THR Persisting trochanteric pain post-op THR

tmzuri

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I am a 75 y/o male who had a THR in the USA 10 months ago. Since the initial post operative recovery period there has been persistent pain over the greater trochanter with any weight bearing. The pain resolves with sitting and reclining. The pain is focal, the more I ambulate the more severe it becomes. I now need to use a cane to take weight off the affected leg and cannot walk 40-50 yards before needing to sit for pain relief.

As I now live in retirement in SE Asia I have contacted the operating orthopedist by e-mail and he had no suggestions or solutions beyond those offered by local orthopedists. Interventions have included x-ray (no evidence of prosthesis instability), local corticosteroid injections into the trochanteric bursa times 2 (no relief), an MRI of the lumbar spine to rule out nerve impringement (disc space narrowing L2-L3 but no nerve entrapment), lab tests for possible subacute infection (all normal).

The pain is a major nuisance for quality of life (I'm relegated to stay at home). I cannot take NSAIDs (renal limitations) and altho other analgesia takes the edge off it is short lived and I have concern about its use for long term.

My post and inquiry is two fold:

1. whether any others have had similar experience with this syndrome (greater trochanteric pain syndrome) post THR and what they did about it
2. whether anyone might recommend an orthopedist who has experience with this entity.

At this point I am ready to travel (climb mountains) to find a knowledgeable guru (solution)......

Thank you
 
@tmzuri Welcome to BoneSmart! So sorry you are in pain post THR. Sounds like you tried several options to address this pain. I'm going to tag our forum medical expert. She will need to ask you more detailed questions before providing your input. Hope you are OK with that. @Josephine
 
So sorry you are suffering. Hoping you can get some answers. Afraid I am not much help in this regard. Josephine starts in high demand, sometimes don't know how she has time to eat...but she will come your way.
In meantime, healing wishes sent your way.
 
@tmzuri hi and welcome to BoneSmart!

whether any others have had similar experience with this syndrome (greater trochanteric pain syndrome)
I had such a problem after my knee replacement.

Can you indicate the site of any pain using this chart?

hip-references-horz.jpg
 
appreciate all responses.
The pain is directly over the greater trochanter. I can easily palpate the trochanter. It is not tender to direct touch or pressure. The pain is precipitated by weight bearing. The focus is exactly lateral -- on your chart best approximation is LL1B / VL1F. All orthopedists to date have not found fault or complication with the replacement procedure or the prosthesis (I am not totally convinced) but are focusing on other etiologies (so far without success). Your thoughts, insights are appreciated.......
 
LL1B / VL1F
Not quite sure what you mean by this as it's not an actual reference but from you comment that it's over the trochanter is enough to tell me it is Trochanteric bursitis
All orthopedists to date have not found fault or complication with the replacement procedure or the prosthesis (I am not totally convinced) but are focusing on other etiologies (so far without success).
Well that doesn't surprise me at all! In my experience, they rarely take alternative conditions into account! But I am pretty certain it's nothing to do with the implants.
 
This (trochanteric bursitis) has already been considered by all orthopedists consulted. They have injected corticosteroid 2 times into the bursa without any change in the pain pattern. Therapeutic trials that most likely rule out bursitis as the culprit. Your input is appreciated. Thank you. I will move on (slowly and gimply)............
 
There has to be something they can figure out. Maybe someone has had these issues here on this forum.
So sorry you are struggling.
 
Do you have an xray to post so I can take a look?
 

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