THR Pain after 2015 Left hip replacement

pyrotaz

new member
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Dec 30, 2020
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Age
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Hi Everyone,

A Little history had my left hip replaced in Nov 2015. Have had ongoing issues with weakness in that hip. I also have an issue of very sudden onset of left severe groin pain that will last for a few hours then going away but leaving me very lame this happens once or twice a month. I always have tightness and pressure in that hip. This past Tuesday I woke up feeling great, got in and out if the shower and started feeling some pain in that hip, with in an hour I had steady 6 out of 10 pain that increased to 8 out of 10 pain on moment and could barely walk. I went to the ER and had blood work for an infection that came back normal. I had an x-ray that showed this:
: A 3 mm lucency is present at the bone metal interface
of the proximal lateral aspect of the left femoral component. No
other lucency adjacent to the hardware components. No
periprosthetic fracture. The pelvic ring is intact.
Impression:
1. Lucency adjacent to the proximal left femoral stem component
which could indicate loosening and/or infection. No
periprosthetic fracture.


I also had a CT scan that showed this:
Asymmetric atrophy of the LEFT psoas muscle and LEFT gluteus
medius. There is also asymmetric stranding along the anterior
aspect of the distal LEFT psoas and anterior to the LEFT
iliopsoas muscles, may reflect mild muscle contusion.


I was sent to an ortho who was very concerned for infection. He placed me on Celebrex and 3 different muscle relaxants. He also had more blood work completed and that came back as normal. He placed the order for a stat MRI with contrast and that showed this:
FINDINGS: The patient has underwent a left total hip arthroplasty since the previous remote 2015 MRI. There is blooming artifact from the patient's total hip arthroplasty. There is edema throughout the captured iliacus muscle and iliopsoas muscle. This is not completely imaged. Its most caudal aspect is not captured. There is no focal collection of fluid. There appears to be a bit of fatty atrophy to the gluteus medius muscle compared to the contralateral right side. There is no edema. I see no other signal or structural abnormality to the soft tissues about the total hip. There is no abnormal enhancement after contrast administration. The pelvis and right hip have a normal appearance. Normal sacroiliac joints. IMPRESSION: Total left hip arthroplasty appears anatomic. There is edema within the iliacus muscle and iliopsoas junction. This is not fully captured. There is no localized collection of fluid. There is some mild fatty atrophy to the left gluteus medius muscles compared to the contralateral right side.

At the moment the pain is a steady 1, although if I move the wrong way it goes to a 5. I am using a cane If I am doing a lot of walking. I am waiting to hear from my ortho but was wondering if anyone has had any similar issues.

Thank you

Marc
 
Hello Marc,
Welcome to BoneSmart. While I don't have any answers for you I am sorry you're dealing with steady pain. I hope you're able to connect with your surgeon soon to make some sense out of this for you and work toward resolving your pain permanently. I wish you only the best. Please stay in touch and let us know what you learn. We're here for you and we care!
@pyrotaz
 
Update:
Saw the Orthro who did my original surgery back in 2015. He did another x-ray looked at it, never looked at the hip and then stated, " I do not due revisions" and sent me to another surgeon that does revisions. Say her and did a round of blood work and more x-rays. She stated that x-rays show possible loosening in one area. She set up a 3 stage Nuclear Bone scan. Had the test and the results states everything seemed normal except for some photopenia around the head if the implant. Any suggestion on what this could suggest? Meet with her next week again
 
@pyrotaz …. It would be difficult for us to determine what may be going on. The situation you’re describing is not a common post-op complaint. The best thing is for you to have an in-depth conversation with your new surgeon to see what is recommended going forward. You can ask about what may have caused your problem, but don’t be surprised if the surgeon cannot say for sure. Many times we don’t know what causes the loss of bone health. But usually there are things that can be done, so I hope your surgeon has some options for you to consider. Please let us know how things go.
 

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