Bilateral THR New Hips, Jan 17th/2012

[gershom]

I had BTHR on January 30th and I, too, have some asymmetry issues. My PT has finally convinced me to not worry (aka "shut up and do your exercises"). What I focus on is pausing for a moment before walking so that I don't limp or favor the different-feeling side in any way. I am probably the most impatient person in the world, and recovery from this is all about patience - my dear wife/coach reminds me each moment.

 

[Matsan]

Well interesting day, I Saw an occupational therapist who confirmed that I have a 1/2 inch leg length discrepency.
Not thrilled with this, but taking it "in stride", my quality of life is already so much better without the hip pain I can manage this.
Then saw my local Dr. for a burning pain at my armpit and down my side....a rash had started to appear, as I suspected, Shingles. What the hell!!? Tomorrow is a new day!

 

[bottomshollow]

Oh, Matsan, I am so sorry about the shingles. My knee surgery had to be postponed for 2 weeks because I came down with them. I caught mine the night they started and when to my GP and was put on meds immediately and got over them in a week. They are miserable----I feel for you.

As for the LLD---it may very well sort itself out in the next three to four months. Sometimes there is an imbalance of the pelvis or muscles and ligaments that have to work themselves out over time. So do not be too concerned at the moment. If it is still this way after about 4 months than it is what it is. I have a 5/8" LLD due to surgery. But the total relief from the pain makes it a small price to pay.

 

[Matsan]

6 weeks....can't believe how quickly its gone! Small blip with coming down with Shingles but got started on antivirals quickly so the duration and serverity was greatly lessened! VERY thankful for this!
I saw my OS for a 6 week follow-up, no concerns. Got the go ahead to drive and cautiously increase exercise, stationary bike, eliptical etc..loving being back in the pool.
I have a question for Orthodoc.
I see in a previous post you commented on LLD discrepency stating that there are 2 ways to approach this, "living with it" or lifts. Can you explain the thoughts behind "living it with it"...does the body sometimes adjust to this without adverse effects? Thanks for any thoughts!

 

[sharonslp]

Matsan, so glad the shingles were caught and treated quickly. I remember when my mother had them....she was in misery for four solid months.

I will be interested to see what Orthodoc says. I have no direct experience with LLD (thank goodness!) but it seems to plague a lot of people here. Many do adjust to it with no further problem, and others do use leg lifts with varying degrees of success. But the prevailing wisdom has always been to give it a good 4-6 months before deciding anything, since it does often resolve itself....or so I've understood.

Did you see the article in the library about it?
https://bonesmart.org/forum/threads/leg-length-differential-lld.6173/

Sharon

 

[Poppet]

Sorry about the shingles.. Had them myself, can be very painful, but pleased you got onto them early.

Quite a few of us encounter some degree of LLD, for most of us it sorts itself out as the body and any pelvic tilt realigns over a few months. Give it time

 

[Matsan]

My OS was surprised when I mentioned my right leg was I believe 1/2 inch shorter. He too said to be cautious with rushing into using any lifts, also the physio at the hip and knee clinic stated to me many OS's don't like the use of lifts for LLD. I had never heard this before. As I work in health care I have contacts with OT's who very much want to "fix" this. That is their world. So I am just interested in hearing the thoughts behind "live with it". I know my son has super flat feet, when he was young I took him to a specialist who said leave them be, where an OT friend insisted on insoles....in the end not keeping up with getting insoles he has had no problems with his very flat feet!
I am aware I need to give it time, and I am hoping things sort out a bit more.....but I will be surprised if they do, when I stand with my right leg straight, my left knee has to buckle to be comfortable. And when I walk I notice a drop.
In the end, it really is not a big deal, I am SO happy with my pain free new hips and looking forward to life!
Just looking at options for the best way to deal with this IF I have too!
Have a FANTASTIC weekend all! Thanks for the above input Poppet and sharonslp! Gail

 

[bottomshollow]

A persons body will adjust to 1/8" to 1/4" LLD without problems. But when you get to 1/2" and greater, you are likely to find that you are very conscious of it; and it causes back, hip, and knee pain. Do keep in mind that most hip replacement patients do not end up with LLD--it just seems that way until the body adjusts to its new alignment.

I have an LLD of 5/8" as a result of my hip replacement. I, of course, wish that I didn't, but it's a small price to pay for the pain free life I have since my surgery. It's not possible to just ignore this much discrepancy. I have the soles of my left shoes lifted. It is not very noticeable and since the materials used are very light weight, I have no sense that the shoe is different. I feel even and comfortable. It is fairly pricey to have this done, but it's worth it to me.

I would not be concerned at this point in time. But if this persists past 3 or 4 months, then you will need to address it.

Take care and keep us posted. We care.

 

[djklaugh]

Matsen
You're still quite early in the recuperation process - so give the LLD a while to straighten itself out! I too felt like I had LLD for a while after BTHR - but it was mostly due to having been so out of whack for so long. Once the muscles were reeducated and rehabbed that sensation went away. When you walk concentrate on standing straight and walking heel toe - and do the PT exercises diligently! Give this at least 6 months if not a bit longer. And do check out the articles about LLD as some folks (even great PT folks) do not know how to measure for this accurately! Also - did you get new shoes after your BTHR - or at least have old ones resoled? IF not then do get this done!!!! Your old shoes are worn down in old maladaptive wear patterns and could very well be skewing your gait.

 

[Orthodoc]

Matsan,

I think a lot of the advice you are getting here is appropriate. As many have suggested a leg length discrepancy can come come from several sources. The hips may be evenly spaced, with an underlying pelvic tilt or scoliosis. This will cause the feeling of a leg difference.

However, sometime the leg may actually be made longer/shorter with the surgery. Your particular surgery was rather recent and I agree with your OS that it is reasonable to give yourself some time before considering lifts. You may also ask your OS to show you your pelvic x-rays. He/she will be able to show you the exact length of both of your hips in this x-ray. That may help your understanding as well. Good luck.

Orthodoc

 

[Matsan]

Well I am 3 months post-op, hard to believe how the body can recover and feel almost back to normal in such a short time!
I am wondering about some continued left groin pain and occassional buttock pain on the same side. This seems to happen when I have been sitting for a longer period of time. NOT pain like before surgery but a ache...
My left leg is 1/2 inch longer than my right, so I am wondering if that may be contributing to this....thinking its a matter of stretching more frequently during the day? I do have a follow-up appt with a PT in a few days.
Any thoughts??
Thanks so much, Gail