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[REVISION THR] Same pain, second surgery

36andTired

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Hello, I am new to doing anything like this. I am a 36 year old male and last year a had a fall down some stairs at work that I shrugged off for a few works. I tried to see my regular doctor but since it happened at work I had to go to someone else, anyway 3 weeks after the fall we find out my femoral head has partially collapsed and that was causing my severe pain with any weight bearing. Fall took place 2/5/18, I had my left THR on 7/5/18. I did therapy for months, I had an injection in my Iliopsoas and that did nothing (sever groin pain, constant throbbing) I was having a lot of thigh pain. My Ortho didn’t know what else to do so he sent me to someone else. March 22nd of 2019 I saw the next surgeon, he looked at my x-ray and in two minutes he saw the problem. The cup that is in my pelvis that hold the ball from the stem was not attached and moving around. July 9th 2019 I had revision surgery. I am about 6 weeks out, the groin pain is worse. The thigh pain throbs on the front of my thigh as well as kind of in the inside too, feel like a deep ache. My left upper button/lower back is in this weird cramped feeling that I can’t get Relief’ from. Physical therapy has not been mich help. I also get a really bad pain mid buttock on the left side if I am reaching for anything low, raising the toilet seat, picking something from a low drawer or getting anything from the floor, when I stand back up and I can’t walk for a few seconds becasie the pain is so bad. I can’t stand on that leg, it feels like it’s going to give out, so I always have to lean on things to get dressed. If I hold on to something and stand on operated leg it hurts (deep) and when I take all weight off it hurts deep, almost a sensations like my leg is going to fall off.. I’m just afraid this one is loose too, I forgot to mention I do have AVN, and the revision was screwed into my pelvic area... (also my incision is still open, about one inch) sorry for the rant. I am sure I left something out; but this pain is driving me crazy!
 
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Mojo333

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:wave: @36andTired
I'm so sorry about this long journey you have been on stemming from your fall.
Terrible that your THR had to be revised but hope you have had some post op xrays to show things are now "in place"
No doubt there's alot of trauma still settling.
Were you giving Weight bearing restrictions and are you still using a cane or other assisted device?
Please check out these recovery guidelines with lots of good information.
Hip Recovery: The Guidelines
1. Don’t worry: Your body will heal all by itself. Relax, let it, don't try and hurry it, don’t worry about any symptoms now, they are almost certainly temporary
2. Control discomfort
rest
elevate
ice
take your pain meds by prescription schedule (not when pain starts!)​
3. Do what you want to do BUT
a. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you
b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.​
4. PT or exercise can be useful BUT take note of these
5. At week 4 and after you should follow this
6. Access to these pages on the website

BIG TIP: Hips actually don't need any exercise to get better. They do a pretty good job of it all on their own if given half a chance. Trouble is, people don't give them a chance and end up with all sorts of aches and pains and sore spots. All they need is the best therapy which is walking and even then not to excess.

We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery.

While members may create as many threads as they like in a majority of BoneSmart's forums, we ask that each member have only one recovery thread. This policy makes it easier to go back and review history before providing advice.
 

Izabel

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:wave: 36andTired and :welome:

I am sorry your suffering has been going on for so long. I cannot advise but an Advisor will come along soon.
In the meantime, take any medications you may have been given, rest and ice the painful areas. :elevate: :ice:

Sending you good wishes hoping you et relief soon.
 

Layla

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I'm sorry to read about your accident, resulting pain and all that's followed.
I'm not understanding why you had to wait 5 months between the fall in February until the THR in July?
Then an additional extended period for the revision after the diagnosis of a loose cup in March of 2019 until your July surgery. I don't know that I think suffering pain at only 6 weeks post op from a revision surgery is all that unusual.

Wondering what meds you're on? If you're not on anything at this point, the forum nurse often recommends Extra Strength Tylenol at 1000 mg every six hours, not to exceed 4000 mg within any 24 hr period. If you're taking anything else that contains Acetaminophen you need to calculate that into the 4000 mg, not to exceed that amount.

As Mojo inquired above, are you under, or were you under, and weight bearing restrictions?

Are you using an assistive device? It is recommended you rely on an assistive device until you're no longer limping.

Are you, or have you iced at all? Please begin icing and elevating if you're not already. It helps with pain and swelling. Ice any /all areas of discomfort for 40-60 minutes, each session, several times daily.
Following is the article on ICE from the Recovery Guidelines in case you haven't read through the articles yet -
http://bonesmart.org/forum/threads/ice-to-control-pain-and-swelling.5493/

If PT isn't helping, set it aside for now. It could be aggravating any ongoing issues.
BIG TIP: Hips actually don't need any exercise to get better. They do a pretty good job of it all on their own if given half a chance. Trouble is, people don't give them a chance and end up with all sorts of aches and pains and sore spots. All they need is the best therapy which is walking and even then not to excess.

Use the golfers reach when bending over to do anything low to help with the pain you describe when doing so.

Consider Magnesium for the cramping you've described. Many have used it with a great result -
Magnesium supports the following:
Bone health
Healthy blood sugar
Cardiovascular health
Muscle relaxation and nerves
Promotes healthy sleep (falling asleep and staying asleep)

An article on Magnesium -
https://bonesmart.org/forum/threads/magnesium-is-a-star.20301/

Have you communicated to your surgeon or a member of his care team that your incision is still open at 6 weeks post op? If you haven't, you should. Wondering if you've been instructed on how to properly care for it?

Below you'll find some Revision threads to peruse, if interested -
https://bonesmart.org/forum/view/hip-replacement-recovery-area.5/?prefix_id=19

Your recovery could be a bit more involved, but we don't want to be dismissive of anything you're concerned about. I hope you're not hesitant in contacting your surgeon's office with your concerns. If you haven't, I think you should make a list as you did above and request a return phone call from your surgeon or a PA.

Stop back often, we'll do our best to advise, support and encourage, but we cannot take the place of your surgeon for matters that don't resolve with some of the tips offered above, and in the Recovery Guidelines.
Wishing you comfort as you continue healing.
@36andTired
 
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Jamie

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I have some of the same concerns that Layla expressed. We're going to need to know more details about what you've been doing since your revision 6 weeks ago.

Please let us know:

* Medications you're taking (type, dose strength, frequency taken)
* Exercises and activity you're doing (list each exercise with number of reps and sets; list specific household chores, work, errands, etc. done on a regular basis)
* Frequency and duration of icing, elevating and resting your leg
* Assistive devices (cane, walker, crutches) used
* Any drainage from the open wound? (a photo would be helpful)
* Last contact with your surgeon and what he had to say about your issues
 
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36andTired

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I will try to answer all the questions listed above. The delay between injury and surgery was primarily workers comp requiring second opinions, I was non weight bearing at all between March of 2018 and July 2018 (first surgery 7/5/18) after that surger I did not have any weight restrictions what so every, after I kept complaining of groin pain, he just said it was muscle. For some reason the first surgeon never saw the “loose cup” after seeing him over and over for pain and discomfort. That is when he referred me to the new doctor that immediately saw the issue. This doctor, also did not put me on weight restrictions, pretty much told me just not to do yoga. I can’t even wear shoes that need to be tied because I can’t really get to my left foot because of the pain. The groin pain is constant and dull. The pain on my backside feel more like a cramp on the dull side (like if you sat on a wallet too long your cheek starts to ache.
For therapy, I’m just doing leg lifts 10 reps 2 times a day. Side steps, I try to walk around and go to the grocery store and stuff so I am not just sitting all day. I do have to use a cane and I have been using a cane since about 3 weeks post op (of the revision 7/9/19)

I slowed down on the pain pills because I could tell the doctor was not wanting to prescribe them any more, I take one hydrocodone per day (5/325). And Iburprofen. I saw the comment about trying Tylenol so I will give that a shot.
I am sorry my posts are so long; and I tried to answer everything.
 

Jaycey

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@36andTired So sorry you are dealing with this pain! For starters I would stop all that exercise. You need to let that hip settle. Leg lifts and side steps are not helping. You are not in training - you are healing.

Are you icing and elevating for at least 45-60 minutes several times per day?

Is there any drainage from your wound?
 
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36andTired

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I knew I forgot to mention something lol. Yes elevating and icing for over an hour at a time, I have to sit on ice and also set ice packs on the front of my leg (high thigh) and in my pants on the crease where my leg and pelvic area meet. I don’t feel any relief from the ice until at least 45 min.
Wound drainage yes, the first two weeks post opp I was going through an 8x10 gauze bandage every couple hours. I still have an open wound where my waist band is, no drainage now. I keep it bandaged, it’s white in color. I’m not swollen, and I am driving (short trips) to the grocery store, I can go to Sams/Costco but only if I need one or two things, can’t spend too much time. I drive an SUV so getting in and out of the car is manageable, a car would be impossible. Hopefully I covered everything.
 

Layla

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You're talking about trying the Extra Strength Tylenol regimen in lieu of the Hydrocodone and Ibuprofen, right?
NOT in addition to. Want to be clear on that...
@36andTired
 

Layla

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You missed one question -
Last contact date with your surgeon...and what he had to say about your issues?
@36andTired
 

Izabel

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I still have an open wound where my waist band is
I don't understand this? Where is your waistband and where is your surgical scar? Not being rude but how tall are you and what is your weight? I ask because my husband calls his waist well below his belly button where he wears his belt with his tummy hanging over! :thud: I think it is supposed to be 6 inches or so above your belly button. :scratch:
 
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36andTired

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I am referring to using Tylenol instead of hydro and ibuprofen. I have been emailing someone in my doctors office. I was emailing daily when I was having a lot of drainage. Last I spoke to them was last week, and the wound looks the same from when they received the last photo. I go in for the first time since surgery on 8/22.

When I say waste band, I am just over 6 feet tall, and weigh 224 lbs. My surgery was anterior approach, incision had to be extended during second surgery but I believe the transcript of surgery said incision was just under 7 inches. (I also consider waist band below belly button, I am “chubbie” My belly doesn’t hang over, but yes it would be in that part of my body on the left side.
 

Jamie

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Thanks for the additional information. I agree with Jaycey that it would be good to stop all the leg lifts and side steps at least until you see your surgeon again. If you can stop everything but just some walking several times a day, keep up with the icing and elevation and take something for the pain for at least a couple of weeks, it would tell you whether you were just doing a bit too much too soon. That's possible.

Make sure you ask your surgeon a lot of questions about that open portion to your wound. Normally it would have closed by now, so even though it's not draining at all, he should offer information on what's going on and when you can expect it to be closed.

Please let us know how the appointment goes. Hang in there. Sometimes recovery can be a bit tricky, but we'll be here for you.
 

Izabel

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Ah ha, thought so! :heehee: You men! 'Chubbie' is okay... 'cuddly'. So you wear briefs like my Hubby. I have antero-lateral and the leg elastic of my briefs irritates my scar so I wear tai briefs (TMI) which have a high leg cut. Perhaps you should change to them :whistle: or boxers for comfort.

My scar is 8" even after 3 surgeries in the same place and is slightly indented. I had a 30cm stem put in and I am just 5'2". I had drainage on the upper section for a good three weeks which worried me as I had had infection, but my Surgeon said it was just blood water. It is still sensitive in that area five months on.

I am surprised your first post-op is not until next week and I sincerely hope you get some positive answers.

Sending best wishes for a peaceful weekend.
 
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36andTired

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I had my follow up appointment yesterday. I go back in three weeks for a “wound check” since my incision is still partially open. He said my pain is soft tissue pain even though walking up and down stairs kills me. I will give it some more time to see if the pain subsides.
 

Layla

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I hope your wound completly closes soon and your pain walking up and down stairs eases.
Not sure if you can avoid the stairs, but if it was me, I certainly would for a time if it's that excruciating.
Thanks for updating. Stay in touch and let us know how you're progressing.
A great weekend to you!
@36andTired
 
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36andTired

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Question, I am not doing PT anymore. I am walking a lot, but just like grocery shopping and stuff. I am having really bad thigh pain still, if I try to put all weight on operated leg it feels like it’s gojng to “give out” and hurts, then when I suspend the leg off the ground it hurts really bad too. So pain with weight and non weight. What could it be, I am sure you need additional info but not sure what else to say. I am going to attach the only X-ray I have a picture of and it’s while I was having the enjection in my Psoas (that never did anything) this X-ray is from 1/30/19 @Layla
 

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36andTired

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How can I tell if my post gets seen? Am I doing something wrong?
 

Layla

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Hi @36andTired
I'm sorry, I'm just now reading your post from Wednesday and overlooked your tag. The x-ray was taken before your 7/9/19 revision so not a current view. Have you contacted the office of your OS with your concerns?

Are you using an assistive device? When did you begin PT, how often / long did you go, when did you stop?
You're only two months post op from your revision so some discomfort can be expected. Did you notice any correlation between the onset of pain in relation to PT?
 

CricketHip

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Hello! @36andTired You have been through a tough year!
You are answering the pertinent questions from the other moderators so I can't really add anything new except to tell you that I am 11 weeks post op tomorrow and I still have a good bit of soft tissue discomfort.
It increases if I overdo things and I'm still icing and resting quite a bit during the day. I still used my cane up until about a week ago..not all of the time but enough that I was annoyed that I needed it!
It's understandable that you are worried that again something is loose or not right but I doubt any surgeon would want to do anything until your hip and surrounding muscles heal for a longer time. That's because the inflamed/ tight muscles, tendons and ligaments take a very long time to calm down.

Glad to read that you have discontinued the exercises..that is a good step in the right direction. Can you find a solution to the shopping? I still avoid walking around in grocery stores or the big box stores.. even picking up a few things ends up being a long process with many steps. I save my steps for walking around my yard and home and for my phased return to work. I figure that is enough at this point.

Sometimes we need to take a step back (literally) and back off on activities to see if we can get a positive result.

One more thing, maybe look at some of the recovery threads, you will see that there are several who have had to take things really slow for much longer than they thought normal, with good results in the end.
I sincerely hope that this is all you need, but for now at least, it's a way to see if your body responds and rewards you in the near future. :flwrysmile:
 

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