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THR Question - One year after thr

HelenaM

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I had an anterior hip replacement one year ago performed by a highly reconnended surgeon. My recovery was normal, until about 9 months, but never pain free although low pain. In the past few months, I have been bothered by burning in my thigh near the scar and soreness when I walk regularly upstairs or lift my leg as in marching. I have had some numbness near the scar on the outside of the thigh since surgery but that doesn’t bother me. My surgeon thinks I may still have some swelling which is compressing a nerve near the incision, and that this will improve. My family doctor thinks I have tendinitis. I had been walking up to three miles in a day, and going about almost my normal routine. Has anyone had these issues going beyond the one year mark, and do you have any thoughts beyond watching, waiting, and stopping activities that seem to hurt? Thank you.
 

Pumpkin

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@HelenaM ,
Welcome to BoneSmart glad you joined us! :welome:

Here is some information about the nerve that may be compressed from your surgery causing some of the symptoms you are experiencing.
Meralgia Paresthetica

My surgeon thinks I may still have some swelling which is compressing a nerve near the incision, and that this will improve. My family doctor thinks I have tendinitis.
Both are possible, you might want see a PT to address possible tendonitis. You should have no pain past discomfort.

Has anyone had these issues going beyond the one year mark, and do you have any thoughts beyond watching, waiting, and stopping activities that seem to hurt?
Recovery from joint replacement can take a year or longer, some members report it took 2 years before they felt fully healed.
You may not want to completely stop the activities that hurt, try cutting them in half and see if that helps.

Since you are at the year mark and continue to have challenges, you may want to seek a second opinion for your THR. Find a surgeon specializing in Revisions, they have the education and background to determine what is happening with troubled hips. Look for a surgeon specializing in complex joint reconstruction or revisions. They should have no relationship with your present OS, not even golf buddies.
 
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HelenaM

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Thank you, Pumpkin. I am more concerned with just knowing or understanding what is going on than thinking about a revision. Some orthopedists in our area are very anxious to perform surgeries after Covid has declined ( I have gotten lots of ads, zoom invitations, and noticed this with my husband’s visits for another orthopedic issue). I would hope that a revision specialist would try to sort things out without a bias leading to more surgery, but...
 

Pumpkin

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I am more concerned with just knowing or understanding what is going on than thinking about a revision.
A revision surgeon or complex joint reconstruction specialist may be able to figure out what is happening with your hip and make the appropriate recommendations. You can always say no.
 
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HelenaM

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I have done some research looking at websites and reviews for orthopedic surgeons. In my area, a number of surgeons, including some who are really young relative to the average, advertise or state that they are “revision specialists”, but I usually can’t find a particular credential, except one surgeon did that type of residency. Are there any credentials that set revision specialists apart, or any questions that should be asked to filter out who is really skilled?
 

Pumpkin

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Look at where they did their residency. Ask how many revisions and primary THR's they do in a year, should be 100-200 with revisions 50+ a year.
A large University practice may be a good place to look
I am not aware of any credentialing, other than they say they do revisions.
 
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HelenaM

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Thanks! That is helpful to know.
 
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HelenaM

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Prior to my anterior hip replacement about a year ago, I was told by several friends or acquaintances who had had this surgery that they were completely pain free after three months and able to accomplish some athletic challenges such as walking up and down 300 steps in Portugal. Two people said they never took anything for pain, even otc. I was a bit skeptical, but I heard a few similar reports.

I am wondering if part of the issue for me might be that my expectations were too high. I still have pain at the 1 or 2 level sometimes, but sometimes a zero.
I do take Tylenol 500 as needed.

Are most people or many really pain free and restored to pre arthritis function in a few months? And without Tylenol or an nsaid?
 

golfer67

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Sorry to hear that you are still having problems after one year. I am in the same predicament that you are only I am at the 10 month mark and very dissatisfied with the result from my hip replacement. Everyone here keeps telling me to wait a year before I get upset but I am already upset. Like you I expected to be over this in no more than 6 months but I just keep getting worse not better. After too much prednisone put me in the ER I finally went to my Primary Doctor and she dismissed the idea of it being too soon to be over the surgery as nonsense and is trying to help me get to the bottom of my problem. Hope you find a solution and I will be following your post to see how you make out.
 

Jaycey

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I am wondering if part of the issue for me might be that my expectations were too high.
I would agree. This is major surgery. The cases of patients being totally pain free just weeks out are very rare.

And unfortunately there is a lot of marketing hype around anterior approach. It is not a quicker and easier recovery.

Give that hip one year or longer!
 

Eman85

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It's hard to compare recoveries and even pain levels. I experience pains with both hips at times, nothing severe or anything that makes me think something is wrong with the implant. Early on maybe around 3 mos I had pain bad enough that I thought I had a problem but rest and ice proved it was soft tissue.
I am always skeptical about the 6 week wonders, I'm sure they are out there but few and far between. I think time kind of erases the memory of any pain and the stories get a little exaggeration over time.
I set the bar pretty low as far as recovery went to start with, I started with just being happy to wake up in recovery and everything else was an added bonus. I was thrilled with the increase ROM and then with the lack of deep joint pain and sharp bone on bone pain. As I said I still have pains in both and wake up stiff in the mornings. Pains fade as I get to moving and I can walk miles and do any and everything I care to do.
 
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HelenaM

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@golfer67,
I am sorry to hear that you have had a difficult recovery, and I hope you too will find a solution. Although I am not where I had expected and hoped to be at one year, I am encouraged to notice some small improvements from week to week. My family doctor sees many patients with replacements, and thinks my particular situation is still within the norm and may improve, so I am hoping for that. I also feel frustrated since it is a long recovery.
 
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HelenaM

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@Eman85
Thanks you for your comments. On the positive side, I am able to walk a much greater distance than I was before the surgery, and was able to stop taking Tramadol early on. I wake up feeling almost normal, and feel sore and stiff later, and in my case, the afternoon decline happens regardless of my activity level!
 
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HelenaM

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@pumpkin

I have read that If you want a second opinion, you should go to a Revision specialist who does not know your surgeon, I live in a large area, but i am sure that most of the joint replacement specialists know each other. Has anyone had any luck with a zoom conference or review with a respected surgeon in another city? X-rays, notes, etc. could be sent. That might be a starting point before going to the time and expense of going out of the area. Another possibility might be to see someone in the area and see if this second surgeon might offer a different perspective or help or a solid/valid confirmation of a colleague before traveling.
 

FCBayern

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I don't have any personnel experience in that, but since Covid remote consults have become much more accepted so I would think your chances would be good @HelenaM.
 
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HelenaM

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Is it possible that surgeons have a valid reason for postponing X-rays and other tests for awhile for certain complaints that a patient may have? Could it be that many issues resolve, although not as soon as we would like? Or could it be that tests can be somewhat unclear and might lead to something unnecessary? That has been said to happen with some other types of tests outside of orthopedics.
 

djklaugh

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@HelenaM There probably are many reasons why tests or x-rays would be postponed - I'm not a medical person so just off the top of my head and from my own experience: 1- with x-rays they are sometimes not clear enough to pin point the problem - particularly if the problem really is with muscle or tendon issues; 2-insurance coverage issues ( some insurances are picky about how often a test or x-ray can be done); 3- Covid has added the complication of hospitals and clinics needing to space patient appointments out so there is less likelihood of infections; 4- the doctor or surgeon might feel more time would improve the problem though IMO that person needs to explain their thinking to the patient.

Other than those general reasons I can't think of any others that might apply to your situation. I sure hope you can get some clear answers soon!
 

Sashimu

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@HelenaM, in my case I asked my surgeon about an MRI at 2 months out, and he told me it was too soon after surgery. As far as I understand it, he said that the disruption of soft tissue caused by the surgery would need to settle down some more before the MRI would provide any answers.
 
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HelenaM

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@Sashimu
My surgeon thinks soft tissue is still healing and needs a little longer. He checked range of motion and gait and was satisfied. He recommended no pt, but walking is ok. My last X-ray was in January, and that looked good. My pain level on most days is 1 or 2, and I have had 0 pain at times. However, I am at the one year mark, and grateful to be doing this well, but disappointed t hat my healing process has been longer and slower than that described by friends and in patient reviews. It has also worried me at times that it was slow, but I am still noticing slight improvements. And I think I did a little too much pt earlier. So I hope your issues will resolve soon. A heating pad does help me now, but it did not earlier on. ;
 

Ric A

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This is very similar to me. Hip 1 9 months ago. Fine until 6 weeks ago now playing up with soft tissue pains and aches and tight calves and hamstrings. Hip 2. Is now 9 weeks post surgery and no issues. I was hoping all pain would be gone by now. I can walk for 3 miles every day and swim for 1 hour twice each week. I have eased back on pt it seems to make things worse. My next meet with surgeon is in August.
 

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