Thigh pain

[wilms]

Hi I have been posting on Duckie 16’s thread I thought I would make my own finally after 3 months and 2 cancelled appointments I have been to see my consultants registrar today.. I had my THR 7 months ago and all was going well. 3 months in and I started experiencing thigh and groin pain with clicking movement in the joint itself. My thigh pain comes on when resting after I have been walking or any form of physical activity, it feels like constant bad toothache sometimes severe enough to make me groan. The main pain is in my mid thigh and can radiate up down and around that area. My groin pain comes and goes, I cann’t put it down to anything I have done in particular at anytime. The movement clicky feeling (no noise just a feeling) when I walk or any movement side to side can bring it on sitting and shuffling my butt on a seat or moving position in bed can make me click. I had an x ray and reported all that I have said here to the doctor. He has told me that the thigh pain is coming from my cementless implant which has some movement because the bone has not as of yet started to grow around it. I could have movement and pain up to 2/3 years and I was in the unlucky 20% who sometimes suffer this! I have a ceramic on ceramic head and cup and this is causing my clicking feeling as it slides across the joint and the groin pain is from the ridge at top of implant joint. He said my x ray shows that I have no new bone growth as of yet around the femur implant but to give it time and just to carry on taking pain killers if and when I need them, so that’s it I’ve come home feeling a bit despondent and the feeling of just ‘get on with it’ so it doesn’t look I will be climbing mount Snowdon anytime again in the near future

 

[alexthecat]

He said that you have no bone growth at all after seven months? That worries me a little.

That 20% figure just sounds wrong. We see lots of people come and go on the forum. I don't believe that 20% of them still have serious pain at your point in revovery. My THR was about 2 years before yours and, by 7 months, I was forgetting all about it.

Can you get a second opinion?

I'll tag Josephine for you. Do you have X-rays you could post for her to see?

 

[wilms]

Hi Alex that's what he said yes I have x rays not very good as took them with I phone off of his monitor

 

[sharonslp]

Wow....I have alarm bells going off, just like Alex. I have cementless implants also, and I have a clear recollection of discussing what happens with cementless and him telling me that bone growth should be well-started by 6-9 weeks, and quite solid by 3 months. There was NO mention of any 20% failure rate...20% is huge, and I can't imagine surgeons going cementless if the risks were that high. This is not to say your surgeon is wrong about it taking more time....but the phrase "second opinion" is flashing in neon lights in my mind. Let's see what Jo says...I hope it's all okay, but.....

Sharon

 

[Jamie]

I agree, Sharon. The idea that you would have TWO YEARS of possible pain and waiting for bone to grow makes no sense. Let's wait for Josephine to respond, but if it was me, I'd be finding a second (and maybe even third) opinion.

 

[wilms]

Thanks for your replies I wasn't even aware until today of what sort of implant I had i.e cementless and ceramic. Jamie he said up to 2/3 years to heal and settle not for the bone to grow ( I hope he didnt mean that) when he was doing an examination he wiggled my leg up, down and side to side when holding my knee and leg steady, I could feel movement in my mid thigh very strange feeling in deed Sharon I'm hoping I'm not classed as a failure because of my problems I am trying to stay optimistic and hope that it will all come right eventually I don't know if he ment the 20% was from there hospital feedback or world wide I also got the usual question do you smoke? no I don't and I'm not over weight either it seems he couldn't think of what else he could blame it on the only other thing he could think of was to say keep busy should then take your mind off of it! :(

 

[Duckie16]

That sounds very nothingy to me Wilms. Silly word I know but basically sounds like your consultant doesn't want to commit. I have been calling for the last week to try and get the results of my blood tests and all to no avail. I am going to call in the morning and create merry hell.

I have NO FAITH at all, any more, in our NHS, and their consultants. They are so hugely overstretched they just cannot give the same degree of service as we used to get.

I am so sorry that you didn't get a proper answer, to explain your pain, but, sadly not surprised. I think that a second opinion might be a good idea, but you and I both know how bloody hard that is to achieve these days.

I wish I could offer a solution to help but, short of a magic wand, I can't. Just stay optimistic and hopefully you will be okay.

Big hugs.

Sarah

 

[HappyHippy]

Hi Wilms,

I'm also a person who failed to have my non-cemented implant integrate with the bone and loosen early. I'm having revision surgery in January, which is 3 years from my first implant.

My pain has been constant and sometimes severe. My first 3-4 months went well, then I started going downhill. There are a few reasons I had problems 1) anterior approach by an inexperienced surgeon. The stem was too loose to begin with. It also appears that it's placed at the wrong angle, which stresses the whole appliance; and 2) Over-aggressive PT. This was my fault, as I wanted to do very well and really pushed myself.

At 7 months you can still have some bone growth occur is what I've read, but you want to take it easy and avoid stairs and overdoing it. I'm 55 also and increased my hormone replacement therapy dosage this last year. It was too late to get growth to the stem, but it increased my bone density. If you're post-menopausal and not on HRT, or only a low dose, you may want to look into a medium to high estrogen replacement for a year or two to stimulate bone growth.

And you may not be able to do anything, but in my experience the surgeons won't declare the surgery a failure until at least 2-3 years pass. Then they are sure the bone won't integrate or that you'll have acceptable fibrous fixation. I've had test after test until I reached 4 mm of space between my stem and bone and strong signs I have micro movement.

I wish I had better news, but I do recommend taking it easy and trying to stimulate bone production by using hormones. If your Dr. didn't place the stem properly, there isn't much you can do. But it is time for a second opinion, and if you need a revision, you won't want this Dr. to do it. They never admit they made a mistake. And I don't want the guy who screwed up to get a second chance.

I did take a look at your X-rays and it looks like you're showing some space (lucency) like me. You have a collared stem which is supposed to give more stability, but I guess it didn't in your case. And the failure rates aren't 20% - more like 10-17%, and all are not stem loosening. My Dr. became very angry when I confronted him at 8 months with my problems, including damage to my lateral fem nerve. He told me most everyone comes out of surgery with that problem. The Stats don't say that though- he was covering for bad technique. My X-rays are on some of my earliest posts if you want to take a look and I'm happy to talk more about what you're going through. It's a rough road when things don't go as they are supposed to.

Best,

TH

 

[alexthecat]

TH, I'm so glad you posted to share your experience. I know you've been through a lot with that hip. Knowledge is power though, and you certainly have that going for you. Best wishes for your surgery in January.

 

[Poppet]

Hi Wilms

' I'm hoping I'm not classed as a failure because of my problems I am trying to stay optimistic and hope that it will all come right eventually'

I agree with all the good advice you have been provided with, second, third opinion is the way to go, and don't think that your THR is a failure yet until you have sought those additional opinions!

 

[Josephine]

Hi, wilms, I'd like to comment for you but first I need to know which hospital and surgeon you had. Also if you would post your xrays as "Full Image" and not "Thumbnail" because thumbnail reduces the image tremendously which prevents me from enlarging it.

 

[wilms]

Hi thankyou for the replies I have been away for the weekend and had a alovely relaxing time Tiredhippy thankyou so much for your in depth reply it has helped tremondously to read Josephine I will try again to put my xrays up again also I had my surgery done at Northampton general hospital and my consultant is Mr Campion Josephine

 

[HappyHippy]

Hi Wilms,

X-ray 1 looks the worst to me. Your stem isn't straight but at an angle, and you do show space around the stem. Mine are similar. Looks like your stem may have been too small to begin with. I've been reading that this can happen, mostly with uncemented stems. You can have just the stem replaced though, and is easier than a full replacement.

Good luck to you.

TH

 

[Jaycey]

I had cementless ceramic and things were pretty settled by my 6 week followup. I did experience some popping sensation until about the 6 month mark. But I agree with others here - a second opinion is called for. You should not have to put up with "2-3 years" of pain.

 

[Josephine]

wilms, I already asked you not to post xrays using the thumbnail option. This reduces the images to a very small size so if I need to enlarge them they just pixilate. The 'full image' option posts them in the size that is on your camera.

 

[wilms]

Sorry Josephine not sure what I am doing wrong I'll try one last time Once again to all that have replied especially Tired Hippy thank you I havespoken to my gp today who is going to do blood test tomorrow for calcium and vitamin D deficiency no mention of 2nd opinion as of yet unfortunately the NHS doesn't move that quickly also I have been put onto new pain killers in a patch form ( matrifen) so hopefully they will help

 

[wilms]

 

[Josephine]

Still very poor quality, I'm afraid. It's not good enough to take a photo of your computer! You needed to get a little closer and stand directly in front of it so I can see what you see when you are looking at it from your seat! Still, I cropped it a bit so I could make it a little better.

From what I can see there is no bone ingrown into the stem. I cannot say about the cup as the quality of the photograph is so poor.

It would seem to me that you need to see a specialist revision surgeon which it would appear from his bio, Mr Campion is not. I can recommend The Royal Orthopaedic Hospital at Birmingham where surgeons Chana, Jays, Revell and Tilman are the revision specialists on staff. It's an NHS hospital and you can get your GP to refer you there for a second opinion. You have the right to do this under theNHS choice: Patient's Charter and your right to choose. I know it says "for your first appointment" but you can push this and get permission from your Primary Care Trust under your kneed for a specialist opinion.

 

[oldyellr]

Josephine, it looks like what wilms has posted are photos of the surgeon's monitor. Not much detail there for diagnostic purposes. That's all I could ever get, for whatever reason.

 

[wilms]

Thank you for your reply JosephineI will take note of the the hospital and surgeons you have kindly found for me As oldyellr has said the pics are from the registrars monitor taken on my phone I am sorry they are not up to scratch:( its not because I am lazy or cann't follow instruction I have never been in possession of my xrays to be able to scan and upload them I am afraid:( thanks again to all I will consult with my GP on my next visit and update then x