THR Possible revision surgery after 3 years

[myglasshalffull]

Regarding mobility scooters (should it come to that), as Deni said they have some really great mobility ones now. Where I live we had a congressman that was paralyzed from waist down & his mobility scooter was quite amazing, went over hills & all almost like a vehicle! Of course I’m sure US gov’t foot the bill for it! But let’s not go in that direction right now.
Please try to stay in a good “head space.” Let’s get to your September appointment before you make any rash decisions about the future. You are only 61. That’s still young in today’s society. I realize you have had a life changing health issue thrown at you that was unexpected.
And I hope your wife allows you patience during this time. I’m very fortunate to have a very understanding & supportive partner. He got me through two recoveries, broken ankle & fractured hip. But we had no plans of moving to another country. I’m sure your wife is frustrated too.
Let’s wait and see what tests reveal. In the meantime I wish you grace.
I’m here for you, I had a lot of depression first several months of recovery so I totally get it.

 

[Coddfish]

Continuing the off topic - Lyon does have a good public transport network including a couple of tram lines and good connectivity from the airport. Obviously the city isn’t flat, but some bits of it are, and I suspect the needs of your wife’s mother would drive you into the more manageable areas of the city. It’s a lovely place. Wonderful food markets and produce. Wonderful cheese. St Joseph…. Perhaps I should go live there! Don’t let go of the dream, it might become possible with time.

 

[Layla]

Hello @HipButSquare and @Deni444
It's great you are both supportive of one another here as it's always nice to see members connecting. While some of the recent discussion centers around joint issues that have, or are presently, holding you back, there is a lot of additional dialogue which makes it more of a challenge for us to move through to see what we may advise on. It will be helpful to keep posts focused on pre-op joint surgery, or post op recovery. Friendly conversation is certainly welcome here, but when conversations get lengthy it can be hard for other members and our staff to follow the thread and spot questions or issues that need support. It may be a good idea if the personal conversations move to direct messages. This way we can keep the forum easy to read for all while still allowing you to connect. Thanks so much for understanding. I hope you both have a nice weekend.

 

[Layla]

while brushing my teeth, I absentmindedly leaned against the sink. I’m tall and the sink is low. It catches me somewhere in the region of where the stem is inserted into the femur.

Well, if I put pressure on a spot at the front of my leg for a minute or so, I’m in agony when relieving the pressure. It feels like my leg locks up.

I am sorry you're experiencing all of this three years post op. I do hope this is not your new normal and you receive some answers soon, leading to relief from the pain and peace of mind so you and your wife are able to move on with your plans.

 

[HipButSquare]

Could you maybe compromise for rural France? Or have you consider a mobility scooter if it comes to it? The latter is my plan if the hip replacements don't enable me to walk at least 2 miles. I have very low goals compared to many. My recovery goal is literally a 2 mile walk on a flat road, to be able to garden my adapted poly tunnel and greenhouse, manage my home, walk my dog and keep chickens. I'd already made the lifestyle leap before getting mobility issues. Worked in London, hubby and I took a 2 year work contract in Belgium to save up a bit, then down sized with a plan for a mini small holding and semi self sufficiency. Not everyone's cup of tea but our dream early retirement. Within a year of moving in to our house needing a lot of work, I literally got up one morning and could hardly walk. Although I really have come to terms with all kinds of possibilities, it's been tough on hubby who works very hard doing what we planned to do together. Despite that we love our home and life if only for it's remote and beautiful location.... Anyway I'm waffling. If I don't meet my goals, I'm getting an all terrain scooter... A cut above the ones you see. Very enabling and I'd get as far as I want enjoying my local area and be able to use it in the garden. You can even get trailers for them. Just trying to suggest that we all try our best to recover what we have lost but there are options to adapt if things go a different way... I think successfully transitioning and adapting is a legitimate example of a recovery journey for some of us.

I read over your post again. You’re brave to take on so much. In some ways, a house can offer easier accessibility than an apartment, but access to services is a concern.

You have gotten me to include this French term,

• “immeuble accessible PMR” (PMR = personnes à mobilité réduite)

in my apartment searches.

This will rule out many apartments in the old part of Lyon. We had already ruled out all the walk ups. Don’t get me started on those tiny elevators in French apartment buildings.

My wife is an amazing gardener. We discovered this after moving out of New York. She turned the front lawn into a thriving garden. We grow tomatoes, peppers, kale, Swiss chard, and string beans, along with many flowers and shrubs, all in a small space.

But, she’s willing to give up the garden to move to an apartment in France, as she sees the garden as a lot of work.

We’d like to find someone to maintain the garden and thirty house plants, but that might be asking for too much.

We all adapt the best way we can. If I can only walk a mile then I’d rather cover a lot of shops and restaurants in that mile. I’m not even close to a mile at this point.

 

[Deni444]

Sent you a PM in response... Re Layla's request above.

 

[HipButSquare]

Someone mentioned to me that certain types of hip implants are associated with mid thigh hip pain

I fed a question to Claude AI and was told that cementless implants with extensively porous surfaces are implicated.

I know my implant is cementless. I’m not sure if it’s surface is considered extensively porous.

Here is Claude AI’s answer,

Hip replacements associated with mid-thigh pain after surgery include several specific types and design features:

**Cementless (uncemented) femoral stems** are most commonly associated with mid-thigh pain, particularly:

- Extensively porous-coated stems
- Proximally coated stems with certain surface textures
- Stems with aggressive surface coatings designed for bone ingrowth

**Specific implant characteristics linked to thigh pain:**

- Stems with rough, beaded, or plasma-sprayed surfaces
- Larger diameter or oversized stems
- Stems made from certain titanium alloys
- Implants with significant stiffness mismatch compared to bone

**Less commonly associated types:**

- Cemented stems generally have lower rates of thigh pain
- Smooth-surfaced stems typically cause less pain than rough-textured ones
- Shorter, tapered stems may have reduced incidence compared to longer, cylindrical designs

The pain typically occurs during weight-bearing activities and can range from mild discomfort to significant pain that affects daily activities. It’s thought to result from micro-motion at the bone-implant interface, stress shielding, or irritation of the bone by the implant surface.

The incidence of mid-thigh pain has decreased with newer implant designs and improved surgical techniques, but it remains a recognized complication, particularly with certain cementless femoral components.

If you’re experiencing this type of pain after hip replacement, it’s important to discuss it with your orthopedic surgeon for proper evaluation and management options.

 

[Layla]

Hi HipButSquare,
I believe you mentioned before that it's been confirmed there is no loosening, but wondering if that was early on?
I can see how you trust your surgeon and it sounds like he's really tried to get to the bottom of your pain. Sometimes though, even great surgeons can miss things. If you don't get much satisfaction from your next meeting with him in 2.5 weeks, wondering if you'd consider a second opinion, which doesn't have to mean you don't trust your OS, it's just another perspective and sometimes a fresh set of eyes may spot something subtle. Obviously your surgeon wants you to have the best possible outcome and hearing another experts thoughts, might actually help him help you.

I know you're traveling to NYC in September and October and wondering if you'd give some more thought to scheduling an appointment with HSS. Possibly you could get in sometime in October to coincide with your trip there. Or at least start with an online consultation with HSS as the top rated orthopedic hospital in the country.
I will include the link. HERE if interested. This as been going on for so long now and it may be worth some consideration since things don't seem to be improving and it's sad to think of you living like this indefinitely.
Best wishes for a day of comfort.
@HipButSquare

 

[HipButSquare]

Hi HipButSquare,
I believe you mentioned before that it's been confirmed there is no loosening, but wondering if that was early on?
I can see how you trust your surgeon and it sounds like he's really tried to get to the bottom of your pain. Sometimes though, even great surgeons can miss things. If you don't get much satisfaction from your next meeting with him in 2.5 weeks, wondering if you'd consider a second opinion, which doesn't have to mean you don't trust your OS, it's just another perspective and sometimes a fresh set of eyes may spot something subtle. Obviously your surgeon wants you to have the best possible outcome and hearing another experts thoughts, might actually help him help you.

I know you're traveling to NYC in September and October and wondering if you'd give some more thought to scheduling an appointment with HSS. Possibly you could get in sometime in October to coincide with your trip there. Or at least start with an online consultation with HSS as the top rated orthopedic hospital in the country.
I will include the link. HERE if interested. This as been going on for so long now and it may be worth some consideration since things don't seem to be improving and it's sad to think of you living like this indefinitely.
Best wishes for a day of comfort.
@HipButSquare

Well, it’s funny. My wife had a labrum tear repaired at HSS. It is a highly rated place but I don’t know if my current insurance covers me there.

It wouldn’t be easy to get treatment in New York when I no longer live in New York but people travel for treatment all the time.

When I was waiting for my wife to get out of labrum surgery at HSS, the woman next to me told me that her young son has destroyed both hips playing golf and was having repairs done on both. She was from out of town and would be spending a month or more in a hotel room working with her son on recovery.

The thing is, I was in a good place a few months ago, and now, something has changed.

My pain levels are tolerable if I don’t walk much but that’s a depressing place to be. I don’t want to walk a hundred miles but two miles could be nice.

I don’t think the micro movement of the stem is necessarily visible on an X-ray but I will ask my surgeon again about that.

 

[benne68]

@HipButSquare Keep in mind that going in for a second opinion doesn't obligate you to having surgery there. I know several BoneSmart members for other parts of the country (and even Canada) who have used HSS to get fresh eyes on their situation.

Since you are familiar with HSS, you know they are ranked #1 in the world for orthopedics. Might be worth a consult even if you have to do it out of pocket.

 

[Layla]

Hi again HipButSquare,
I am wondering if your surgeon has ever encouraged you to seek a second opinion? From what you've shared, he sounds like a good surgeon so my guess is he would support you, should you choose this route. Consider a conversation with him about seeking another opinion, reassuring him you appreciate all he's done, but since you're still struggling and without answers you'd appreciate another perspective. Keeping the communication open will undoubtedly make providing records and imagining something he's more than happy to share. HSS is world renowned and highly respected so I'd think he'd welcome the idea. Fingers crossed for you as you contemplate this. It may be the ticket?
@HipButSquare

 

[HipButSquare]

Hi again HipButSquare,
I am wondering if your surgeon has ever encouraged you to seek a second opinion? From what you've shared, he sounds like a good surgeon so my guess is he would support you, should you choose this route. Consider a conversation with him about seeking another opinion, reassuring him you appreciate all he's done, but since you're still struggling and without answers you'd appreciate another perspective. Keeping the communication open will undoubtedly make providing records and imagining something he's more than happy to share. HSS is world renowned and highly respected so I'd think he'd welcome the idea. Fingers crossed for you as you contemplate this. It may be the ticket?
@HipButSquare

Thanks for the support.

He hasn’t suggested getting a second opinion. I could ask about that at my next appointment.

 

[HipButSquare]

This morning, I saw my surgeon.

He ordered a special MRI that subtracts the metal from the images. I think is it called MARS. That will happen in the beginning of November.

He also gave me a script for physical therapy. I start next week. I don’t walk much these days. I hope the pain is muscular and I can somehow fix it.

 

[Deni444]

The MARS scan sounds encouraging, I understand they offer quite a detailed image of bone and soft tissue. I would imagine providing greater opportunity to diagnose any potential issues. It seems a long time to wait however considering your discomfort. Did you receive any specific guidance in terms of area of focus for the physiotherapy? Did you pursue the option of a second opinion?

 

[HipButSquare]

The MARS scan sounds encouraging, I understand they offer quite a detailed image of bone and soft tissue. I would imagine providing greater opportunity to diagnose any potential issues. It seems a long time to wait however considering your discomfort. Did you receive any specific guidance in terms of area of focus for the physiotherapy? Did you pursue the option of a second opinion?

I believe the MARS scan is a software based processing of the MRI images. Without MARS, the MRI can return a result that says “scattered,” meaning that the images are basically unusable.

I didn’t bring up the second opinion. I’m willing to give this a chance before getting a second opinion.

I didn’t receive specific guidance regarding physical therapy. I’ll explain my mid thigh hip pain and negotiate something that does not hurt me too badly, I hope. That’s what the surgeon said to do.

Without X-rays or bone scans that show conclusive evidence that the implant is moving, or the bone is not growing into the implant, my current surgeon is not going to do revision surgery.

I don’t want revision surgery if I can somehow work past the pain in some other way.

A friend mentioned “hydro dissection,” the separation of tissue planes by injection of saline, but that has considerable risks, including infection and necrosis.

I am fully aware that I can make the situation worse, and don’t want to do that.

I appreciate everyone’s advice and support. It means a lot to me.

If I might add one personal note, my wife, who has French citizenship, and I, are now considering a move to Dublin. If anyone can offer help, please DM me. Thanks.

 

[Deni444]

I really hope the physio will provide some relief and you will see some ongoing improvement! Unfortunately, I haven't got any experience on the different treatment options you mentioned but maybe someone else may be able to jump in with a comment. All the best with a potential move to Dublin! Just across the water from me but a place I know very little about.

 

[HipButSquare]

Well, I went to a few sessions of physical therapy and wound up with Covid. They told me other people had called in sick when I called in sick. Wonderful.

This happened one week after I got the Moderna shot. I haven’t tested positive for Covid in five years.

No more physical therapy for me.

This bout with Covid has been miserable. I’m on Paxlovid. That seems to help.

 

[Jamie]

Wow.....that's soooo not fair!! I'm sorry you got Covid from the therapy and hope you get better soon.

You'll do just fine without formal therapy. You know what to do and really walking is the best thing for a new hip.

 

[Layla]

I am sorry to read you've come down with Covid on top of your recovery. Wishing you a smooth and speedy recovery all around. Hopefully your strength and mobility return quickly and your hip recovery journey remains on track. Keep us posted and feel better soon!
@HipButSquare