United States
Hi everyone. I’m 61, 2.5 years out from a right THR (April 2024, cemented femoral stem), and I’ve had pain since early on. I’m hoping to hear from anyone with a similar story and to get leads on a revision specialist for a second opinion. I live in the Seattle area but am willing to travel anywhere for a great revision specialist for a second opinion.
My history
My surgeon told me he found during surgery that my femur is extremely wide, one of the widest he’s operated on, and he couldn’t have known beforehand. The largest stock stem he had still wasn’t wide enough, so he cemented it in.
The pain started in my groin and was first diagnosed as iliopsoas tendonitis. It never went away. It has since spread to my mid and upper thigh, and the groin is hurting again. It’s sharp when I first load the leg, when I start walking after sitting or lying down, and when I lift the leg in bed (like rolling onto my side). My first steps are the worst. I hobble, and I’m not sure the limp ever fully goes away. Prolonged cycling and the elliptical make my thigh pain worse. It doesn’t wake me at night. I have no numbness or tingling, but that quad looks smaller than the other side.
For months, I was told it should improve and was sent to physio. About a year ago I asked whether the implant was moving, and it was dismissed. He checked with colleagues, who agreed.
What the imaging shows
My surgeon says my symptoms sound more like the stem is loosening, but the images don’t prove it, so he isn’t convinced and has put revision off. He’s cautious because revision could leave me worse off. He plans to revise only if pain or function becomes intolerable or the imaging progresses. He’s having custom stems made in case, and my next X-rays are in 6 months, sooner if I get worse. Before I commit to surgery, I want to be sure the stem is really the cause and not something else.
What I’m hoping to learn
My history
My surgeon told me he found during surgery that my femur is extremely wide, one of the widest he’s operated on, and he couldn’t have known beforehand. The largest stock stem he had still wasn’t wide enough, so he cemented it in.
The pain started in my groin and was first diagnosed as iliopsoas tendonitis. It never went away. It has since spread to my mid and upper thigh, and the groin is hurting again. It’s sharp when I first load the leg, when I start walking after sitting or lying down, and when I lift the leg in bed (like rolling onto my side). My first steps are the worst. I hobble, and I’m not sure the limp ever fully goes away. Prolonged cycling and the elliptical make my thigh pain worse. It doesn’t wake me at night. I have no numbness or tingling, but that quad looks smaller than the other side.
For months, I was told it should improve and was sent to physio. About a year ago I asked whether the implant was moving, and it was dismissed. He checked with colleagues, who agreed.
What the imaging shows
- X-rays before each visit (Oct 2025, Mar 2026, Aug 2026) show a faint lucent line along the stem-cement interface, up to 2 mm, more prominent on the outer side. It wasn’t on my early post-op films but hasn’t progressed since late 2025.
- No sign of the stem sinking or migrating, and no fracture.
- ESR and CRP were normal in March.
- A CT this week, done to plan a custom stem, shows the same mild lucency and no fracture. It also notes a small amount of heterotopic ossification near the greater trochanter and demineralized bones.
My surgeon says my symptoms sound more like the stem is loosening, but the images don’t prove it, so he isn’t convinced and has put revision off. He’s cautious because revision could leave me worse off. He plans to revise only if pain or function becomes intolerable or the imaging progresses. He’s having custom stems made in case, and my next X-rays are in 6 months, sooner if I get worse. Before I commit to surgery, I want to be sure the stem is really the cause and not something else.
What I’m hoping to learn
- Has anyone had a stem that looked stable or borderline on X-rays but turned out to be loose? What finally confirmed it?
- If you had a revision, how did the pain compare to before?
- Has anyone had a custom stem for a very wide canal? How did it go?
- Did anyone have similar pain that turned out to be psoas or something other than the stem?
- Can anyone recommend a hip revision specialist in Washington State (or worth traveling to) for a second opinion?
