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THR Severe pain after 15 months<

@Dickie 1 it's unnecessary to quote a post just to reply to it. Just scoot on down to the bottom of the page and start typing! Unless there is some specific phrase you want to address, of course!
Then do it like this How to quote a post.

However, on this occasion you've quoted your OWN post and not made a message in it at all! This is a definite NO-NO! So why did you do it?
 
Dickie 1 said:
There is no bone resorption around the acetabular cup or femoral stem of the THR prosthesis.
Subperiosteal new bone is noted on the medial aspect of the proximal shaft above the level of the femoral stem. The stem does not appear to abut the medial cortex suggesting it is not due to a stress reaction, but may instead be due to a healing stress fracture of the femoral shaft. New bone was not evident on a previous x-ray on March '17.
Conclusion: suspected healing stress fracture
Click to expand...
I think you've interpreted these results correctly, near as I can tell without actually seeing the xray. But it all describes a good degree of healing (note text in bold) so I'd leave it be and see how it goes. These stress fractures are invariably minor issues and should sort themselves out eventually.
 
Thank you Josephine, regarding the quote, it just appeared there, it wasn't intentional and I couldn't delete it.
I must of hit a wrong button, I didn't know how to delete it. I am not the greatest computer brain, I was using the laptop and it has a mind of its own. This is why I prefer the desk top.
I'm glad that my medical brain is still in good order.
Now to get to the bottom of the ongoing pain then. That certainly isn't going away and my mobility or weight bearing isn't improving either. Thank you, I'll try to delete the quoted post.
 
Well I phoned the OS and I made an appointment for next week. Then this afternoon, the OS phoned me at home, he believes that the stress fracture has always been there, that the fall off the step incident a few weeks ago has opened it right up.
He said that both the femoral implant and acutabulem implant are fixed well.
He was very excited that the cause was found. I am not so convinced, as he was that this is the cause of the pain. Should the stress fracture have shown up on the MRI that No 2 surgeon had done in March? I understand that they don't always show on x-ray.
He is sending me for bone density testing now.
Surely if it was a stress fracture all along, it should have healed by now, after nearly 16 months.
What do any Moderators think?
 
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Dickie 1 said:
Surely if it was a stress fracture all along, it should have healed by now, after nearly 16 months.
Click to expand...
Dickie 1 said:
that the fall off the step incident a few weeks ago has opened it right up.
Click to expand...
Sounds like you had a weak spot that may have reacted to that fall. But I'm not a medical expert. I'll tag @Josephine for her input.
 
Thank you Jaycey, that is what I think as well. The pain definitely increased after the step incident, but has decreased again back to the level that I had been experiencing all along. To me it also would have been present on the MRI that I had done back in March 2017.

I am pleased that there does not appear to have loosening of the prosthetics, at least that is one box ticked off. I look forward to a reply when time permits. I love this forum, it is so inspirational and comforting for sound advice.
 
The OS phoned me back and he said the fracture has been there all along (so I assume from the THR), but too small to see, the CT was showing the healing callous, not the fracture. No it wouldn't be seen on an MRI.
I said well what do we do to change things so it can heal, as it hasn't healed in 16 months? Are you addressing the pain and lack of mobility, Yes, but doing bone density testing, Osteoporosis, can cause the implant to micro move causing pain.
I'm back on crutches, rest, rest and rest, it is too hard to use crutches at home, really, but when I am out.
He isn't thrilled about me going away, but if I do, I must rest and use crutches the whole time.
I hope he is right. So had I not come off the step at home, as it opened up the fracture apparently, we would still be unaware. He said that I can continue pool work.
Thank you for the prayer my Aussie Girl, please pray that I don't do a peri prosthetic fracture while away.
What do the Moderators think ? Is this reasonable?
 
@Josephine would possibly have some thoughts.
Gracious...guess better to know this now?
Are you OK? I know this has got to be making you super anxious. Hopefully someone much more informed about such matters well be asking soon.
Try not to let all of this blow you up.
Answers finally, now what? That is how I hope you are trying to approach this terrible complication.
Really wishing best for you.:fingersx:
 
Dickie 1 said:
Should the stress fracture have shown up on the MRI that No 2 surgeon had done in March? I understand that they don't always show on x-ray.
Click to expand...
It's quite the reverse. Fractures almost always show up on xrays but they can sometimes get missed in an MRI scan.
Dickie 1 said:
Surely if it was a stress fracture all along, it should have healed by now, after nearly 16 months.
Click to expand...
Not at all! Let me give you a little tutorial

Bone healing is a complex thing: If a bone is broken and secured either with a cast or with screws and such, the object of it is to hold the fracture site absolutely secure and in contact, one side against the other. This allows and even encourages the new bone growth to be created between the broken surfaces. Over a period of time, new bone is grown and eventually joins the two surfaces together and the fracture is healed.

However, should this new growth be disturbed, usually by movement, then the healing process is arrested, the surfaces of the bone lose their freshly fractured state and seal, eventually becoming much like the cortical or surface bone. So healing has failed.
Dickie 1 said:
the CT was showing the healing callus, not the fracture.
Click to expand...
With stress fractures, they very often fail to heal because there is some movement which interferes with the healing process. The evidence of healing is a dense new bone growth we call callus but this should be resorbed after a few weeks. In your case, it would appear that it didn't get resorbed so was actually evidence that there was a non-union. He missed that!
Dickie 1 said:
I said well what do we do to change things so it can heal, as it hasn't healed in 16 months? Osteoporosis, can cause the implant to micro move causing pain.
Click to expand...
The osteoporosis won't cause the micro-movement - only the nonunion will do that.
 
Hello there....... @Josephine. Thank you Josephine for your reply and education, orthopaedics isn't my area of expertise at all. I am always happy to learn from experience.
What should I do then next to encourage healing or am I stuck like this for life?
Should OS then consider more active treatment to enable the fracture to heal, for example surgical intervention?
All he wants to do is a bone density scan and nothing else, then act if osteoporosis is found.
To me this is not active treatment. OS said this stress fracture (mid shaft of femur) could take months to heal.
I've spent the last 16 months in terrible pain and with limited mobility. I do not desire to continue like this for months to come.
If you were in my situation, what would you do next? Thank you in advance.
 
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It will be easier to get Jo's attention if you tag her even if you are continuing a conversation. She is forum-wide. Like so...@Josephine, what do you think?
That way she will be alterted you need to ask her a question.
I am interested in what she thinks too as it doesn't sound like what she described is anything that will fix itself.
Hang in there, sorry you are having this complication.
 
Thank you Mojo...... A slightly better day today pain wise. Maybe the less weight bearing is helping.? Fingers crossed.
 
Certainly staying off of a stress fracture has to help. What a complication after a year...we do know when things aren't right don't we?
Hope you can get a plan started to get something healing.
We are in crazy hurricane season on this side of the world. Now it's going to barrel on top of Georgia so gas and basic commodities are at a minimum.
I'm not worried, Florida is the main concern.
Please try to be as easy as you can on that leg until it can get worked out. Hoping you get a plan soon:flwrysmile:
 
Update, I made it to Seattle, had 10 wonderful days there and then came home on a cruise ship. My hip behaved itself, I didn't push my luck (used crutches), but it went well. The rest on the ship allowed the pain to calm, but not go away, no change to stiffness or mobility.
On my return to home, the 2nd opinion OS rooms had phoned. I returned their call and said I would cancel as a stress fracture had been discovered. They advised me to keep the appointment anyway, so I attended this week.
I told him that I had been to the original surgeon and that a stress fracture was discovered, this being the cause of all the pain.
His reply was: He was glad my pain had reduced, that from the same CT scan he could see no evidence of the prosthetic adhering to the bone and he feels that the stress fracture is a red herring. I need to be closely monitored with x-rays at the end of march. I was a tad surprised that his comment was the polar opposite to the original surgeon and I am very glad I attended the appointment.
My Aussie Girl, thank you for the ongoing prayers. My friend locally has invited me to a healing session at her house. I am in less pain than I was. So that is a positive there.
 
:prayer: still sweetie I am glad you're still seeking answers but more so that you had two good trips and are a little more pain free
 
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