New Pain at 5 Months Post OP THR

[Hippo28Nov08]

Hi,
Just wondering if anyone has experienced increasing pain on walking at around 5mths post op (L THR). I have a new (sharp stabbing) pain on the outside of the hip around the knicker line level at top of leg, (feels like it might be muscle?) which stops me in my tracks and all I can do to walk is shuffle along. I don't want to go back to using a crutch or stick, but sometimes I feel totally stuck to try and walk. This happens all the time. I also still have problems with the ilio-tibial band hurting outside upper thigh and outside knee (lifting my kneecap). I had an antero lateral approach.

I have had physio from week 4, with gym cycling, and stretching and strengthening.

Went back to my surgeon two weeks ago and he says the joint is excellent and I know it is.

I would be interested to know if anyone else has experienced something similar at around 5 / 6mths post op?

Cheers
Hippo

 

[Texas]

Hi Welcome I am a knee person so I dont know, but everyone will be along soon to help you. Sorry you are having trouble, sure hope you feel better soon......Kim

 

[Karen54]

Hi Hippo, check out PRGal's thread "What's Happened" in the After Hip Replacement - Recovery Discussions. Sorry I don't know how to put a link to it, but you should find it on Page 3. She describes a lot of the same symptoms you're having. I think it is still just the healing process going on. Good luck to you!

 

[JudyS]

Hi Hippo,
I am afraid I do not know where the knicker line that you are referring to is??? Just outside the hip or down towards the knee. I had knee surgery 6 months after my right hip replacement so It makes it difficult for me to separate issues. I still have some type of discomfort in the outside of the joint area. I am not sure if mine comes from my lower back though. My physical therapist is working on my ITB band so again I am not sure if that is from the knee surgery!!!

But with people saying up to a year to recover, it seems logical that this is part of the recovery for you. Can you go back to your physio to see what you should be working on to help? Did you call your OS's office as you were just there?
Of course if I would first try icing it until you can get in to see someone about it.
judy

 

[Hippo28Nov08]

Hi Judy
Thanks for your reply. The knicker line is top of the leg on outside. I went back to see my surgeon 3 weeks earlier than the planned routine visit. Surgeon said no to more physio but just to do the gentle quad exercises, and a bit of cycling. He did say that because of the state of my hip pre op, and that I limped for about a year, that I may limp up until a year post op, but that's not the major concern - its that sharp stabbing pain I get on the outside of the top of the leg which literally stops me in my tracks (happens each morning after walking about 20 steps and stays like it for the rest of the day), so for the last two weeks I have literally been shuffling around.
Cheers
Hippo

 

[JudyS]

hippo,
Was that your doc's advice for the stabbing pain as well? No more physio, just bike and quad exercises? Do ice though it should help.
judy

 

[Hippo28Nov08]

HI Judy,
Yes, but it has become much more frequent (every day and each time I try to walk) than when I saw him two weeks ago. It had only happened a couple of times when I saw the surgeon, and my main issue at that time was really the pain on the outside of the knee, ilio tibial band, and the knee cap lifting when I walk. The ilio tibial band problem is nothing compared to this new problem.
Cheers
Hippo

 

[Jamie]

Hi Hippo, check out PRGal's thread "What's Happened" in the After Hip Replacement - Recovery Discussions. Sorry I don't know how to put a link to it, but you should find it on Page 3. She describes a lot of the same symptoms you're having. I think it is still just the healing process going on. Good luck to you!

Here is a link to that thread:

https://bonesmart.org/forum/showthread.php?t=3071

 

[Josephine]

I suspect what you have is an inflammation of the bursa where the muscle glides over the femur, or more specifically, the greater trochanter, as shown in this image. The muscle concerned is known as the tensor fasciae lata which is closely associated with iliotibial tract (it's called a band where it passes across the front of the knee) so would also be caused by whatever is causing your ITB problems.

Sometimes this is simply an area of inflammation and sometimes it also has a little bag of fluid in the centre known as a bursa. Since the surgeon didn't mention this, I'm guessing there is no bursa but did you actually mention it to him? Either way, it still might benefit from an injection of steriods to encourage the inflammation to settle down.

There is also an issue that you would probably benefit from easing off on the gym work for a while, from icing the area regularly and possibly from taking some NSAIDs like ibuprofen (unless you have a medical reason for not using them).

IOW, bursitis is usually a signal that you're overdoing things and you should therefore take it easy on yourself for a while.

 

[UTdave]

Hey Hippo,

I'm at about 7 months on my first hip and have noticed a similar, though not exact problem. I get pain deep around the joint (not in the groin, but rather to the outside) that is like a stabbing electric shock. It shoots down to my knee. I think maybe my small rotators are getting stretched and worked and then spasm, possibly irritating the old sciatic nerve. Anyhow, self-diagnosis aside, the good thing is it's pretty predictable (too many days in a row of exercise without ibuprofen) and easily remedied with a day or two of rest and ibuprofen. The bad news is, the snow is melting and it's time to get outside, making it VERY hard to take a day off of exercise!!

Personally, I promised myself a visit to the outpt physio department this month for a "50,000 mile tune up" and am hoping they can tell me where my shortcomings lie now that some time has passed. Any athlete can tell you that you make the most gains in overall performance from working on your weakest single aspect of the game. Hopefully they can point that out for me.

 

[UTdave]

BTW - another funny thing is I have no such pain in the other, newer hip (which is about 3 months old now). I get some minor pain at the incision during heavy exercise, but nothing really lasting. Wonder if the first one scarred in a bit tight due to inability to really stretch because of the severe limitations of the remaining bad hip. Perhaps now those muscles are all getting stretched out? I'll tell ya in a year or so!

 

[Hippo28Nov08]

Hi Josephine,
Thank you for your reply and the illustration as well. I would say that you have hit the nail on the head and that is exactly what is happening. I have had a problem in the lower part of the iliotibial band since about week 5 or 6 with pain on the outside of the leg just above the knee and kneecap lifting up, so I guess it is all connected. That pain is also just the same and not getting any better. The physical therapist said the band was tight and needed stretching, so I have been doing stretches over the last couple of months, but to me, it has only made it all worse. My own feeling is just to let nature take it's course in repairing it at this stage, so I stopped the PT about 10 days ago. I told the surgeon i was extremely tender (like touching a boil) on the outside of the hip and there is still a large lump just below that which you can see visibly sliding over the femur in a large "click" when i move the leg at certain angles. He said it was just inflammation and would in time all settle down.
I appreciate your comments and suggestions and guess I might have to go back to a crutch to rest it while I am walking and see how that goes.
Cheers
Hippo

 

[PRGal]

Hi Hippo--it's my thread that was referenced here, so thought I'd chime in. I also had a touch of bursitis, which, at a little over 6 mos. post-op, is pretty much gone. Luckily, mine wasn't terribly severe, and I found that an ibuprofen or two, plus some occasional ice, helped a lot when it was at its worst. It doesn't go away overnight, but should improve over several weeks. Meanwhile, you may find this article informative:

https://emedicine.medscape.com/article/87788-overview

Hope it gets better soon!