THR Psoas tendonitis post-THR

[HelenaM]

@Sashimu
I hope you will get your MRI soon, and that it will provide some answers. And that things will improve!

 

[Sashimu]

I'd been feeling better, so last week I went for a walk. I walked for 20 minutes or so and was starting to feel a little burn in my groin, so I sat down for 10 minutes, then walked the 5 minutes back to the car. Seems like that aggravated things so much that I've been in more pain since then. The last week has been pretty miserable, and the left leg is bothering me more and more. So I'm putting the brakes back on; guess that's all I can do.

I set up another call with my surgeon to see if I can get him to expedite the MRI. Feeling pretty down.

 

[Layla]

I’m really sorry, Sashimu. It has to be so disheartening. I hope your surgeon understands your frustration in dealing with pain and not progressing as you hoped. With any luck, he’ll get you in soon, diagnose any issues and formulate a plan to bring you relief.
Hang in there and don’t forget we’re here for you.
@Sashimu

 

[Sashimu]

I had a very pleasant surprise the other day... My family doctor's office called to set up a phone appointment. I asked what he wanted to speak to me about and the MOA said my recovery! I think very highly of my doctor but still, I could hardly believe that someone in the healthcare system was actually reaching out to see how I was doing! That's unheard of!

But after I've told him where I am with my recovery, I'll definitely be asking his advice on whether I need an MRI before I can get an injection and if so, what's the best way to expedite it; and whether he will refer me to a rehab doctor for an assessment...i.e., the type of specialist who would actually give me an injection. It's not at all clear whether my problems are due to the placement of the prosthesis/removal of the extra bone or if it's strictly soft tissue, or both. The fact that my surgeon mentions revision every time I talk to him makes me very anxious.

The last physio I saw also noticed that my surgical leg is misaligned. Viewed from the front, it's not straight; the knee is closer to the midline then the hip or the foot. Again, who knows whether that's a cause or a result of my problem.

I could also ask my family doctor about that second opinion again. Maybe an idea whose time has come?

Wish me luck.

 

[HelenaM]

@Sashimu,
I would want a second opinion, especially since revision has been mentioned. As well as the MRI.

 

[Hippielife]

@Sashimu .. it’s way to early for a second opinion. Not necessary since your still experiencing pain is really very normal this soon after surgery. Your hip is still healing, only 3 months out from major surgery. The problem is with issues after surgery …. doctors don’t go into enough detail about how the body reacts and what is involved after major surgery. Most info is do this don’t do that. In reality it’s a very long involved complicated surgery. Your body has been thru a lot.

Take the time to chill more and rest. Your hip will do ok with a lot of short walks around the house. Uneven pavement or any uneven ground can put a lot more stress on the operated joint. New shoes is a must after surgery as the walking gate is different after thr with new hip. Body balance is different as well as all the relationships to other joints during movement. It’s all connected…

MRI’s don’t show everything especially if it’s soft tissue still healing. Also the brain has taken time to learn how to move with the new components replacing the hip joint. Most of us want to get right back into life since we were in pain for so long before hip replacement. Yes once healed the pain will be gone from old joint causing pain as the new joint heals it takes 6 months to a year To get past the surgery repercussions on the body.

I have had three hip joint replacements, each one was different and one hip joint is well over 24 years old. Take care of your new hip and it will take care of you . And more importantly know and understand your current limitations as you move thru many different healing adjustments.

 

[Sashimu]

Thanks, @Hippielife. It's been actually almost 5 months; not sure if that would affect your comments?

 

[Celle]

MRI’s don’t show everything especially if it’s soft tissue still healing.

An MRI can show soft tissue that is still healing. It can also show inflammation there.

In orthopedics, an MRI may be used to examine bones, joints, and soft tissues such as cartilage, muscles, and tendons for injuries or the presence of structural abnormalities or certain other conditions, such as inflammatory disease, osteonecrosis, and bone marrow disease.

it’s way to early for a second opinion.

While it's true that most surgeons prefer to wait until about a year post-op before offering a second opinion, - that's because many problems during early recovery do sort themselves out by a year post-op - it may be possible to get one, especially if you surgeon or your family doctor request it.

 

[SaraK]

While I did have an MRI before my psoas injection, it wasn't very helpful because the "metal artifacts" from the metal implants made it difficult to see the psoas near the implant (note that I have a metal femoral ball and not ceramic). When I finally saw a surgeon that did revisions (my original surgeon was not as helpful as yours), he did an x-ray to confirm no loosening and tests for metalosis and infection to rule those. He didn't seem surprised that the MRI ordered by the pain management doc was inconclusive.

After the test results came back, he referred me to a radiology center for the injection. (Not sure what it's like there but around here, injections might be done by surgeon, rehab Dr or radiologist.)

The injection was both to confirm the diagnosis but also try to treat it. I was told that, if it worked, I could get an injection up to once every 3 months. It took a few days to take hold but then I had a couple of blissful painfree weeks. Then it cam back. The surgeon said that the limited time the relief lasted meant injections weren't a long-term solution for me but that the relief I'd had was a good sign for success of a release surgery. I had the release surgery a couple of weeks later and haven't regretted it!

 

[Sashimu]

Your story is encouraging, @SaraK! My prothesis is metal too; my surgeon said I'd get a MARS (metal artifact reduction sequence) MRI. I guess that helps somewhat? I hope so anyway.

My family doctor said he didn't think I'd be able to get an injection until after the MRI, so I'm going to see my surgeon tomorrow to see if he can/will try to expedite it. I also want to get him to look at my surgical (right) leg, which is internally rotated, according to the physio I've been seeing (not sure what that's about) and my left leg, which is more and more frequently sore, cramping, popping, etc. Pretty sure a rehab doc would be doing the injection.

More tomorrow...

 

[SaraK]

Good luck tomorrow!

 

[Layla]

I hope you have a good visit with your surgeon today. Let us know how it goes.
Happy Wednesday, Sashimu.
@Sashimu

 

[HelenaM]

@Sashimu
I hope you are having a nice weather and making some progress with the medical system or with pain relief. Send you good wishes for healing!

 

[HelenaM]

@Sashimu
I haven't seen a post from you in a while, and I hope that this means you are doing better and enjoying the cooler weather. Best wishes,
Helena

 

[Sashimu]

Thanks for checking in, @HelenaM. After 8 months, I can say I am doing better. My groin continues to pinch and burn much of the time, but it's usually a dull roar that I can somewhat tune out. But the good news is, I can walk farther now, up to an hour with just a short little rest in the middle, without the pain getting any worse. Just that makes feel so much better about my situation.

Which is good, because I talked to my surgeon this morning about the results from the MRI I had last week. It didn't reveal anything seriously wrong, such as particle disease or a pseudotumour (ugly possibilities that I never thought about, fortunately, but that's what he was looking for). Nothing visibly wrong with the psoas tendon. Therefore, nothing further to be done at this point, except to carry on with my exercises and walking, and hope for continued improvement. I did see that my left hip is up to "moderate" OA, so a left THR may be in my future. I sure hope not, after this experience.

I just read your thread and I'm happy to hear you are doing so well. I'm obviously also one of those whose recoveries are long drawn out as well.

 

[HelenaM]

I am so glad to hear that things have improved. Being able to walk for an hour is a big step because it must mean you can get out and do some of the things you enjoy. My husband and I have been able to walk around a nearby lake that has some wildlife and beautiful fall colors and a few paved trails, and I have been doing more and more shopping in stores ( had three shots and wear a mask)I have found standing a little more challenging than walking, and try to side step a little or shift around when standing. Hope your recovery will continue to go well, and send wishes for a wonderful holiday season. @Sashimu

 

[Hippielife]

@Sashimu …Your surgery was only done last March 2021.. in my experience there is short term healing is first 6 months and long term up to 12 -18 months.
Just work on walking, it will heal on its own. We go thru so much before surgery and after… time and patience is hard especially at the second 6 months stage…hints to quality walking…Walk in full solid gait, heel to toe, new shoes,proper arch support and lift only loads under 5 pounds, practice good posture on even solid ground and give your body time …sending healing vibes your way..

 

[DancerHips]

@Sashimu I love hearing that you can walk for an hour now. I think you're about 6 weeks ahead of me and we've both had some challenges! I was feeling pretty good finally, after PT, then went on a vacation to NYC where the walking caught up to me. And that's just incidental walking since I have a subway pass! This is the stretch that has really helped me with the operated leg straight and "pushing back" on the bent leg:

My groin pain is virtually gone, now dealing with pain side of hip to knee with a lot of activity. Icing in NYC as we "speak"! Good luck for continued improvement.

 

[Hippielife]

How you walk and what shoes you wear makes a huge difference in recovery….
wear new shoes not the old shoes with old walk..
inserts for proper arch supports.
stand up straight.
walk heel to toe in each stride.
this all effects the gait adding to a better recovery .

 

[Sashimu]

Thanks for the suggestions and good wishes!
I will definitely try that stretch, @DancerHips...hope you're having some fun in NYC to go with the ice!

@Hippielife, I actually just went to see the PT who makes my orthotics. He watched me walk and made a couple of observations about my gait. Sounds like I am swinging my right hip a bit because of tight/weak muscles, so they need work, but he is making me a new pair of orthotics that I'm sure will help. My surgeon also said, like you, that complete healing would take one to two years.