Revision THR Second times a charm?

[Sockeyewillie]

I meant to add photo of my new implant and my old. Notice the difference in the depth into the femur.

 

[Layla]

Wow! Nice update and great visit with the surgeon. It sounds like you recovered from the twist and had a very active day. Thanks for updating. It's nice to read you're feeling better,
Have a great holiday!
@Sockeyewillie

 

[myglasshalffull]

Great update...stay well

 

[Sockeyewillie]

I got to tell you that I feel worse this week than last. I’m apprehensive because of the way I’m experiencing pain. It reminds me of the same pain that led to this revision. I know it has only been 7 weeks but I can’t help it.

 

[Elf1]

@Sockeyewillie you did quite a bit over the weekend so that could be contributing to you feeling worse. Try to rest up, relax, elevate, and ice for a few days and see if it makes a difference. If it continues or gets worse you might want to call the surgeon's office and voice your concerns with them. Hopefully its just a trip to the ODIC.

 

[Sockeyewillie]

@Elf1 My concern is that it all feels like bone and implant pain. The muscular portion feels well no pain there.

 

[Eman85]

Only advice I have is sit and ice and see if the pain subsides. If it does it's tissue, bone pain won't go away with ice. If you relax for a couple of days there's a good chance the pain will stop. What is it about a THR that makes us want to suddenly be over achievers when the rest of our life we wanted time off to relax?

 

[myglasshalffull]

I think it's like when we were kids, if they say don't do something you automatically want to do it. I find in recovery some of us like to push the envelope just to see what we can get away with.
Plus for me at different stages in recovery I felt great early on then reality kicks you in butt and then you start to pay attention to your body's likes and dislikes.
I think even after a year I'm still in some sort of "recovery" mode.

 

[Layla]

I did pivot on it mistakenly yesterday and felt a sharp pain on the front of my thigh. I’m hoping it was muscle and tissue. I immediately iced for the rest of the day and rested. This morning I rose with pain that reminded me of the type I experienced that led to revision. Before today I woke up every morning without any pain or resistance in my operative leg. It wouldn’t last long but was encouraging. I’ll have to see how the day goes. Irrational fear probably but I can’t help it.

You did pivot, or twist, so it makes sense that you’d feel pain. This was only 16 days ago.

Did 5 hours of yard work, catching up, weed whacking, raking, wheel barrow. Fired up the tractor and moved some loam. Graded the driveway. Had some chicken coop work to catch up on also.

This seems like a lot of activity, just seven days ago, at only six weeks post op.
Wondering if you mentioned the pivot to your OS and if so, what his thoughts were?

I certainly understand your apprehension given you experienced a revision. If you didn’t discuss your fears it with your OS on July 1st, wondering if you’d consider calling the office for some reassurance? It is sad to think of you dealing with this uncertainty. I hope today is a good day.
@Sockeyewillie

 

[Sockeyewillie]

@Layla I was waiting for your input in particular. I did mention my pivot to my OS. He said “ouch”. I was feeling pretty good that day and the x-ray, that I shared above, looked good to him.
I’ve been icing a lot more, I had back off quite a bit, and I believe it’s helping. Today was/is a better day.
I am pushing my luck with the amount of chores I’ve been trying to get done on the homestead.
I’m taking a few more weeks off from work on FMLA and I should use them to get better instead of trying to get more work down around here.
Thanks everyone for the support!

 

[Layla]

Please do continue to rest and ice, then lean into activity slowly. It is so easy to push it when were feeling good and it doesn't hurt until we stop. In these early weeks and months, remind yourself often of the controlled trauma your body endured and allow yourself the TLC you deserve at only 52 days post op. Short amount of time after major surgery and in the whole scheme of things considering you want this implant in place, hopefully for life. Consider getting help for chores around the home that can't wait, for the time being, if possible.

I’m taking a few more weeks off from work on FMLA and I should use them to get better instead of trying to get more work down around here.

YES! Now you're talking!
Happy Sunday to you and, Pennie...hope its a good one!

 

[Sockeyewillie]

Can anyone speak to this question about pain/discomfort? I feel like most , if not all, of my muscular pain is gone but I continue to have pain that to me feels like it originates in my femur. A good example is when seated in my recliner and I perform a straight leg lift I feel pain at the top of the lift. When I return my leg to the base the pain is significantly more and immediately subsides.

 

[Layla]

Hello, it is nice to hear from you! Been wondering how you were doing...giving it a few days.

I believe I had the same, Sockeyewillie. It's called femoral stem pain. This is how its described:
Thigh pain may occur as a result of stress shielding of the femoral stem. The stiff femoral stem may impinge upon the weak bone especially further down the thigh bone. The stress of the femoral stem may lead to thickening of the bone down the thigh bone.

I noticed it when I'd raise my leg to rest it on the coffee table in front of my sofa and honestly, I felt like it lasted a couple of years. I'm not kidding. I did ask my OS about it at my one year post op visit and he answered me while preoccupied and said something similar to "it's likely knocking the bone". I didn't like the sound of it, but since he seemed unaffected by it, I didn't press it. I can certainly understand your concern given all you've been through. However, that is my best non medical professional, guess. Google "Femoral Stem Pain post THR and see if you feel it describes your pain. Let us know what you think afterward. We do care!
@Sockeyewillie

 

[Sockeyewillie]

@Layla Thank you for you response. It’s probably the only one I need to hear.

 

[Layla]

You're welcome. I just found this also. Yours is cementless, right?

The rise in the use of cementless femoral stems has increased incidences of thigh pain. Historically, surgeons used bone cement to secure cemented hip joints. The new cementless joint allows the bone to grow and attach to it. Despite its benefits, cementless surgeries are more likely to cause femoral stem pain than cemented procedures.

However, while thigh pain is a possible complication, it does not usually persist over the long term. Most hip replacement surgeries result in a significant reduction in pain and improved quality of life.

 

[Sockeyewillie]

Stress shielding is what my OS diagnosed before my revision and is what it feels like now.

 

[Sockeyewillie]

• Thigh pain may occur as a result of stress shielding of the femoral stem. The stiff femoral stem may impinge upon the weak bone especially further down the thigh bone.
  The stress of the femoral stem may lead to thickening of the bone down the thigh bone. Stress shielding occurs due to mismatch of the forces acting at the end of the femoral stem. Patients usually complain of thigh pain rather than hip or groin pain.

 

[Layla]

I'm tagging @Jamie and @Jaycey from Admin to see what their thoughts are. Jamie may still be on the forum tonight, but, Jaycey, is in the UK, so she won't be around until tomorrow.

 

[Sockeyewillie]

Yes, cementless

 

[Jamie]

I think you do need to give this situation a little more time. You definitely overdid things in addition to having the twisting incident. Even though you might feel good with the new hip, this is just like your first joint replacement and your body is still healing. Maybe you can hire someone to help with the home chores, if they are a problem for you. You need to allow time for the bone ingrowth. If straight leg raises are painful for you at this point, don't do them. This time of recuperation is VERY important, as it is the time your body builds the bone tissues that grow into your new stem. Doing a lot of physical activity like you described could cause disruptions in this delicate new growth. I'm not saying that has happened, just that it is possible. It's too soon for your surgeon to be able to determine if that's the case, so your best course of action is just to scale back the activity and slow way, way down. If that doesn't cause the pain levels to decrease, then make another appointment with your surgeon in 3-4 weeks....or sooner if the pain increases.