THR LLD Due to Pelvic Tilt

[Layla]

Thanks to both you, @Beckford and @Diane60 for taking your time to document your stories on the forum. Your experiences may benefit many in the years to come and following your recoveries is a learning experience for us. Wishing you both comfort and complete healing.
Enjoy the weekend!

 

[leejaa]

Must be a relief to hear that healing is progressing and the revision looks good. You have had such a long road with this hip. Being able to start putting full weight on the hip is a big step and another sign of progress. I hope you have a peaceful day.

 

[Layla]

Hey Diane,
Just noticed it’s three months since your revision.
Happy Anniversary! Hope you do something to celebrate. Nice dinner? Ice Cream? A little Champs? Whatever you do...enjoy!
@Diane60

 

[Layla]

Happy Four Month Anniversary!
Hope you’re hanging in there and all is going well for you.
Have a wonderful week!
@Diane60

 

[Dublingal]

Hi @Diane60,
I read your last post, I can certainly understand your feelings, especially since this has been such a difficult experience with all that you have been through with multiple dislocations and surgeries.

Your situation is unique. We all are individuals. So, my experience might not be useful to you, but I did find reading how others approached their recoveries helpful to me and still do. I struggle with uncertainty. When I was a couple of months out from surgery, while I was glad for those members who wrote about how over time (months) they definitely improved and recovered, I wondered and worried a lot if this would apply to me, would I get better?

To deal with frustration and uncertainty and pain, I lean on my faith and I sought professional advice from highly trained medical experts.

I am now at 7 months from my right hip replacement. My gratitude is immense. I still worry. My pelvis still sometimes tilts. I just saw my OS, for many many months my LLD was around 3/4 to one inch. It is now 3 mm.

Hi Diane,
Hope you don't mind me asking.. Did you have xrays that showed a pelvic tilt early in in recovery? Ive had 8 weeks post op x-ray and it shows significant raise on my operated side which causes a limp. The PA said to get shoe lift but OS told me at 2 wks post op not to. My hip was in bad shape pre op and it took a lot to repair. Looks like half a centimeter diff right now on the femur but the pelvis diff is much more in height difference. Just wondering what your thoughts are?

 

[Diane60]

Thanks for sharing this information with us, is was very informative. Well, It’s been 4 months and I still can’t walk due to LLD. My PT feels this is due to my muscles after hiking my leg up for 8 months waiting for my new hip to be fabricated.
To answer your question regarding X-rays, my X-rays showed my right hip hiked up much higher than the left, hence LLD. I haven’t had any measurements taken. My PT caught me one time with heel lifts and I was forbidden to wear them again so soon after my operation in May. There are times I feel like my legs are even, especially after PT but then it changes again and I’m off. I had to come to terms that I might be handicapped for the rest of my life and move on. I’ve been out of work for a year now and I want my life back. If I have to roll in with a walker or 4 wheeler, than so be it. My attitude good or bad is that I finally get a new hip but I’m left handicapped. If I knew what I know now, would I have gone through the pain with arthritis or a new hip. Well right now, I can’t honestly answer that question. All I can say is do your homework and read everything on BoneSmart before making that decision.

 

[Pumpkin]

@Diane60,
After 4 months, this has not improved, and your PT has not been able to effectively address your pelvic tilt, or the possibility of an actual LLD, it is time to find someone else.
Recommend you find another PT for fresh eyes on your LLD who who get to the bottom of why your pelvic tilt has not started to resolve. You can also ask for a referral to an orthotist or podiatrist to check what is happening.

A pelvic tilt can cause an apparent LLD.
A LLD can cause an apparent pelvic tilt.

You need to find someone to address this, and explain thoroughly to you what is going on with your hip and LLD.
Then provide an effective treatment plan. Right now your present PT has been unable to do either.

 

[Beckford]

Hi Dianne,
Sorry to hear that you are struggling still, but at four months it’s still early and you mustn’t give up and think you will be handicapped. I was born with an atomical leg length difference. The body can usually cope with up to 2 cm. after that it really does throw everything off kilter . But say for example you have a difference of 3 cm , it’s very easy to make up the difference with a shoe insert or a bit on the heel ( most good shoe repair people can do this ). I had a lower limb scan , called an EOS scan. It was at the European scanning centre in Harley Street London. I did pay but it wasn’t as expensive as I thought. What this gave me was a precise measurement so I know exactly my own leg length discrepancy. Another thing I did to check this was make up a block or use books , I then stood with my shorter leg on the books and played around until I found the height that made me feel really comfortable. But I definitely agree with Pumpkin, I would get someone else to look at you and if necessary a bone scan . Once you know more then you can make a plan and if you need a shoe raise to help with your balance then at least you know you are doing the right thing. I hope all this makes sense , I am basically saying there will be a solution to the problem and keep positive as I am sure you will keep improving. It’s a long bumpy journey and I have days when it all gets me down but I have also learned that through sheer vanity and refusing to wear a raised shoe it has definitely affected other areas because of all the compensation mechanisms the body uses. Also remember you had a revision, I couldn’t walk for a year when I had my left hip revised and I often thought I would never walk again unaided but it’s fine now so please don’t give up. Xx

 

[Diane60]

Well I’ve transferred to my home and am so happy. I’m coping the best I can being on my own for the first time in a year. I transferred to a new PT but they are not really making me happy. I told them that I’ve been to PT for the last few months but they’re treating me like I just started doing not much of anything. They said they don’t know why I still can’t walk but if they really did their homework, they would know that I’ve had multiple dislocations, multiple revisions and 4 surgeries plus a new custom made hip. You would think a god PT would understand why I’m still not walking close to 5 months. My hip is not strong enough. Am I doing something wrong? Should I be walking? I’m still using a walker. I’m confused. I need a good PT in northern Virginia like the ones I had I my home town but they are just to far to travel or I’d stay with them. My evaluation with the new PTs was a joke. She gave me a list of exercises to do and that was it. Yesterday, day two was just as bad. She made a few measurements and I was gone. I need a good PT that is going to work with me and not expect me to do everything on my own. I hate doing exercises at home. I want them to see how it looks if my hips are straight, I can’t look at myself. I need PT to work with me. Anyone have a good PT in the Centreville,VA location?

 

[Layla]

Congrats on getting back home. I’m sorry you’re disappointed with your new PT. There are plenty of physical therapists out there, I‘d try, try, try again until you find a good fit. I hope someone from your area comes along with a good recommendation for you.

Please don’t question your recovery timeline. You’ve been through a lot and it‘s only just a little over four months since your last surgery. Hang in there and look forward to feeling stronger and steadier as you continue healing.
Hugs and best wishes. I hope you have a good weekend!
@Diane60

 

[Diane60]

Thanks Layla. I knew if I reached out to bone smart you all would make me feel better.

 

[helenium]

Hi @Diane60 . Great to read that you're finally home and so happy to be there. I would have thought that just coping on your own would be plenty of additional exercise for you at present! I was gradually becoming more independent then in March, at the start of lockdown here in the UK, I had to fend for myself. It was difficult, and not how I'd envisaged my recovery.

Please don’t question your recovery timeline. You’ve been through a lot and it‘s only just a little over four months since your last surgery. Hang in there and look forward to feeling stronger and steadier as you continue healing.

Completely agree with Layla here. You've said it yourself, your hip isn't strong enough yet for you to be walking without assistance (understandably so), and that should be obvious to a good PT. Hope you're able to find one who you're happy with and fully understands what your hip has been through.

Sending best wishes as you continue healing.

 

[Diane60]

Awwww... you guys are amazing! Thank you so much!

 

[zauberflöte]

Hi @Diane60 -- NoVA? Could you PM me and I'll see if I can find something? I'm in Piedmont area, so not an expert on your area, but I have a cousin up there who might have friends with joint replacements etc. We'll see what we can do for you!

 

[Diane60]

Well, it's been quite a while since my last post but I feel confident that someone out there in the Bonesmart world may have answers for me.

Long story short, I've had multiple hip dislocations, multiple hip revisions and 4 surgeries. My last surgery was May 20, 2020 and I finally got a new fabricated hip.

I've been working on strength training and gait but I'm not able to walk without a cane inside and I have to use a walker outside. I'm not strong enough or brave enough to walk outside with a cane.

I'm so frustrated! When I am walking using my walker, all is good. Walking sticks are even better for my range of motion but I'm still afraid of falling. While standing using my walker, I can let go and stand up straight and tall without holding on. My balance seems good. When I am sitting, I can move both legs up and down, left and right, no problem. The problem is that I can't lift my left leg without holding onto my walker or anything. I just don't have the mobility to lift my leg while standing. This is the hip that I never had any problems with but the one with all the dislocations and surgeries, I can lift. ????

The doctors at UVA gave me the deer in the headlight look. They said it might be my spine because the x-rays for my "new" hips look good. They had no answers for me. So very disappointing.

So I now have 2 new hips and I'm disabled for the rest of my life. I was wondering if anyone out in the Bonesmart world has every experience any problems like this? Where do I go from here? What kind of specialist could help me? I just want answers before excepting that I'm fully disabled and will never walk again. So sad....

 

[helenium]

Hi @Diane60

the x-rays for my "new" hips look good.

Well that's really good news.

I just don't have the mobility to lift my leg while standing

... and the not so good. Do you have a PT's opinion on this?

First, let's make sure I'm understanding this correctly.
You stand on your newest (right) hip, and you can't lift your left leg up?
But you can do it if you hold on to your walker?

Keeping your pelvis level (keep fingertips on a counter-top, no falling allowed), are you able to stand/balance on just your left leg? And how about on just your right one?

 

[Jaycey]

@Diane60 I suggest you see a PT whose specialty is spine. They can at least assess you and hopefully come up with a plan.

Failing that - see a spinal specialist for a second opinion on your surgeon's diagnosis.

Please keep us updated!

 

[helenium]

I was around 12 months post op before I could stand unaided on my 'new' side and lift the other leg up. It was a case of gaining adequate strength on the newly revised side rather than a lack of mobility on the other.

 

[Jamie]

Diane, you might consider getting an opinion from a special team the Hospital for Special Surgery (HSS) has set up. We frequently recommend Dr. Della Valle who is part of that group, so I would suggest you contact his office to find out more. I believe the cost for a case review is around $500 and I think you can do most of it long distance without a trip to New York.

Dr. Della Valle

 

[Diane60]

Thanks everyone. I will contact the Hospital for Special Surgery (HSS) and have a consultation with them.

I would like to ask Helenium what exactly she did as far as gaining your strength? I was a bad patient when it came to PT because they just sent me home with exercises and I need more so I rejoined the Women's Club gym to gain strength and so far that has been working great. It sounds like from Helenium I need to have more patience. My 6 month from surgery is Dec 20. Is strength training enough or do I need to see a PT and do floor exercies (yuk). Sorry, I don't mean to knock PT but it's what your use to, I guess.

I'll keep you updated once I decide what to do next.