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THR LTHR Subsidence at week 7

lyric

new member
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Jan 25, 2025
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51
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Hi, I had my left hip replaced in November 2024 (anterior approach) and I’d say I was progressing fairly well thru week 6. I was past the pain and just had normal weakness and occasionally getting out and enjoying the Christmas festivities/parties. I was starting to feel more confident and stronger in my steps, even forgetting my cane at times which I was using only because I still had a limp and didn’t want to develop bad habits until i was strong enough without limp.

Then at week 7, I began to have a different, severe pain when putting any weight on the leg. I thought it was because I overdid it over the holidays so i backed off and rested and iced a lot. When I went to PT, which I was doing twice a week, I told my therapist what was going on and she thought it could be 1) result of too much activity too soon or 2) IT band syndrome. But the pain persisted and even worsened by the following week, so I reached out to my OS/care team. After multiple X-rays and CT scan at week 10, my OS found that I had a complication that he rarely sees. He said it wasn’t my IT band, it was subsidence. My stem had sunk into the femur bone and wasn’t supposed to and there is risk of fracture if I keep walking on it. I was devastated. He gave me two options: 1) revision surgery immediately with a larger stem and collar to keep from dropping and cable to wrap the femur to prevent fracture or 2) wait to give more time for the bone to grow into the stem and see how my body responds, if the pain goes away and maybe I won’t need surgery. How much time that would take is unknown and I fear fracture in the meantime which is why he told me to go real easy, only use walker, avoid stairs.

I chose to go with option 2 at least for this week and we are going to reassess from week to week. What I’ve noticed in the weeks that I’ve been taking it easy (I’m now at week 11), the pain is equally bad when I’m non-weight-bearing. Meaning, I have severe pain when I get up to stand but ALSO when I shift in a recliner/bed or slightly move my foot outward or inward when sitting upright, or when dropping my foot into pants while seated etc. The pain I feel is sharp, usually causing me to gasp or yelp or swear out loud, and is felt mid-thigh and around incision area, sometimes even shooting down to outer side of my knee. I can have pain incidents like this 25 times throughout the day (I’ve begun to count each occurrence this week) but they go away after a minute with the longest pain lasting 15 min or so, until it gets triggered again.

What I’m curious is if anyone else has experienced subsidence and did it cause this same specific pain or was it only pain when you put weight on it? I’m wondering if there could be something ELSE causing my pain. Also, I’m torn whether I should endure the pain with hopes that it’ll just stop within a month or so or do I do the revision? At this rate, in 4 weeks time it has remain steady if not, slightly worsened.

I appreciate any advice, insight, thoughts. I know there were few similar cases I came across here on Bonesmart a while back but want to dive in a little deeper. I know @Sockeyewillie seemed to have similar case so would appreciate any insight.

Thanks!
 
Hello and Welcome to BoneSmart. I am sorry you're dealing with uncertainty and the challenge given your diagnosis. While I don't have any advice to offer, I truly hope you find relief soon and wish you comfort in the meantime.

I found two threads in addition to Sockeyewillie, who stops by ocassionally.


Please leave the exact date of your THR and we will create a signature for you. It makes it easier for those stopping by to see within a quick glance how far along you are. Thanks in advance.
@lyric
 
I will leave our Recovery Guidelines since you're only a couple months post op as some of the articles may be beneficial -


HIP RECOVERY GUIDELINES
As you begin healing, please keep in mind that each recovery is unique. While the BoneSmart philosophy successfully works for many, there will be exceptions. Between the recommendations found here, your surgeon's recovery protocol and any physical therapy you may engage in, the key is to find what works best for you.

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.

If you want to use something to assist with healing and scar management, BoneSmart recommends hypochlorous solution. Members in the US can purchase ACTIVE Antimicrobial Hydrogel through BoneSmart at a discount. Similar products should be available in the UK and other countries.

2. Control discomfort:
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
The recovery articles
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?

Nutrition is of paramount importance. Available here are dietary tips, nutrition basics and additional food supplements. These articles are both general advice on food and specific guidelines aimed at people both pre- and post-surgery.

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.
 
Hello Lyric,

I have nothing to add to Layla's excellent counsel, but please know that we are pulling for you.
Please keep us posted.
We are sisters and brothers relative to joint issues! :yes:
Your friend, Zorro
 
Thank you Zorro and Layla for the well wishes! My THR was on 11/13/2024. I did read thru those threads you shared and found some similarities and curious if Nikky , Dowgirl or Wheatsiebat has insight they can provide if they drop in again (sorry seems I can’t tag them in my reply here?).
 
curious if Nikky , Dowgirl or Wheatsiebat has insight they can provide
Unfortunately, neither Nikki nor Wheatsiebat have been on the Forum in a year, so you likely won't hear from them

We haven't heard from @Dowgirl since that November post, but I am tagging herl for you in case she stops by.


If you want to tag another member, just type their username and add the @ sign in front of it (no space) -- jJust like I did above.:)
 

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