THR One yr post THR with ongoing pain - MRI report included

[benne68]

@RPDX24 Just want you to know that Hip4Life has been away on vacation since her last post. I'm sure she will reply to you once she is back.

 

[Layla]

I am terrified that this will not improve and I am commiting to another surgery that is irreversible. .

I understand this journey is way longer than what you thought you signed up for. I am sorry you're still dealing with pain and uncertainty. You've already been through major surgery and come out on the other side, you can do it again. At 52 you're younger and likely stronger than you'll ever be and with the research you've done coupled with your OS's skill and your trust in him, the odds are that this procedure will be what gets you back on track.
We're here for you all the way! You can do this, RPDX.

 

[Hip4life]

@RPDX24 Hi, Eric. Sorry for my absence. With my psoas issue, there would be times that my symptoms eased up and then came raging back. The groin and back pain were always there with activity-especially walking. I remember complaining to my OS that the hip joint pain was gone post op but I still could only walk about half the distance I was walking pre-hip issues. The pain was significant enough to make me have to stop my walk. I'd rest and the pain would subside for the most part. Sometimes, as you described, I would make a particular movement, feeling a sliding across the front of my hip with a "snapping" sensation. That could bring tears to my eyes and then I would have increased groin pain for a few days afterward. I could not get into my driver's seat without significant pain/stiffness. None of that was acceptable to me. I have been an athlete and physically active all my life. I had a physically demanding job. Being in more or less constant pain was NOT how I wanted to live. Where was the pain relief everyone else got when they were recovered from their THR?!

I understand your frustration and apprehension. Pain and symptoms are going to be different for each individual with the same diagnosis. I never really paid much attention to individual areas, per se. My discomfort was specific to the groin and lower back but could also be diffuse through the rest of the glutes/hip. I attributed that to my pelvic/hip muscles trying to compensate again for the way I moved due to my tendinitis. Will there be future problems? I can't say. So far, I'm doing great. In fact, the back pain and the diffuse hip pain pretty much were fixed at that time by the release. I have other arthritic changes to the pelvis and the spine with the accompanying discomforts but I'm not crossing those bridges until I have to. The one thing I can emphatically say is I don't have ANY regrets having done the surgery. I got the freedom to live that physically active life I wanted for the past going on 6 years, now. Yeah. It was worth it I'd say. That's all I could ever ask for.

 

[RPDX24]

@Hip4life I’ve tried to reach out to others that have had this procedure and no response yet. I think what is really concerning is the fact my glutes have signs of atrophy and tendonapthy as well. It seems they would need to be healthy to take over some of the load of if I move ahead with a Psoas release So I don’t know how to proceed.

The first 6 months after THR I was lifting my leg into the car, but I don’t know if my body learned to compensate. It isn’t something that bothers me at this point. The standard physical in office test for Psoas impingement doesn’t show clear indication. It did early on for sure. My Psoas strength got better than my glutes started to deteriorate. The more I try to walk, the pain is vague in the front but burns in the lower back and upper glute on the side of my surgery. I am considering Shockwave therapy for my glutes. I’m just very uncomfortable moving ahead when my glutes are in such rough shape. Seems like results are a mixed bag as well for Psoas release. Did you have pain with rest? Mine is only bad when waking more than half a block. I feel like my case is somehow more unique and complex:( thank you, for getting back to me.

 

[benne68]

tried to reach out to others that have had this procedure and no response yet

Sometimes former members stop coming to the forum once their issue is resolved, so that might be the problem you are having getting replies. If you look at the date of the last post in their thread, it may give you an idea of whether they are currently an active member. If they've been on recently, be sure you have tagged them correctly.

We'll be happy to help with this if you tell us which members you've tried to reach.

 

[Layla]

Hi RPDX,
If you click / tap on the avatar of any member, which in your case is the aqua circle with the R in the middle, you will see a "Last seen" date, noting when they were last on the forum.
Hope this helps!

Tagging correctly may bring you some luck even if the member hasn't been seen in awhile since some members sign up for email notifications.

Wishing you a pleasant weekend!
@RPDX24

 

[Hip4life]

@RPDX24 Hi, Eric. If you're still unsure, you could always opt to go back to trying conservative measures. A good PT should be able to address your glutes problems. However, it's interesting to me that you're concerned with this muscle group which is the opposite worker of the iliopsoas muscle group. Luckily, like other features of the body, there are helpers and redundancies so we can continue to function even if one part is not able to do its job.

All of my OS consults gave me that option of continued conservative treatment vs surgery. It's a safe choice to pursue. Then it's finding the right therapist who can actually pinpoint the right course of treatment. I've been down that road a few times, as well. You may very well end right back at square one. But you will have tried. As one of my fellow BoneSmarties counseled me when I was in a similar spot: "You will still have the [other] surgery option available if this doesn't work out."

I would never advise anyone to go against their intuition. You know your body the best. Sometimes issues can improve on their own with a little help and time. Some don't. If you're feeling that you need to try alternative therapies first, then go for it. You'll know eventually if they're going to work. It will take effort and patience on your part to see those results, though. It'll also buy you some time to work through how you feel about surgery if it comes down to that as your final option. Even then, it's still an elective surgery and you still have the choice. Keep us in the loop. -Pat

 

[RPDX24]

@Hip4life Hi, my main concern is the main muscle group that would need to take over the stability and load for the area are my glutes. The min and med tendons both have tendinopathy. And my
Glutes are not firing. Know one seems to be be sure of the main driver. So I could make a bad situation worse. I am just petrified. I have another MRI on Sept 10th. I'm thinking abioit trying another injection as well. I can't seem to think straight around this situation. Did you have any glute and lower back pain?

Thank you for your support and dialogue around this!

 

[Hip4life]

@RPDX24 Hi, Eric. I understand the trepidation. I did NOT have any glute pain and the release actually relieved the low back ache I would have when walking for any length of time. I went back to being on my feet for practically 12 hours during my work day, walking, hiking, cycling, swimming, and all my other activities without having to give it another thought. It took a little patience and a couple of months to get the strength COMPLETELY back in my leg but I was back to doing most of that activity, WITHOUT PAIN, in a couple of weeks. Honestly, after the initial soreness from the release, I only thought about how great it was to be getting back to my life. Finally! There were no other issues that brought my attention back to it.

I might add, anecdotally, that when I had to recover and rehab my opposite hip tendon repair, my right THR/tendon release hip and leg were champs in getting it done. I asked a lot of them during those weeks and months, and they never let me down. I can say I never thought once about them not being up to the task during that time.

It will be interesting to hear what your new MRI says. Keep us posted. Let us know how we can help.

 

[RPDX24]

@Hip4life

Thank you,

I want so bad to have your experience. Just having my glutes in shutdown mode and the tendons degenerative doesn’t bode well for a Psoas release success. I wish I had a clear path forward. Glute tendon issues with Psoas issues seems to be foreign territory for all. My glutes weren’t an issue until maybe 12 months in. I think they shut down as the psoas became overactive. That is simply my theory though. I want to walk without pain and resume living as this is not a life I want to live long term.

 

[Hip4life]

@RPDX24 I know. Don't discount what a good PT program can do for you post release. I did not need PT for it but I didn't have the glute issues. Once the "problem child" is fixed, I would think you could get some definitive help with the other muscles and strengthening. Hang in there. Pat.

 

[RPDX24]

@Hip4life Hi, I’m doing another injection next week. Without the steroid. Are you surprised o can do leg lifts and get into my car without much discomfort? Again, this was not the case for the first 9 months. In theory I guess my glutes/hamstrings and lower back bio mechanics could have changed to compensate for my Psoas. I am just so scared about another irreversible misstep. I can barely walk my dog a block without feeling unstable and pain setting in. I’ve also asked another hospital to evaluate my CT for cup overhang and positioning since it was not mentioned in the report. I can’t live like this.

 

[Deni444]

I can't provide a list of my different soft tissue issues, I have so many. I can relate to a very slow recovery experiencing many of the difficulties you describe. My new hip is good but my soft tissue is a mess on both sides after too many years of living with undiagnosed dysplasia and worn out hips. I can only imagine what I put my muscles and tendons through, hill walking for 15 miles and 5 day wilderness canoeing. It's incredibly slow but I am seeing improvement now following THR on just one side. I get frequent set backs as the soft tissue relapses particularly if I push one set of muscles too far. A tiny bit extra is often too much. Physio although undoubtedly helpful is something I have to be incredibly careful with because of the imbalances. Walking very short distances but multiple times a day is what I believe has helped me most. I was beginning to think I'd never get better because I couldn't achieve a short outdoor walk without having a serious relapse. They say that, walking is the gentlest activity for a full body exercise if approached with a great deal of attention to form and posture. I'm convinced through experience that this is true. It's a simple thing that's made a huge difference. At first I did 5 minutes and then 10 minutes at a time up and down my conservatory. It's helping a lot.

I can't currently walk my over excited dog... I really feel for you but I'm not giving in. I'm determined to be able to walk her... Eventually. Don't give up, keep your spirits up

 

[Layla]

I am sorry for all of the pain you're enduring. I do hope the injection next week brings you some relief.
Wishing you comfort and brighter days. Hang in there.
@RPDX24

 

[Hip4life]

@RPDX24 Hi, Eric. So, the injection is just a pain killer (e.g. lidocaine, etc.)? Is it to try and definitively see if the IP tendon is the culprit? Pain relief? Both? I don't know what to make of the fact that you don't have the "classic" symptoms (no pain with stairs and getting into the car, etc.) of IP tendonitis. Soft tissue and pain can be such complex issues to try and sort out. Our bodies are good at compensating for a lot but what manifests itself as a result can be unexpected and confusing. I do understand the frustration, panic, and desperation all of this causes. Keep soldiering on the best you can until you get feedback from the CT interpretation, MRI, and the injection. I feel there has to be an answer for you. You just haven't turned it up yet. It may be a combination of therapies, as well. You're persistent and being your own best advocate. That is great but it is so hard to be patient with the sometimes slow turning of the wheels in medicine, especially when you're hurting. Hoping this round has your answer. Blessings for comfort as you wait. We're here for you. -Pat.

 

[Layla]

Stopping by to say Hi RPDX and see how your doing. Did you experience any relief through the injections?
I hope so. Please let us know how you're doing. Here for you if you need support.
Wishing you a peaceful weekend.
@RPDX24

 

[RPDX24]

Hi,

I still need to do the injection. I’m doing a follow up MRI at the end of the month. I’m running out of options and my mobility is awful. I regret letting myself have THR. I should have exhausted my options. There is scar tissue around the cup as well as Psoas impingement. The glutes have shut down;(

Wish I had better news!! I’m going to ask for a lidocaine injection only to check the Psoas.

 

[Layla]

I am so sorry. That is a lot. I wish you comfort and some luck with what you have planned soon.
One step at a time. Don't give up and know that we're here for you if you need us.
@RPDX24

 

[Jamie]

I'm so sorry you're having difficulty finding someone who can help with what you're going through. Without reading back through your thread to find out, I hope you won't mind me asking if you had considered getting a video review of your case by the surgeon team at the Hospital for Special Surgery in New York city? The team is especially good with complex cases so they might have some options not put on the table for you. I know one of the surgeons in this group, Dr. Alejandro Della Valle if you want to request an appointment with him.

 

[benne68]

Hi @RPDX24.

We haven't heard from you in a while and are wondering how you are doing. Did the lidocaine injection shed any light on what was going on? Please give us an update when you have a chance.

Happy holidays!