Hemi-Arthroplasty Pain in hip after hip replacement surgery

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Steak

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Hello guys, my dad had a fall 4 months ago and broke his left hip.

He had a left hip replacement surgery done and after it he complaints there are pain in his left hip.

Til now he still exprincing pain in his left hip and is not encourage to walk around.

We had visited the doctor again this month for a review of his X-rays and the doctor said the X-rays looks very good and not addressing the pain my father is feeling.

I am lost in what to do next and why is my father still feeling pain. I be very glad if someone can let me know what is the problem.

Below are the photos of my dad X-rays
ai.imgur.com_drJnPRA.jpg

ai.imgur.com_YVXRv81.jpg
 
Did your father have Physical Therapy? It could be muscle related. Strengthening the muscles and stretching may help if there is proven nothing wrong with the replacement itself.
 
I think you need @Josephine to take a look at those x-rays. She is away from the forum at the moment, but she will be back soon. I have tagged her, so she will be notified of this thread when she returns.
 
Did your father have Physical Therapy? It could be muscle related. Strengthening the muscles and stretching may help if there is proven nothing wrong with the replacement itself.

Hello there. A few weeks after his surgery had Physical Therapy but he rarely particpate. He keeps his saying his left hip and thigh area is painful, sigh.

I wish the doctor could have help address the problem but he says the pain is nothing to do with the hip surgery even though my father pain is on the hip surgery side.
 
@Steak is your father taking anything for the pain? If he is not moving around and not taking anything for the pain that is an issue. It's cycle, you need pain medication to get more mobile. Getting mobile means those muscles gain strength. Icing also helps with post op pain. Here are some articles for you to read while you are waiting for Jo:
First are the BoneSmart mantras ....
- rest, elevate, ice and take your pain meds by the clock
- if it hurts, don't do it and don't allow anyone - especially a physiotherapist - to do it to you
- if your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again
- if you won't die if it's not done, don't do it
- never stand when you can sit, never sit when you can lie down, never stay awake when you can go to sleep!
- be active as much as you need to be but not more than is necessary, meaning so much that you end up being in pain, exhausted or desperate to sit down or lay down!

Pain management and the pain chart
Healing: how long does it take?
Chart representation of THR recovery
Dislocation risk and 90 degree rule
Energy drain for THRs
Pain and swelling control: elevation is the key
Activity progression for THRs
Home physio (PT)
Post op blues is a reality - be prepared for it
Myth busting: on getting addicted to pain meds
Sleep deprivation is pretty much inevitable - but what causes it?
 
Jaycey, fantastic! I be reading those. Thank you so much!
Yes, he's taking pain meds. There's 3 types. Panadol, stronger pain med and pain relief patches. He mention the pain is achy bone pain.
His left feet have been swollen 3-4 days ago and have gone down abit after some massage and hot towels
 
Hi @Steak
Is this pain constant, or only on moving?
Did he have this pain the ENTIRE way through, or just recently?
Does it go away and return, or is it always present?
 
So sorry to hear your father is having problems. Josephine will be along very soon to chat with you. Is there any way you can directly load the xrays to a post as an image? Taking a photo of them on a computer screen makes them very difficult to see clearly.
 
@Steak I wonder if your dad is still getting out daily and working or if he is home sitting most of the time. The best therapy for his hip is walking. He may want to check in with a Physio to make sure he is walking with a good gait in case he has picked up any bad habits in his walk during recovery. If he is just walking around his office and a lot of up & down with sitting he likely needs a short walk or two a day when he is just walking even if it is just a couple of blocks.

I just heard from a friend that you had a very big storm in Singapore earlier today - I hope your roof is still on your house! :)
 
I'm going to ask you some questions and it would be very helpful if you would answer each one individually - numbered as I have done - in as much detail as you can then I'll come back as see where things are ....

1. what approach did your father have for your surgery? Anterior, posterior, lateral? You can look here to see the various types THR approaches or incisions

1. what are his pain levels right now? (remember the 1-10 scale: 1 = no pain and 10 = the worst you can imagine. And don't compare this with the bone-on-bone pain you had before surgery!
aflagsforworship.co.uk_jo_pic_images_nonofisss.gif
)
Also don't forget to include other forms of pain such as soreness, burning, stabbing, throbbing, aching, swelling and stiffness

2. what pain medications has he been prescribed, how much is he taking (in mg please) and how often?

3. what is his activity level? What does he do in the way of housework, cooking, cleaning, shopping, etc., and

7. what kind of PT exercises and exercises at home is he doing? How much and how often? (and detailed details would be appreciated, please! Reps, sets and session and all that)

Note:
If you're not familiar with this, it goes like so:
1 lift of a 500kg bell bar = 1 rep or repetition.
Doing 5 reps and then a brief rest = 1 set of 5.
And doing 5 sets and finishing = a session.
 
Can you tell me the exact site of his pain using this chart?
Please note the instructions in the smaller image

aflagsforworship.co.uk_jo_pic_images_referesrs.jpg


aflagsforworship.co.uk_jo_pic_images_ahipsodsd.jpg
 
Wow so many replies from helpful folks here!

Hi @Steak
Is this pain constant, or only on moving?
Did he have this pain the ENTIRE way through, or just recently?
Does it go away and return, or is it always present?

Hello MarjorHeidi, the pain have been constant since surgery and he gets it while moving.


So sorry to hear your father is having problems. Josephine will be along very soon to chat with you. Is there any way you can directly load the xrays to a post as an image? Taking a photo of them on a computer screen makes them very difficult to see clearly.

Thank you for your concern Jamie, Im afraid these are the only shots of xrays I have. It was taken over the doctor's shoulder with an iphone.


@Steak I wonder if your dad is still getting out daily and working or if he is home sitting most of the time. The best therapy for his hip is walking. He may want to check in with a Physio to make sure he is walking with a good gait in case he has picked up any bad habits in his walk during recovery. If he is just walking around his office and a lot of up & down with sitting he likely needs a short walk or two a day when he is just walking even if it is just a couple of blocks.

I just heard from a friend that you had a very big storm in Singapore earlier today - I hope your roof is still on your house! :)

At the moment he is always on his bed :( He gets tired very easily and the pain is stopping him from trying to move around.

On side note on the weather here in Singapore, Yes its very Big rain! Also today! Roof still on, we mostly stay in conceret apartments here so its quite solid :)
 
Hello Josephine! I've been hearing so much about you!

I will get back to you with the answers cause I don't have all of them right now!

Updated @Josephine

1. what approach did your father have for your surgery?
He had lateral, its through the side
1. what are his pain levels right now?
Pain level is 6 when moving, aching and stiffness.
Left foot was swollen 6 days ago and looks normal today but slightly darker then the right

2. what pain medications has he been prescribed, how much is he taking (in mg please) and how often?
Paracetamol 500MG tab, he takes 2 of these once a day.
Etoricoxib 60MG tab (Arcoxia), he doesn't take this.

3. what is his activity level? What does he do in the way of housework, cooking, cleaning, shopping, etc.,
7. what kind of PT exercises and exercises at home is he doing?
He has been discharge from the hospital and rehabilitation centre on the 26th Sept and so far his mostly on his bed, sitting, lying down back and sometimes front when he wants to write something. We have a caretaker taking care of him and the last time he went to bathe was 6 days ago (maybe that's why got swollen foot?)

Can you tell me the exact site of his pain using this chart?
LF4 D, E, F, G
LF5 B, C
LF6 B, C
 
Last edited by a moderator:
3. what is his activity level?
Pain level is 6 when moving, aching and stiffness.
Left foot was swollen 6 days ago and looks normal today but slightly darker then the right
okay ....
Paracetamol 500MG tab, he takes 2 of these once a day.
Etoricoxib 60MG tab (Arcoxia), he doesn't take this.
In an earlier post you said he was taking 3 types. Panadol, a stronger pain med and pain relief patches. Can you give me more detail here? Like what is the 'stronger pain med' and what medication is in the patches?
He has been discharge from the hospital and rehabilitation centre on the 26th Sept and so far his mostly on his bed, sitting, lying down back and sometimes front when he wants to write something. We have a caretaker taking care of him and the last time he went to bathe was 6 days ago (maybe that's why got swollen foot?)
What was the date of his surgery?
 
And this is roughly the site of his pain then?

steak.jpg
 
3. what is his activity level?
Mostly on his bed. Visits the toilet to poo 8 meters away. Also Showered today and yesterday after the swelling of his foot went down
In an earlier post you said he was taking 3 types. Panadol, a stronger pain med and pain relief patches. Can you give me more detail here? Like what is the 'stronger pain med' and what medication is in the patches?
Etoricoxib 60MG TAB (Arcoxia) is the stronger pain med.
The pain relief patches is Anti-inflammatory Analgesic KefenTech Plaster

What was the date of his surgery?
Date of surgery was on 12th of July.
Ketoprofen 30mg.

And this is roughly the site of his pain then?
I reconfirm with him and his main pain is in L5f B,C and L6f B,C when he tries to walk.
He does say he tight area L4f, L5f, L6f D,E,F,G also feels aching
[/QUOTE]
 
Thank you for the surgery date. But you also haven't shared with us what his age is.

Are you serious telling me that after 16 weeks, he's still in pain and is not ambulant even about his own home? Does his surgeon know this or his GP? This seems absolutely terrible. He should be walking about, even going out for trips to the shops and the park.

Etoricoxib is not a pain killer, it's an anti-inflammatory, quite a different kind of medication, as is Ketoprofen, the active ingredient of KefenTech. They are not pain killers and anyway, he shouldn't be using two types of anti-inflammatories - that's very dangerous to his stomach.

So apart from the fact that his medications are totally inadequate for the pain he is experiencing, the pain may actually be caused by his inactivity. Our muscles are made to work and function and if they cannot do that, the experience cramps and soreness as a result. He needs to be taking paracetamol (acetaminophen) for his pain and getting active to iron the cramps out of his muscles.
 
He is appoarching 69. We told his consulting doctor about his pain and the doctor just said he shouldn't be exprincing pain and could be spinal related and stopped at there. Not very helpful to us.

Oh my! We had no idea, good thing he hasn't taken Etoricoxib yet. Will take it away.

I see, ok on my next visit will encourage him to move around more with aid of paracetamol.

Thank you so much Josphine :)
 
When you do, make sure he has 1,000mgs 3-4 times a day. He will feel a lot better for it.

And make him take walks around the house for about 5 minutes every hour on the hour. As he gets better, he could increase that to 10 minutes and so on. By the end of next week, he should be walking well enough.
 
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