THR Shin/Knee pain 5 Months post op THR

Mts950

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Hello,

I'm 5 months Post op from L anterior THR and have experienced shin and knee pain since week 2 in recovery. At my 4 week check up with OS, xrays showed hip joint was fine as well as tibia. OS didn't know what to think of the shin pain but it should go away with time. I decided to get mri of lower back to check for herniated disc, it showed slight L4 bulge so I got epidural cortisone and it did nothing. I also was prescribed Gabapentin for nerve pain, it did nothing! I decided to get second opinion from another OS, he said xrays looked ok but that he would of used smaller cup and no screw. He also recommended more blood work to check for infection, came back fine. He also recommended Emg, I did that test, neurologist says my lower leg nerves are working fine. So you can see I have done every test that has been thrown at me and still have lower leg pain. Walking is difficult, especially when I first get out of bed and getting out a chair. I'm now curious if I have an MCL sprain, 90 degree bend in left knee can be painful too touch. But why shin pain?
Has anybody else had these issues from hip surgery? if so, what was your result? Ya, ya, I know you all say this takes time to heal, but this is nonsense! I didn't have any pain pre surgery, I just wanted my range of motion back in my hip.

Thanks for your time.

Mike.
 
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subie2021

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Hi Mike,
Sorry that you're having problems with your leg after getting a new hip.
During THR surgery your leg is manipulated fairly hard and sometimes knees hurt afterwards. Did any of your doctors xray or MRI your knee to check for injury?
Have they checked for leg length discrepancy which can cause knee pain?
Has anyone, maybe a physical therapist, checked your gait? Lots of us find we have new gait patterns, and sometimes they can put strain on knees. Have you gone from a pre op poor gait to a post op normal gait, or have you been compensating in a different way out of concern over your new hip?
Best wishes for finding answers and a solution to your painful knee.
 
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Mts950

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Thank you,
Yes on xray of knee, no on mri. Leg length was measured during surgery and after and it is fine. I do question gait , have been to many PT sessions for this, will bring it up again at next pt. Gait compensation is a very good possibility. That fact that the first steps out of bed with shin pain and knee pain baffle me??
 

subie2021

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My guess would be the pain would be something in there is cranky about having to go to work, like when someone has plantar fasciitis.
Out of curiosity I checked a trigger point chart and saw that several muscle in the hip can cause problems down the line including knee and shin - adductor longis and brevis, rectus femoris, and vastus medialis. Maybe trigger point work would give you some relief?
I've used triggerpoints dot net for a "map" in the past.
 

Jamie

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Hi, Mike....sorry you're experiencing this pain. What is your activity and exercise level like on a normal day? It may be that you need to scale things back for a few weeks to let things in your knee settle. If you haven't purchased new shoes, that's something that works for many people. Our shoes have old wear patterns from pre-surgery days that cause imbalances once you have your joint replaced. This can cause the type of pain you're describing.

You might also explore an app available from one of our partners, OneStep, as an addition to your local therapy sessions. It is available to try for free at no cost for BoneSmart members and then if you want to continue with the program, the monthly cost is reduced 15%. You must sign up through our BoneSmart link to receive these promotions, though. The benefit of using OneStep is that the app has the ability to measure your gait each time you take a short walk, so you always know when you're walking correctly or not. It provides a medical-grade gait analysis that is usually not available at most therapy clinics. The OneStep therapists will work with your local therapy program to be sure you get the best of both worlds.
 
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Mts950

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My guess would be the pain would be something in there is cranky about having to go to work, like when someone has plantar fasciitis.
Out of curiosity I checked a trigger point chart and saw that several muscle in the hip can cause problems down the line including knee and shin - adductor longis and brevis, rectus femoris, and vastus medialis. Maybe trigger point work would give you some relief?
I've used triggerpoints dot net for a "map" in the past.
Thanks! I will check this out!
 

Jamie

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Mike, I see you registered to give OneStep a try. Please let us know how that works out for you.
 
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Mike,
My IPhone tracks steps as well as walking asymmetry, it's quite useful. I find when I overdo my walking (in the past), I would develop shin splints then I'd back off my excessive walking for a day or two.
I'll be 4 months post op on 16th and I'm up to about 2 miles now, still take cane with me but also walk freely. I kind of overdid it the other day so last two days been chilling a little more but still getting good amount of walking in.
My asymmetry has improved and down to 0 the other day which means my steps are good proportioned.
I had meniscus tear several years ago, I opted to self heal which I did over a period of about 3 months, I had been walking very aggressively uphills and tore the meniscus. My OS said surgery doesn't always fix it and it can weaken another part of the knee so I took his advice and healed on my own.
Maybe grab a knee compression sleeve??? I use one occasionally and my knee feels better.
Hope all your issues resolve soon.
All my best.
 
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Mts950

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I’m nearly 7 months post left THR and still can’t walk right and have pain in shin and knee. I feel it most when I get up out of a chair or after sitting for a while. There is pain and I limp. Sometimes it feels like my knee will buckle.
I went to my OS this week again to see what he says with new X-rays, they all looked fine he said. When I explained to him about the pain I feel when getting up from sitting, that caught his attention and mentioned that maybe the femoral stem is loose? Pt says it is muscle skeletal and I say no way! My OS is now going to confer with a Dr. Kwan out of Mass General in Boston about this, I will be waiting to see what he says??
Thanks for any input!

Mike-
 
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Wow, hopefully your femoral stem isn't loose, holy moly.
Did they just Xray knee or hip as well???
You are in good hands with Mass General.
Let us know, I wish you the best.
 
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Mts950

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Thanks! Yeah, both hip and knee were
X-rayed. From what I’m reading in all these threads, sounds The OS will never admit there is a major problem. I’m taking this into my own hands and will find the best revision Os I can find! I have felt from the beginning something was truly wrong after my surgery.
 

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I think you're wise to seek a second opinion from a reputable revision surgeon, Mike. I am wondering if you'd like to share your exact surgery date and which hip so we can create a signature for you? We'd really like to support and encourage you as you're seeking options and especially if you have to go through a revision and recovery. Please know that we're here for you and we care. I hope you have a nice rest of the weekend. :)
@Mts950
 
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Mike, in this current heath care atmosphere you have to be your own advocate.
Doctors won't admit they are wrong or make mistake because they are all worried about malpractice.
You have to kick and scream (not literally), to be heard.
good luck.
 

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