THR Need recommendation for SF Bay Area Kaiser surgeon

[Layla]

Happy Three Month Anniversary!
Hopefully you‘ve been able to slow down a bit and find time to ice and elevate.
With any luck you’re doing better. Sure hope so.
Stay safe!
@lullingly

 

[Layla]

Happy Four Month Anniversary! (one day early)
Hope you’re enjoying your new hip and your kiddos are enjoying a more energetic and happier mommy. That pre-op pain is an energy sucker for sure.
May your days only get better and better!
@lullingly

 

[lullingly]

Hey everyone, 10 months out, I've been healing really well! But lately I've been having this weird pain in my heels, worse in my non-operative leg, and I'm developing a bunionette on the outside of my operative foot.

The heel pain is only when I walk barefoot, it's like I can feel my heel bone like it's extra sharp. It doesn't bother me much when I wear shoes. It doesn't feel like plantar fasciitis. What could it be?

I'm hoping the bunionette will be fixed up by getting new shoes... I wore my plastic birkenstocks into the ground and I think that might have caused it. It's pretty mild, I've been icing it and it helps.

Anybody else experience foot issues like these post op?

@Layla and other moderators, can you change my title to "foot issues/heel pain 10 months post-op"? Thank you!

 

[Jaycey]

It is not unusual to have problems with your feet post THR. You are walking very differently now - carrying your weight differently.

First, have you purchased new shoes. We recommend not wearing shoes that you wore pre-op as the old wearing pattern can cause all kinds of aches and pains. Good, sturdy walking shoes might just help you.

You might also want to see a good podiatrist. They can analyse your gait and may be able to prescribe an insert for your shoe to help correct any issues.

 

[CricketHip]

@lullingly yes! I have been plagued with foot pain since my most recent THR on the right side. I think I have it under control but then I don't
My gait was improved considerably since both hips were replaced but apparently my feet have other ideas about that. Mine is mainly in my right achilles and then both feet have lateral foot pain.

Currently, after I walk for exercise or after standing on my feet at work all day, I ice both feet, grab some lotion or cream and do a gentle massage on them and they seem to be improving.
But it's very strange, it's similar to having a bad sprain on the operative leg, I think a good bit of my problems stemmed from some manhandling during the surgery. I am not complaining because I'm sure it was necessary to get my hip replaced but wish it would clear up! I think I am around 15 months post op now.

Other factors: arthritis in the feet and weight gain. These are very much adding to my issues. If you think about it- if we have arthritis in our hips, it stands to reason that it's elsewhere in our bodies.

I mention this because I hate to blame everything on my new hips. I'm debating signing up for some foot therapy IF our COVID numbers don't continue to escalate.

Good luck with your footies. It's a tough one..

 

[lullingly]

Hello everyone,

I'm two and a half years post op, and recent x-rays have shown something strange and my surgeon doesn't know what to make of it. He is a relatively new surgeon and hasn't seen anything like it before.

I wish I had taken screen shot of my x-ray when I was having a video visit, but I didn't so I've only got this drawing to show you what's up (the stem is actually a lot longer, I have a extra log stem):

The stem is bumping into my femur, bone has grown around the tip a bit making a ledge it is resting on, and there is some lucency at the bottom of the stem. The top of the implant is well grown in and not loose at all. It's causing occasional mild pain in my mid thigh, nothing too bad. Once it hurt enough to make me limp a bit for a day, and that's why I went in for the x-ray.

At this point he thinks we just have to keep an eye on it, especially since it's not causing me trouble. I'm wondering if anyone else has experienced something like this? I feel pretty worried because from an engineering standpoint, it doesn't look very sturdy...

 

[Mojo333]

@lullingly
I understand this is a hand drawn rendition but I really think this should be addressed immediately.

The stem is bumping into my femur, bone has grown around the tip a bit making a ledge it is resting on, and there is some lucency at the bottom of the stem.

In my opinion, the stem is compromising the femur bone by "bumping into it" and if the alignment is anything like you are showing, then you will need another surgeon to look at it ...preferably one specializing in revisions (not saying this is a given) and that has no current association with your current surgeon.

Waiting could cause damage to your femur and I think you should try to get a copy of the image - which is your right - to forward to a prospective surgeon for a second opinion.
I am really sorry that you are dealing with this, but it really isn't okay to wait and see.

 

[BellaMac]

Agree with @lullingly.

 

[Jamie]

Mojo333 is correct. What you are describing sounds like a loosening of the implant at the tip of the stem (the wearing away of the bone to create a "shelf" and the lucency). Please let us know if you need help finding a revision surgeon to take a look. But I don't see any benefit to a "wait and see" approach.

 

[Eman85]

Just me but I would want at least another opinion.

my surgeon doesn't know what to make of it. He is a relatively new surgeon and hasn't seen anything like it before.

That says a lot right there.

 

[lullingly]

Hello everyone,

As per my last post, I need to get a second opinion. Please recommend me Kaiser orthopedic surgeons in or near the SF Bay Area, especially ones who are experienced with non-standard cases. Thanks so much!

Mods, can you change my thread title to "looking for SF bay area surgeon recs"? Thanks

P.S. I'm attaching my x-ray for your curiosity. It's not as crazy as my drawing! But still concerning. Since posting I have been pain free most of the time, though I have had two bouts of pain that just lasted a day or 2.

 

[Jaycey]

@lullingly Changed your thread title for you. Since I am in the UK, I'll let my US colleagues recommend someone. Our admin list doesn't include any Kaiser surgeons.

 

[djklaugh]

@lullingly I am so sorry you are having these problems! Finding a Kaiser surgeon with the expertise to address your concerns can be frustrating. Have you asked your current surgeon for a referral to someone with this expertise? The current one probably knows his colleagues across the SF region and would know who to refer you to ... or would know who to ask!

Since Kaiser physicians are not in practice outside of the Kaiser network it can be difficult to find information about their specialties and areas of expertise. You could try using your Kaiser medical portal and use the search for physician function to get a list of orthopedic surgeons. Whether that will show someone with experience in hip revisions I don't know but it is worth a try.

While I am a retired Kaiser employee alas my experience is only with the Northwest Region so I have no knowledge of surgeons in SF.

 

[Jamie]

I modified your thread title just a bit to say you must locate a Kaiser surgeon. It wouldn’t be of much benefit for people to recommend surgeons outside your insurance network. It may take some work, but be persistent with Kaiser and the doctors you’re seeing to get a recommendation for a surgeon who does a lot of revisions. Your problem is not all that uncommon in the world of revision surgery, so there should be choices for you should you want multiple opinions.

Many times this occurs when an implant becomes loose. Even the slightest loosening can result in movement that then starts remodeling (wearing away) of the bone where the contact is made. The fact that your original surgeon was not familiar with this is a little troubling, but any good revision surgeon should have a lot of experience diagnosing and fixing the problem with a revision.

Please let us know if you have any questions or concerns. I’m sorry to hear you’re going through this, but the good news is it can be fixed and you can be on your way again.

 

[lullingly]

Thanks, @djklaugh. I did email my surgeon to ask. I tried the search for a physician function but I wasn't finding anything at all, but I'll try different ways of searching.

 

[lovetocookandsew]

@lullingly When you say SF area, how far out from SF are you willing to go?

 

[lullingly]

@lovetocookandsew, 2, 3 hours drive? The closer the better but willing to travel!

 

[lovetocookandsew]

Look at Dr. Klug at Roseville Kaiser. He's supposed to be one of the best, and I think he does a lot of revisions.