THR Metal, illiopsoas, or both?? My story

[C Mac]

Hi Mark,

Did you read this thread about psoas issues?

https://bonesmart.org/forum/psoas-tendon-probs-t13576.html

I'm sure that Jo will comment on your question about the tendon release as she also gave an opinion in the above thread.

I'm not at all surprised to hear that swimming doesn't work for you with the tendon issue! There are a number of others in the forum that have written about their psoas issues -- Lisanewmc is one that just spent some time off from activity and back on the crutch to settle hers down. Seems that when most complain of having issues with their psoas they are told by their OS to take a break from activity for a while and let it settle down, not to keep going and try to push through it.

I hope that you can find a way to get to a more comfortable place with the tendon and continue to get answers from your surgeon on the MoM issue. It is frustrating to have to "dial back" on the activity, but hopefully it will be a temporary dialing back. You are fortunate to have an OS that is so involved in monitoring your situation.

Take care,
Cardie

 

[MarkC]

Yes, I am very confident in my OS. He is part of all the hhopla about mom studies and such and is one of the leading voices in the states....up on the latest greatest (actually, they both are). We'll see. Thanks, M

 

[MarkC]

I can also say that I have had many many sessions with chiro (more than can count) over the last two years. I have a great massage therapist and the best I have felt was after a deep tissue message in that area (be carefull lady....ha ha ha ha). But it continues. And, complete rest does NOT work...it does not.

BTW, my OS (one that did the replacement) said exactly the same thing about the spasm..he is probably dead on, but we gots to do something about it. Like I said before, my new IS suspects both metal and tendon (two sources) and we are trying to see which one is creating most I suppose.

 

[Josephine]

There's another lady who is having ilio-psoas issues and the tenotomy as been suggested to her as well. Here's her thread Nine months down the line You can read what I have said to her about the tenotomy.

 

[C Mac]

Wondering what the difference in opinion is between Aussie Bev's thread and the Nine months down the line thread, Jo?

Thanks,
Cardie

 

[skicubad]

Mark, I also had a large head MOM RTHR done 14 months ago and even though I feel great and am back to all my sports, the straight leg lift has always been tough and somewhat painful from day one. I can't see how if it was a metal ion issue, it would have been present from day one even before the ions had time to build up. My ortho does not seem concerned and since the pain is not intese but more of a tendonitis like soreness, I am going to continue and just keep an eye on it. Other than that issue (which rarely bothers me) the pain is all gone and I feel very good. I wonder if a revision could be done as easily as just relining the cup or the ball and leaving everything else in place? Maybe Jo knows and will let us know. Anyway, what I am dealing with is fairly minor and I continue to plug away at work and at play. Best of luck to you Mark and all the other hippies out there. Vic

 

[Josephine]

Depends how much damage has been done. If it's in the early stages then yes, a change of ball and cup liner could be done.



Cardie, I'm not sure what you mean ....

 

[C Mac]

Cardie, I'm not sure what you mean ....

It was this message that you wrote in Aussie Bev's thread:

"Noooooo! That's really taking a sledgehammer to crack a walnut! Go see a good chiropractor or massage therapist who will get this tendon/muscle to calm down with some nice deep massage. You will probably need to go several times before it gets sorted, like you may need to have a cortisone shot more than once. But don't ever, ever let anyone cut it - that ligament is far too important to do that."

________
Cardie

 

[MarkC]

Hey Vic, I agree somewhat with what you are saying. I had the illiopsoas issue after my scope before I even had the replacement. It was very stubborn after my scope and hurt in the same way. I honestly think the question is whether all the pain is from that or not. I have the different types of pain..the one in front is a tough one and then the pain that comes from the side is almost different if you know what I mean. Now I will say that my OS certainly believes at this time that the revision would be only changing ball to ceramic and liner to a hardest poly. He believes that everything is lined up perfect and that everything is solid. From all I have read, I don't think anyone really knows for sure how much the metal plays a part. My original OS did not give the metal much of a thought either but my new OS has stated to me that he thinks it is "probably causeing me some pain along with that tendon" even though my tests were all fairly clean. I don't think he would say that if he did not believe it becasue he is definately not pushing for revision at this time.

I could tell yesterday right after the injection that I got pain relief with a straight leg lift (of course from the lydocain) and am hopeful that when the steroid kicks in that it will give good relief. If it does, I think the question will become (how long will it last?? What to do if it does not?? etc.. I have had a tendon released on my elbow for "tennid elbow" back in 1997 after two years of absolute hell and it worked like a charm. Completely alleviated the pain and it has never come back (well here and there a flare up but that is natural). I had tons of people say that they would not have that elbow surgery but trusted the OS and he was right.

If my pain is very managable and I don't have to take anti inflamatories or other pain meds to enjoy life, I will continue to hold out until the summer when I am tested again. If I can't walk over a few miles without it really acning and bothering me, I may take my chances. I got the replacement to be able to be active without pain and at 41, I don't think I am willing to settle for constant aching pain if I do not have to.

I have read that some folks with these issues just get better and my OS seems to think that there is a possibility that the tendon actually releases itself over time but they are not really sure why these folks' symptoms go away.

 

[Josephine]

I can't find it .. I checked all of Aussie Bev's threads.

 

[skicubad]

What Jo mentioned about the cup rubbing slightly on the tendon kind of hit home with what I have felt there from the beginning. It would also explain the slight pop I feel there with some motions. I agree with CMac about being conservative. Mark, I also struggled for years with tennis elbow but got over it with cortisone and it has never returned. Tendinitis is a complain.. Good luck. Vic

 

[MarkC]

my tendonitis was absolutely crippling (with elbow). I went 2 years oagonizing pain and was willing to do anything. It worked so I am a believer in te tendon release treatment when all else fails. But I am wanting to be conservative myself. We'll see.

Had a troublesome night last night. I think that I am reacting to the actual injection...it is actually bruised where the needle went in and it hurt like a person last night and woke me up. A couple of advil and away it went to I could sleep. I hope thet the steroid will kick in as I know the lidocane wore off. Still feels somewhat better today. Anybody had any experience with these cortizone injections in their illiopsoas tendons?? Got on the elliptical last night and could tell that it was going to probably fire it up a bit.....and it did.

 

[MarkC]

Well today I have been taking it easy. Walked yesterday and the last half of the walk hurt every step. It is a bit strange, I can tell that the tendon seems calmer (front leg lift pain but over all, I think the needle must have just fired up the whole thing because I have had to take anti-inflammatories (naproxen today) to keep it tolerable. Today it actually hurts more in the butt area but I definitely think that the shot itself has aggravated the whole thing. I am hoping that this is just from the trauma of the needle and that it will settle. My OS said to give it 5-7 days to know whether it would really work. So far, I think it's made it worse overall ... uuuggghhhh. Still tolerable for sure but then again, all pain is tolerable if it doesn't totally stop you and I really have no idea what my pain threshold has become. Anyone else had this guided cortisone injection and can relate? I would love to hear from you.

By the way, Merry Christmas and I hope everyone has a great Holiday. Mark

 

[Josephine]

You have it all correct, Mark. The injection does stir things up a bit so it can take up to a week before you know if it's going to work. You do know you can take Tylenol with ibuprofen, don't you? Tylenol/ibuprofen cocktail

​

 

[MarkC]

now that is good info. Thanks for all you do here Josephine!! I will check out that thread about the cocktail.

 

[MarkC]

quick questin, so does this mean I could take 1000mg tyl and between 400-800 ibu at the same time or alternate?

 

[Josephine]

Well nominally together but it doesn't quite work like that as paracetamol can be taken 4-6 hrly whilst the ibuprofen should be taken 8hrly. Figure it out!

 

[MarkC]

gotcha, amazing...have had way less pain with that tendon in the front and seems to have brought on side of hip and buttock pain that I have not had in quite a while (have to laugh rather than cry)...pick your poison maybe... I will try to stay off pain meds tomorrow and see what happens. Maybe go ahead and try to go about a workout and move through the day. Will have been 5 days so I want to see where I am. Hoping for the best. The kids with grandmother for a couple of nights so I can be miserable if I have to and not rain on their Christmas. It is sort of a strange sensation as I can tell that the front groin pain (as with straight leg lift) is less, but then the side heat and rt upper butt pain is more than usual...maybe the shot sort of inflamed the hole place, I don't know. I did take the meds today though and maybe they are holding it off too. I hate to complain here but I need to vent and maybe it is theraputic for me to vent here.

I am very encouraged by those of you who are having great success...keep those stories coming...when I get there, I will be shouting from the roof tops. I do hope to be able to help anyone who is going through a similar sitchuation of anyone who I can lend advice to as well. I am grateful for finding this forum. I may contact a couple of you through private messages who have been in similar sitchuations if you don't mind, mark

 

[Josephine]

It certainly is therapeutic, Mark.

You know, you reminded me there of an old man who had lots of aches and pains but steadfastly refused to ever take anything. Eventually someone managed to persuade him to take a couple of paracetamol which he did very grudgingly. Then about 3 hours later he announced that his pain was a lot better now ending "so see - I didn't need to take them pills after all"! :DOH:

 

[MarkC]

ha ha ha ha..I can see what you are saying. I will let you know that I have been taking meds the last few days for sure. I probably took more yesterday though. I have some perscription "Naprolan" that I have taken (says to take one a day) but most the time, I take the ibupophen or tylenol...but if I take 800mg of the ibuprophen, I usually only take it once a day and then maybe take tylenol at night before bed or something. We'll see how today goes...I am going to move today...just sitting around for a couple of days does not really seem to help so time to get moving and see what gives.