THR Arthroscopic hip bursectomy post THR?

Nyc1961

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Hello, everyone...

I'm so happy to have this support but unfortunate to also realize I’m among too many with ungoing unresolved problems; never thought I would be one of them!!

Now for my story.....underwent anterior hip replacement surgery on my left hip on September 22. I'm now eight months post op and still dealing with pain, swelling and nerve damage. I have so many issues and I feel like a ping pong ball, going back and forth from doctor to doctor, starting with my evasive hip surgeon. I also visited an orthopedic urgent care three weeks ago.

A spine surgeon took a new X-ray (I have lumbar and cervical stenosis) and even though lumbar is not nearly as serious as cervical, surgeon noted irritation, more on left lumbar and suggested a transforaminal epidural at L4/5 and L5/S1. I had that done and the pain immediately disappeared but it was only temporary lasting until the lidocaine wore off.

In addition, since surgery I I have been diagnosed with severe trochanter bursitis, psoas syndrome, piriformis tendinitis, glute muscle atrophy and weakness, hip flexor and iliotibial band problems, and now a baker’s cyst behind my left knee.

My hip surgeon finally agreed for me to get a corticosteroid injection without x-ray guidance for the trochanter bursitis because I told him the spine surgeon was willing to do it. He was worried about his implant being disturbed! Nothing has really helped so far and my spine surgeon ordered a lumbar an MRI which I’m going to have this week.

The hip surgeon keeps telling me it’s my spine. The spine surgeon is pretty certain it’s my hip. What a nightmare!! So much for thinking a hip replacement would solve the problems of labrum tears. I am 77 years old and because I had osteoarthritis in my hip, no surgeon would just repair labral tears.

So I no longer have a limp, my shoulders look completely straight, I can lift my leg up when dressing, but a cruel joke since I can’t bend down. I have groin pain, thigh is always swollen and can’t even touch my thigh because of sensitivity pins and needles and numbness. I have extreme pain at the bone, pelvic bone on the left side of my back and it clicks and is swollen. I'm wondering if now is the time to seek opinion from another surgeon.

Every X-ray shows the implant is perfect. The surgeon, just for a precaution, inserted two iliac screws and a cerclage cable because my bone tissue was so thin. I have osteopenia and there was no fracture but he noted a very slight crack during surgery, so that was the reason for screws and cable being implanted. The implant was cemented.

So much for him telling me I’d be back to walking my four miles a day after a few months.

In addition, I started PT in November when the pain seemed to accelerate. PT has only made things worse. The PT was stretching glutes, as well as the psoas and piriformis. Initially things felt better for a day or so at a time. But I totally stopped going a month ago after a grueling hour session left me in tears. I couldn’t walk for a week. My surgeon is supposedly the best in California - not one negative review, except for me!

I'm totally depressed and wishing I never had this procedure!!
 
Last edited by a moderator:
Hi, and welcome to BoneSmart. As you can see, I've copied your very detailed description of problems with your hip and created a thread for you here in the recovery forum. This will be the place where you talk about what is going on and provide updates for us. It might help to bookmark this thread so you can find it easily.

I do think it's time you search for some additional opinions. In your thread, it would also be helpful if you'd describe what treatments you've been doing for each of the problems and whether or not there has been any progress. All the things you've described seem to indicate that you may have overdone the activity and physical therapy after your surgery, so some information about your past and current activity levels would also be helpful. Overdoing things is quite common after hip surgery, especially for people who are normally very active like you are.
 
Hi Jamie,

Thanks so much for your prompt response! And yes, if you could copy this over and start a thread, I would be most appreciative.

When this thread is started, I’ll update and answer the questions you thought would be helpful. I also had a feeling, after looking back on the past several months that perhaps I did too much initially. The only advice given to me was to do as much as I felt comfortable doing but I probably was upset with not progressing at a level which I assumed was the norm for this surgery; lots of painful lessons learned. Just because this was done with an anterior approach, I finally realized this is still major surgery!!
 
I'm really glad to hear you've realized that your anterior hip replacement was very MUCH major surgery. Unfortunately some information you read on the web and even some surgeons tend to downplay that and instead talk about how fast you'll be up and around afterwards. While that can be true, you still undergo basically the same trauma to your bones and soft tissue plus your body has to deal with any after effects of the anesthesia. It's a big deal. Today's surgical techniques are so good with things like multi-modal pain management and pain medications injected directly into the leg tissue before closing, that people don't experience the pain levels they used to right after surgery. Instead, it's easy to believe that no pain equals being back to normal. It's a common problem we see with BoneSmarties for both hips and knees.

The good news is that it can resolve itself IF you allow your body time to recover. It will take longer than if you had taken it slower from the beginning, but healing is definitely possible. Since you have multiple issues, you'll need to deal with each one separately. We can talk more about that on your thread.

Just don't let yourself get down about what has happened. We'll help you and guide you to any therapy or medical assistance you might need. That's what we're here for. :thumb:
 
Oh Jamie,

If only I had known! So many lessons learned and today is a particularly difficult, painful day!
Everything you just mentioned is true. I blindly went ahead and should have even postponed surgery until I researched how to fully recover. What I have learned, surgeons are only concerned with their implant being okay and do not give adequate follow up care or explain many of the pitfalls and serious problems that can occur by their total lack of concern for treating you as an individual. There was such a lack of support overall. Maybe they are all that way. Now I have to plod ahead and yes, address each problem, wondering if I’ll ever truly feel well again.
 
Not all surgeons are like that. But sadly, we see a lot of patients who express the same feelings you have. Please try not to worry. Most of the time, soft tissue issues can be resolved. It just can take a while and you have to be prepared for that. Patience and consistency is critical. You'll be making small steps forward for each issue you have and trying to hurry things up is counterproductive. But please don't worry. That's why BoneSmart is here.....to help you and support you through whatever challenges you have. We have LOTS of successes under our belts! Let's see if we can make you one as well. :console2:
 
Thank you Jamie! As you can tell, I’m feeling very down right now. Living alone magnifies fears. I’ve been a widow 31 years and have always survived so much adversity. I’ve been fortunate having good health and this past year, along with Covid-19 has chipped away at my resilience.

I'm trying to deal with pain and not take Tramadol, which is the only medication that brings relief for awhile. I can’t take Aleve because I have GERD and Tylenol does nothing for pain which seems to be everywhere surrounding that new hip. Of course, Tramadol causes other issues so life is not much fun right now.

I’m actually looking forward to my lumbar MRI Tuesday. Having spine and hip issues is too overwhelming to deal with right now.

My biggest fear is perhaps something technically is wrong with the implant; perhaps the size, or the positioning? It’s the unknown that is accelerating my fears right now.

I'm wondering when it would be appropriate to see another hip surgeon regarding possible revision. Is that the next step? I can’t believe I have so many problems as a result of this nightmare surgery.

On a positive note, I still work five days a week as an aide in an elementary school, plus being a school crossing guard. I'm on my feet a few hours each day and average between 1.6 and 2.3 miles a day. I’m exhausted but doing this is a financial necessity and the kids keep my spirits up.

I just received another phone call from my PT telling me I should go back to seeing her again. I have real trepidation about that!! A million thanks for this free therapy session today! You helped more than I can say in this email!
 
Well, you are not alone in this fight to get better. I'm 7 months post op, anterior, THR. I too have been diagnosed with all of the above. BUT I had lumbar back surgery in Jan 2020 and hip replaced in Oct 2020. So they can't point fingers in my case. I'm in PT but not doing a whole lot. He's working on strengthening my glutes as well. I too feel as if PT is not for me even though I love my therapists. I've had bursitis injections, trochanter injections, to no avail. I'm just hoping 1 day I'll wake up to be able to feel my left thigh, bend without pain, and sleep on my left side! Best of luck and hang in there!!! I hope they find a solution for you!
 
My goodness!! I can’t believe there is actually another person out there who I’d dealing with exactly the same problems I’ve been having. Reading this certainly helps to know I’m not alone but where do we go from here? It’s so difficult to remain positive when pain is part of your every day life. I’m going for a lumbar MRI tomorrow to rule out pain coming from my spine. I have come to detest that phrase rule out! I also would love to bend without pain and feel my thigh. Right now, I’m debating whether to continue PT. I also love my therapist but don’t hold out much hope for my glutes to ever regain their strength. I know it took a lifetime for them to become so weak so in doing the math, it’s not a practical viable option they’re going to recover. Lol And my last few PT sessions were so painful; couldn’t walk for a week. I find myself wondering more each day if all my problems could be attributed to surgery errors.
Thanks so much for your support and I’m wishing real improvement for you too!!
 
Hi @Nyc1961
Welcome to the forum.
So sorry you have been struggling.
:sad:
since surgery I I have been diagnosed with severe trochanter bursitis, psoas syndrome, piriformis tendinitis, glute muscle atrophy and weakness, hip flexor and iliotibial band problems, and now a baker’s cyst behind my left knee
Oh my stars...:sigh:

PT has only made things worse. The PT was stretching flutes, as well as the psoas and piriformis. Initially things felt better for a day or so at a time. But I totally stopped going a month ago after a grueling hour session left me in tears. I couldn’t walk for a week.
And my last few PT sessions were so painful; couldn’t walk for a week
This PT is something that is certainly not helping...
I understand weakness in certain areas can cause problems, but if overdoing it early on caused tendonitis and other issues then this seems to be exacerbating the situation, in my opinion.

I would certainly take a time out from PT especially until you get answers from spine tests.
You deserve to get some relief from your pain and certainly not have it get worse after physical therapy.
Resting and icing are still helpful protocols.
Hope you get some answers soon.
 
I stopped PT for about 6 weeks thinking that was causing my pain, but I think I was just not ready for it. I'm only in therapy for about 30 minutes twice a week. I do 15 squats, dog/donkey, bird dog, monster steps with band around knees, side steps with band around my knees and leg lifts with 4 lb. weights on my ankles. The leg lifts hurt the worst as I feel a pinch at the top of my incision, but it's better than it used to be. He also told me to get on my treadmill with it flat, and walk slowly and try to lengthen my stride. This has really helped. I guess some of us are just slow healers. Best of luck, and I'll be following your progression! Hang in there, we will eventually get to there.
 
Thanks for the encouragement. I had a lumbar MRI a few days ago and will be following up with my spine neurosurgeon on June 2. I was able to read the Radiologist’s report in my chart
online and nothing seemed to have changed since my last MRI a year ago
but of course, I’ll wait and hear what my doctor says. In the meantime, pain is back in my groin, thigh is swollen and swelling also in sciatic joint. Nerve pain is miserable and tender to the touch. So much for my hip surgeon’s expertise in administering the injection for trochanter bursitis; no relief at all! So now back to square one wondering if I’ll ever be well and without pain again. I can’t turn my left leg outward without pain and squatting is out of the question. It’s fun trying to clean my apartment and need to sit on the floor to get some tasks done. My surgeon never responded to my text asking for an authorization for hip X-rays. Piriformis, psoas and glutes may never return to normal; feel so depressed. Maybe injections in those muscles? And another trochanter injection? My PT who caused me so much pain said scar tissue is also a problem. Researching hip surgeons for second opinion which is exhausting and scary. Eight months of pain and misery. I should have left my torn labrum and arthritic hip alone!! So disappointed in my surgeon and feel so alone.
 
Definitely sounds like you need a second set of eyes on that hip. Have you tried our Surgeon Locator (blue bar at the top of each page)?

Or if you let us know your location and who you saw we might be able to recommend someone.
 
@Nyc1961 I had my thr about a year ago. I had some pt early on to get going. Some of it was practical skills, like getting into a car seat, and walking evenly, so that helped. My surgeon did not really push pt except walking, and told me not to do some exercises that caused pain. I requested some pt at 10 months because I thought I might be able to increase my walking distance and that may have irritated my hip flexors. This may be improving since I have stopped pt. I think I am still improving slowly, but I am worried as you are about the implant. i am also feeling that pt is not necessarily great for me, I need to be careful about it. I can do a lot but hurt later.
I am working on just walking and my normal routine of life for now. Sorry that you are having a difficult experience.
 
Initially, my surgeon also felt walking would be sufficient and didn’t recommend PT. Perhaps I did too much because when I saw him two months later after pain level was so bad, he then said I definitely needed PT to address tight hip flexors and issues with iliopsoas and iliotibial band. I’ve decided to now trust my own instincts and will stay away PT for now. The painful last PT session was something I don’t wish to repeat. I am walking and like you, trying to not do too much which always causes increased pain and swelling. For me, the frustration is not knowing the cause for all my problems. I keep hearing it takes a year to feel “normal”. But in the meantime, I’m definitely going to find another surgeon for a second opinion.
 
Jaycey,
I read your post by not sure how to reply specifically to your post. Do I just click on Administrator? I would like to keep my surgeon’s name confidential.
 
@Nyc1961
You can use the personal message feature to answer Jaycey or any member.
We encourage members to post to public forum but certainly understand this instance.
Here is some information in case you have questions on how this works.
 
I also am completely bewildered and find it astonishing that after reading hundreds of reviews before and after surgery, every one of my surgeon’s patients had an amazing and positive surgical experience! They were all back to normal in a few months; no mention of trochanter bursitis or all the other problems I’m dealing with every day. I now wonder what is wrong with my body and certainly not good for my self esteem. He’s a young renowned and gifted surgeon which makes my experience all the more depressing. I never found one negative review; a complete mystery!
 
@Nyc1961

Yes, seeing that many positive reviews would be extremely frustrating and isolating. I'm so sorry!

Reviews can be skewed, depending on a lot of factors, including how motivated or comfortable people are with giving public reviews. Who knows who the reviewers are?

Have you found out anything regarding your pain? Have you found someone for a second opinion?

Take care.
 
@Nyc1961
I think it is possible that my surgeon did a good job, but that the surgery itself is a rockier road than I had expected, and that the real recovery time is longer. Several friends or acquaintances impressed me with stories of rapid recoveries, so it was this as much or more than reviews that influenced me. Perplexing! I am returning once more to my surgeon to ask that he look more closely, and then may go for a second and even third opinion depending on how it goes. Best wishes.
 

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