which I have reached.

 

[Leahdp]

@Josephine I've been thinking about what you said and getting depressed. Saying it never does bond to the bone, I'm sure that means a revision. What would a revision for that type of fail consist of?

 

[Debru4]

Sending healing vibes your way!

 

[Leahdp]

@Debru4. He expects the pain to resolve itself and the bone to tighten around the stem. He didn't say there was any precautions or things to worry about other than pain. He suggested exercises foe the limp. We didn't discuss what ifs. He is pretty positive and would probably tell me to worry about it if and when we get to that point but until then concentrate on the limp.

 

[NanaKP]

Hello @Leahdp - I'm sorry to hear you've had such a rough go since your THR. I too had a GT fracture but I wasn't aware of that fracture until I had done PT for 12 weeks on it (all the while the pain and limp got increasingly worse). I had cerclage clamp and wiring "installed" at 12 weeks. I always felt pain on that side and found going up or down stairs leading with that leg to be incredibly painful after the hardware was put in. I have since had that hardware removed (10 weeks ago) and I feel so much better. In between those hardware surgeries, I had my other hip replaced and that went exactly like it should have. No doubt, if I would've had that hip done first, I would've known immediately that something was wrong with the other one. My "problem child" as I call the first hip is still quite painful and limiting because it is weak (my OS said the tissue was quite traumatized with having 3 surgeries since May). I am NOT doing formal PT, but walking on my treadmill, stretching & exercises that I choose to do on my own. I also go back to icing when I have extra soreness (or the discomfort wakes me in the middle of the night).

I have gone to see my OS every 4-5 weeks for Xrays since my first hip replacement May 2, 2018. He's been very good to me, I LOVE his right hand gal and the rest of the staff. It sounds like you are very happy with your surgeon, that is KEY. Please be patient with yourself - definitely don't do anything that hurts (advice from my doctor a/k/a Dr. Hipster himself) and jot down notes daily on how you're feeling, what # you would rate your pain, etc. I have gotten frustrated with my lack of progress more than once through my journey but this forum has helped me know that this is my normal and I will get there.

I hope my sharing has helped you somewhat.