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[THR] Nerve damage - Anterior approach

Discussion in 'Hip Replacement Recovery Area' started by Hiker2, Aug 9, 2017.

  1. Hiker2

    Hiker2 new member
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    Six weeks ago I had an anterior THR. All went well except I now have an area of my front/outer thigh, about 6" x 10", which has lost normal sensation, apparently due to damage to the lateral femoral cutaneous nerve.

    I believe this is quite common, but that sensation is not always fully restored. The popular view seems to be that nothing can be done about it, other than to just wait .... and nerve repair is very slow.

    One person anecdotally reported some improvement by taking shorter steps when walking, whilst another report seemed to indicate that extreme stretching in certain exercises may not be beneficial.

    I am endeavoring to be proactive so as to improve my chances of restoring normal sensation. I have listed below what I am doing to hopefully expedite repair of my nerve. I don't know if any of it makes any difference.

    I encourage others to contribute to this thread with their ideas of what they perceive may, or may not, have assisted them.

    - I never sleep on the affected area as the pressure may be damaging;
    - I gently massage the area;
    - I abstain from alcohol;
    - I conscientiously do my physiotherapy;
    - I walk daily. I am now able to walk a total of an hour a day;
    - I consulted a naturopath who prescribed Repairase and zinc tablets for me.
    - I am eating a healthy diet.
    - I might see an osteopath.
     
  2. Gone again

    Gone again senior

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    Seems to be pretty normal. I'm at seven weeks anterior. Still numb just below incision and sore above side of knee. Not bad but don't want the dogs tail hitting it. Other surgery site I have still has some numbness after four years.
    I sleep on boath sides
    I don't massage the scar
    I'll have a beer
    I don't do PT
    I walk as much as I can. Work out in the garage. Yesterday I installed a garden gate for my daughter. Putting new brakes on the ATV. Just living life as normal as possible without any heavy lifting.
     
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  3. Mojo333

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    I am at 3 months out with bilateral anterior approach THR. Numbness in front and lateral thighs prevalent the first 8 weeks with my experience and has been lessening...slowly over the past month. Still some zingers on sides of thighs at odd times and I was told by OS it may mostly dissipate or fully dissipate with time. I do most all mentioned on your list with the exception of the supplements...I take a multivitamin/mineral supplement along with extra C daily. I am super easy with PT as it has tendency to aggravate. I do stretching, ROM, and try to leave things with bands, weights, to a minimum as strength training can be picked up after all deep tissue nerve and muscle healing has had its chance. Just my path, but if it only gets this good, I'm good with it. I would have been a cripple if they had not cut my legs open to repair hips.
     
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  4. Mojo333

    Mojo333 FORUM ADVISOR Forum Advisor

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    I get just as confused as everyone else about PT how much, when, etc. But my thinking is - I hope - based on some common sense. My prosthetics are made with tiny divets to give surface area time for bone to form to it hence using Walker for first weeks to keep some weight off...moving around but not stressing that new rod that is hopefully affixing in my femer...giving those muscles, tendons, nerves that were cut/stretched out time to calm down... it just takes some months for that to happen. Calm down and heal...I tell myself daily as I too am not good at being patient.
    How many folks do I know who had back surgeries that haven't helped. I know none that ever gave it the proper recovery time. Time to RE-COVER what was torn asunder, right?
     
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  5. zauberflöte

    zauberflöte big-cheese

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    @Hiker2 I have had two anteriors also, and numbness. I was actually expecting it, as I'd had a significant numb spot on my belly for a long time after a hysterectomy many years ago. It's been 28 years, and there is still a hint of numbness around that scar. The right hip still has a numb spot the size of my palm, far away from the scar, about where you mention. It's much smaller than it was 4 years ago. All I've done is ignore it :heehee: I have many more fun (and not-fun) things on my list. I really don't notice it unless I go poking around. Who has time for that, says I? The left numb spot is pretty spectacular, but I expect it to shrink and fade as the other two have done. Again, I don't have time. Many more pressing health issues to keep juggling.
     
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  6. dougie0216

    dougie0216 graduate

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    @Hiker2 Greetings, I am a recent double hippy. I still have a numb spot that is about 2in/5cm square just below and to the left of my LTHR incision. The numb area was significantly larger immediately after surgery. Gradually, the numb area has diminished with time. I am so used to it, I really don't even think about it.

    I had a 3 or 4 inch square area of numbness after RTHR that included the bottom part of the incision and then towards the outside of the leg. It is down to about a square inch right at the bottom of the incision now. I just felt it to check, and I can feel pressure, it is just the skin has no sensation.

    I have a very good friend that lost the feeling below his knee after a posterior approach 8 or 9 years ago. He never got it back. He still rides 50 to 60 miles on his bicycle routinely.

    IMHO, six weeks is a little too early to determine if any numbness is permanent. Chances are you will get some of the area back.
     
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  7. Josephine

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    This is an inevitable consequence of the surgery because the surgeon has to make his incision almost exactly where the LFC nerve is. You can see in this image, the green is the nerve and the blue shaded area is where the incision might be made.

    incisions for anterior approaches.jpg


    A similar thing happens in knee replacements - the incision is inevitably made across the saphenous nerve and leave a sizeable numb patch which can last for many months. Read how mine progressed here Numb area after TKR: how long will it last?

    saphenous nerve at knee a.jpg

    None of what you suggest will enhance the 'healing' of a cut nerve. The worst thing you can do with a nerve is stimulate it, work it or massage it. Nerves just don't like that. Nerves also do take a very long time to repair, something like 6-12 months, maybe even longer.



    'divets' Mojo? Gosh, that makes it sound like we just walloped the implant to get them in the surface!

    The substance is call hydroxyapatite, a very sophisticated mineral that has many characteristics akin to bone. Thus when placed in close approximation to bone, the bone cells will transfer into it and grow a bond.

    uncemented.jpg
     
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  8. Mojo333

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    Coolest thing ever. Thanks Josephine.
     
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  9. gwenc

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    Very cool picture Jo! I wondered exactly what it looked like. Now I can envision it inside me.
     
  10. gaulsuerou

    gaulsuerou senior

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    Hi @Hiker2
    I as well had double anterior THR 5 weeks ago, I have minimal numbness on one side, and my left side has a more sensitive patch, I always would've described them as sensitive zingy patches as opposed to numbness. They are getting less sensitive as time goes on, in the beginning if anything brushed against my skin it would send me through the roof. Like Gone Again I sleep on both sides, have a drink now and then, I do eat a healthy diet and get lots of exercise, my life is just about back to normal. I just started PT she's going more with range of motion and leaving the strengthening for later till after everything has healed. I think I go once a week for six weeks and she will probably cut me loose. I have nothing bad to say about the surgery compared to the way I was moving pre-surgery. Like everyone agrees I believe things are still healing and I believe it will get better with time, good luck with your continued recovery!
    Gail


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  11. Mojo333

    Mojo333 FORUM ADVISOR Forum Advisor

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    Good to hear you are doing well too @gaulsuerou ...
     
  12. gaulsuerou

    gaulsuerou senior

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    Hi @Mojo333
    Good to hear from everybody, I have been quite busy, yesterday I was on my feet for eight hours trimming out windows at our camp, going up and down a 12 foot ladder too many times than I can count, nailing up baseboards. Very little slows me down, my PT is going to work at getting me up off the floor more gracefully as time goes on LOL, I'm almost thinking it could be time for me to start back to work but have come to enjoy the time off now that I am feeling better, and I'm am contemplating full retirement!


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  13. Layla

    Layla FORUM ADVISOR Forum Advisor

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    Hi @gaulsuerou
    Nice to hear you're doing so well! You are braver than I, the ladder would scare me. Haven't tried the floor yet either but I'm quite sure the first few times would be comical. Something else I've yet to try.....kneeling.
    I hear we can pretty much kneel from the onset but I really haven't had reason to try.
    Continued healing and a great weekend to you!
     
  14. Hiker2

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    Thanks all for your comments. Not sure if it's minimizing or not yet.
     
  15. gwenc

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    Interesting comments. I wouldn't describe my patch as "numb", but just tender. I am at 10 plus weeks post anterior. I have been getting weekly massages for years, and took a 3 week break after surgery. At first she avoided the area around the incision and the entire hip completely. Over time she started skirting around it and gently soothing it with very little pressue. I have found it helps keep the muscles relaxed, but I agree that stimulating that particular area of nerve damage is not a good thing. I have gotten a few zingers after massage that didn't feel right. I am going to ask her to avoid that small area completely again.
     
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  16. zauberflöte

    zauberflöte big-cheese

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    @Hiker2 I wouldn't worry. There is a chart in the library that tells of the time it takes various tissues to heal. Nerves, it says, take 3 to 13 MONTHS. So we must be patient patients, letting the body do its healing on its own timetable. All those things you mentioned that you do sound like very good things to do just anyway. I find myself gently rubbing my numb spot especially on waking, as I've been so still for so long that it almost feels like it "goes to sleep". The rest of the time, I have to say I am oblivious to it. I think my brain compensates for the lack of feeling fabric rub against it by completing the sensation for me out of the bits of sensation received from areas around the numb patch. I am much more concerned about "how well does the hip work?" LOL
     
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  17. Josephine

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    Can take years!
     
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  18. Hiker2

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    Update - I am now at about nine months post op. The affected area has been gradually improving. Sensation is returning well.
     
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  19. Jaycey

    Jaycey SUPER MODERATOR Moderator

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    @Hiker2 Thanks for the update! Glad this is easing for you. Your input will encourage others with the same issue to just hang in there. Nerves take a long time to mend.
     
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  20. MammaT

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    Hi @Hiker2. I have had the nerve numbness with both replacement. My left took over a year for the whole spot to resolve. My right has much larger spot (same anterior approach, same surgeon) but it is showing gradual improvement. Thanks for the update-we don’t always recognize how long the total healing can take. A friend who had replacement years ago told me she has a small quarter size spot that never came back, but since she has full rom and no pain, she’s happy with that as the worst lasting side effect.
     

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