THR Pain one year after, sigh

[HipButSquare]

I am having undiagnosed pain one year out from my posterior right hip replacement.

My recent MRI and blood work were fine. I had gotten up to walking a mile and a half and now can barely walk around the block.

I’m on Gabapentin but I don’t think it helps much. I take Tylenol once in a while.

I’ve put on almost twenty pounds since the surgery and can’t exercise to take off the weight. I will cut calories.

My pain is mainly in the quad, with numbness in the outside of the hip.

My surgeon is puzzled and he has decades of experience doing hip replacements. He’s not going to do exploratory surgery.

It so frustrating to not know if I’ll be able to get past this pain.

 

[Layla]

Hello HipButSquare, Welcome to BoneSmart and thanks for joining us!

Please share the exact date of your Right THR so we’re able to create a signature for you.

I am sorry you’re currently struggling with pain. Depending upon what other activity you’re engaging in daily through work, exercise, involvement in sports, it’s difficult to know what’s going on. It you’re unable to trace it to any new activity, and you’re not getting any satisfaction from your surgeon, you’re far enough post op to consider a second opinion from a reputable surgeon, totally unrelated to your current surgeon or the practice he’s a part of.

I‘d search for a revision specialist. I am not hinting that you need a revision, but if you do decide to seek a second opinion, it may as well be with someone experienced in revision that can help you determine the origin of your pain and work toward resolving the issue.

Please keep us posted, we’re here for support if you need us.
@HipButSquare

 

[HipButSquare]

Hello Layla, thanks for the post.

My total hip replacement on the right hip, posterior approach, was on 7/13/2022.

My surgeon is willing to fix his own work, some will not. The trouble is that he sees nothing wrong in the recent X-rays or the MRI.

My activity level is close to zero. I walk a little bit on a desk treadmill and perhaps a quarter of a mile outside, infrequently.

I’m not involved in any sports or exercise, something that is not good, I realize.

I do not want to go through a revision as that will set me back significantly. If someone finds a clear reason for a revision then I will go through with it.

 

[Layla]

Thanks for sharing your surgery date.
I do hope you find the source of the pain you’re struggling with, or that it resolves on its own soon. It is difficult enough to engage in activity, let alone sports when we’re dealing with discomfort and pain. I do understand your hesitation in not seeking a second opinion if you have full trust in your surgeon, however, it may be something you’ll consider if this continues and your surgeon is out of ideas to help discover the source of your pain. I wish you only the best!
@HipButSquare

 

[HipButSquare]

I think the hardest thing to deal with is the assumption that people have that everything must have gone perfectly and that I should be feeling no pain one year out.

Clearly, that is not the case for some percentage of people.

The other issue is not being able to exercise. At 45 years of age, I ran a 5:57 mile. Now, at 58, I can’t run or row, so I can’t raise my heart rate.

The legs are the largest levers on the body and they raise the heart rate the most.

I have a small desk treadmill and I try to walk while working but the pain limits me.

Is it better to stop almost all activity or should I keep walking through the pain?

 

[Jaycey]

Is it better to stop almost all activity or should I keep walking through the pain?

I would stop all activity and see if this eases. Does icing the area help at all?

 

[Charlie33]

In line with @Layla suggestion to get a second opinion, I'd also seek out a good physiatrist for an evaluation (description link below). In my view they fill a gap between the surgeon and the physical therapist, are objective with no skin in the game and also look at the whole picture connection between spine/pelvis which is critical. I found a resource after various trial and error with just OS and PT and found helpful. Just use any search engine.

 

[HipButSquare]

Funny, my wife had hip cup resurfacing at HSS. She came through it fine. I provided ice machine and leg bending machine support.

But, we’re a long way from New York now. Just curious, why a recommendation for HSS? Is this site somehow affiliated with HSS?

The hip cup resurfacing was far less invasive and involved than my total hip replacement, lol.

I first read that as psychiatrist and thought, well, I do need to have my head examined.

I wonder if my insurance covers a physiatrist.

 

[Layla]

Just curious, why a recommendation for HSS? Is this site somehow affiliated with HSS?

No, BoneSmart is not affiliated with HSS, but through a quick online search you will find that HSS has been ranked the # 1 hospital in the nation for Orthopedics for the past thirteen years.

 

[HipButSquare]

Just curious, why a recommendation for HSS? Is this site somehow affiliated with HSS?

No, BoneSmart is not affiliated with HSS, but through a quick online search you will find that HSS has been ranked the # 1 hospital in the nation for Orthopedics for the past thirteen years.

I can believe it, I’m not surprised. We lived in Manhattan for 20 years before moving out. This was before I had my hip replacement done.

My wife said she had to apply to HSS in order to be accepted for surgery.

I did have a $1.5m robot assist in my surgery. The surgeon said the robot was useful for setting leg length.

 

[Layla]

My wife said she had to apply to HSS in order to be accepted for surgery.

Made me chuckle.
Your wife had to "apply", but then she got to interview and decide whether they got the job.

 

[HipButSquare]

My wife said she had to apply to HSS in order to be accepted for surgery.

Made me chuckle.
Your wife had to "apply", but then she got to interview and decide whether they got the job.

Both sides have to agree. If the surgeon didn’t want to take the case, he wouldn’t have. She had to submit her X-rays, MRIs, and reports.

It’s New York. I’m pretty sure they have plenty of patients to choose from.

 

[Layla]

It’s New York. I’m pretty sure they have plenty of patients to choose from

Yes! Plus I'm sure people travel from surrounding states also.

 

[HipButSquare]

It’s New York. I’m pretty sure they have plenty of patients to choose from

Yes! Plus I'm sure people travel from surrounding states also.

Yes, people come from all over.

While I was waiting for my wife to go through her surgery, and following her number on the big screen televisions, I struck up a conversation with the woman sitting next to me.

She was from Nantucket and was there for her son. He was young, perhaps 18-22, and he had managed to damage both his hip sockets by hitting a lot of golf balls to try to attract the attention of golf pros.

She was facing a month or more in a hotel room, working with the ice and leg bending machines.

 

[Layla]

If I lived within an hour or two of HSS it's where I'd want to have my surgery. I don't know about any further than that though. Flying would make me too nervous. I'd worry about a blood clot. That's just me though. Some members have flown relatively soon after joint replacement and it was a non event.

 

[Charlie33]

Hi, suggested HSS link as it is an excellent source of information, and know 3 folks who want there for hips and had a great experience.
That said did not have my surgery there and honestly feel a good, community based hospital with a surgeon doing 100+ a year will do a fantastic job anywhere in the world.

When I saw my physiatrist for the first time it shed
a lot of light on my situation. For me, less stretching, more functional movement exercises were the key. Walking and biking are great for general activity and cardio, but only part of a bigger fitness picture I didn’t appreciate. Other than upper body, no free weights for me, all body weight or resistance with bands etc. is all I feel I need to build range and strength. That said everyone has their own path to find!

Also physiatrist also coordinated with my PT so when I wrapped up earlier this year with formal PT I had a foundation to build off.

Anyway hope this helps. You are in great hands with Layla Mojo and the folks here!

 

[HipButSquare]

If I lived within an hour or two of HSS it's where I'd want to have my surgery. I don't know about any further than that though. Flying would make me too nervous. I'd worry about a blood clot. That's just me though. Some members have flown relatively soon after joint replacement and it was a non event.

I can’t imagine having tried to get on a plane shortly after surgery considering the pain I was in.

They wanted to send me home the same day as the surgery but I was so shaky they stashed me in pre-op for the night. That wasn’t pleasant but it was interesting to listen to all the action.

I considered staying in a hotel across the street from the hospital for a few days after surgery but wound up paying $500 for an ambulance to take me home and had them use their motorized wheelchair to climb up the stairs to the second floor.

The ambulance sent me a bill with the following explanation for the trip: “Unspecified lack of coordination.” That gave me a good laugh.

Charlie33, thanks for the tips. I might try to find a local physiatrist. I am now out of the New York scene. The city imposes its own stressors, I know them well, but I am not up for it now.

A big issue is dealing with one’s spouse’s expectations for recovery and the sadness at not meeting those expectations.

 

[HipButSquare]

Oh, your statement about a surgeon doing 100+ a year was telling. My surgeon has done a lot of hip replacements and is the section head at the hospital.

He told me how many they had to do to pay off the robot and it was a lot.

I don’t expect perfect results from any surgeon and I don’t assume someone else would have done better.

We are all experiments of one and we take different amounts of time to heal.

 

[Eman85]

I always like the price of the robot somehow makes it better. It's like putting me in a formula 1 car, a lot has to do with who is driving. No pressure on the hospital and docs to pay for that machine. My money is always on the ones that do it for the passion not the money or the reputation. Find a doc that is interested in you and your problem.

 

[HipButSquare]

I always like the price of the robot somehow makes it better. It's like putting me in a formula 1 car, a lot has to do with who is driving. No pressure on the hospital and docs to pay for that machine. My money is always on the ones that do it for the passion not the money or the reputation. Find a doc that is interested in you and your problem.

The robot doesn’t do the surgery, it measures more accurately than a human can for setting leg length, and helps with cutting the exact amount for fitting the cup.

I’ll take a skilled surgeon with robotic assistance over just a skilled surgeon. When the surgeon told me that the robot provides for greater accuracy, I believed him.

Passion has little to do with skill and accuracy. I don’t think a passionate surgeon with crude tools would have done a better job.