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THR THR - 2 1/2 years post op with possible ileopsoas tendonitis

gemdamon

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Hi all. I am new to this site and hoping to get some help/suggestions for how to proceed. I had a right THR post op 6 mo. I had a normal recovery and started back to 'regular' activities about 2 1/2 mo post op. I completed my 12 weeks of PT without incident and continued the exercises for some time afterwards. I went slow and added more walking, exercise bike etc. Iced and took NSAIDs as needed (didn't need pain meds such as Oxy past 2 mo). By 4-5 mo I was exercising daily, hiking and walking the beach averaging >10K steps without a problem.

Now, lately I have had intermittent shooting pain in that groin and soreness as the day progressed, discomfort similar to before the surgery while sitting, standing and driving a car. I am in complete shock as I thought by this time I would be back to fully exercising and hitting way more than 10K steps.

My surgeons office asked me to go in but unfortunately I have to wait for a referral from my PCP due to insurance. It's been a week and I feel at times that maybe going to the ER to get the appropriate tests done to determine the problem may be easier and take a lot less time. Just plain frustrated.


I'm really trying to ask your expert opinions on how to proceed? Wait for the insurance and referral and just lay, ice and add NSAIDs or go to ER?

And some ideas on what it could be? I've heard of iliopsoas tendon and it sounds similar but I don't want to assume that Google knows the answers.

I appreciate any and all help/suggestions you have.
 
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alexthecat

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@gemdamon welcome to Bonesmart! You'll notice that I moved your post to a thread of your own. You'll get more individualized attention here. If you have any further questions or updates, be sure to post them here.

If you'd like to pick a different title for your thread, let us know and we'll change it for you. Also, if you'd like to give of the date of your surgery, we can create a signature for you. That makes it easier for people to give more meaningful advice.
 

Jamie

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The best thing to do is to see your surgeon. If you go to the ER, you won't likely be seen by an orthopedic specialist.....just the ER doc. In the meantime, I suggest that you greatly scale back your activity level, ice the areas that hurt and take Tylenol for your pain. You need to take the Tylenol in 1000mg doses at least 4 hours apart and no more than 4000mg total in any 24 hour period. Be sure to include any other medications that have acetaminophen (Tylenol) in them in your daily total....like cold and sinus medicines.
 

Celle

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Hello @gemdamon - and :welome:

Please will you tell us the full date of your hip replacement and which hip it is, so we can make a signature for you? Thank you.:flwrysmile:
 
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gemdamon

gemdamon

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Right THR on 10/24/18 in Phoenix, AZ. Thank you.
 

SE Florida

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Where I live, the ER would be the last place I'd go. They would just go through the standard protocol but then tell you to follow up with your OS. You could call your PCP back and remind them about the referral and tell them you're in extreme pain and it's urgent to get in. Sometimes referrals seem to get stuck in the system.
 

KathyB

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Hi @gemdamon, you and I had surgery about the same time. I totally agree with @Jamie about cutting way back (if not totally) on exercising and icing a lot and taking Tylenol until things get sorted out. As both @Jamie and @SE Florida have advised, I also would suggest your seeing your OS and letting your PCP know the situation is urgent so you can be seen asap. At a little over 6 months from my surgery, I still do not do as much as I would like on any given day. That being said, I am making continued progress with how much I can do daily and in increasing my stamina. The progress is usually noted from one month to the next. Based on all the Bonesmart advice, I did not do any PT other than slowly getting back to doing daily activities. Bonesmart also advises that full recovery takes about a year or longer. I still ice and elevate once a day and more on days if I have any twinges, soreness, etc. resulting from doing any new activities or overdoing. Let us know how things go with your visit to your OS.
 

GrannyC

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If it were me, I’d call my GP for the referral, ask them when it would be sent, then call OS office to make make appt. I’d go ahead and make the appt now and then call the day before the appt to be sure they have received referral. I had a pulled psoas muscle that showed up about a year after surgery. I could only feel it when I lifted my leg for things like getting in and out of vehicle, getting into bed, etc. it took a long time to clear up - nearly a year. I agree with the others that I definitely would NOT go to ER as you will not get same care as with your OS office where they specialize in these things. I’d cut back the exercising, too, until you know what is going on. You don’t want to make matters any worse. Wishing you good answers soon...
 
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gemdamon

gemdamon

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Thanks so much. The process of getting the referral was brutal and now I am waiting for the Ortho office to acknowledge they have received it BEFORE they will even let me make an appt. I am now having a burning sensation on my outer thigh of that same side along with the other symptoms. Same symptoms as a "condition is known as meralgia paresthetica". Not that I am self diagnosing but I can't help but google until someone finally calls me for an appt. I am super depressed and in agony over this. My poor kiddos keep trying to help but they know they are limited as to how they can help as well. I've been limiting my activity and icing to no avail. Why does it have to be this hard to get an appt. for a dang doctors office. : {
 

Carriemay60

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I wish I could offer some advice but my heart goes out to you. I hope you get some answers very soon! :friends:
 

GrannyC

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I never seem to have that much patience for these things so if it were me, I’d call dr office who is sending referral first thing Mon morning to ask if it has been sent, if so when and if not, please send ASAP as I’m in agony!!! Once it has been sent, I’d call ortho office again for appt and let them know you found out it has been sent. They normally fax those things so it almost instant. If ortho office is same one who did your surgery, I’m not sure why they won’t make appt unless it is a surgery thing. I had to go back to my ortho office several times during first year for routine checks. Then I was released at one year after surgery. Sending positive wishes your way...
 

Eman85

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Just from your original post I'd say your body is telling you to stop. You pushed through all of that PT and overdoing with pain killers and NSAIDS. My advice will cost nothing, sit down for a week and see what happens.
 

Bfam85

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Hello there...Of course, I am not an orthopedic doctor :loll:but it sounds like good old over doing it syndrome. You probably don't feel you did over do it, but the same thing happened to me after my first thr in 12/14. My joy over not being in pain and enjoying the gym, biking, etc. turned to nasty tendonitis from thinking I could do what I used to do, just scaled back. I think it was because all of my muscles, tendons, etc. were not in the same places as they were prior to surgery. I would stop everything (yes, I know) until things calm down. Hope you're feeling better quickly!
 
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gemdamon

gemdamon

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Thank you all. It's funny how crying gets you further. LOL. I called Friday crying and they immediately found a surgeon for me to speak to. She called in some inflammatory meds and scheduled me for an x-ray this week. I am keeping activity to a minimum (as well as I can) and am hopeful it's just that I overdid it. I guess I just don't know where that line starts as far as pushing too hard. Maybe it's a mom thing or a stubborn want to be 'okay' again. Take care and I'll let you all know what it turns out to be. Hugs from AZ.
 
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gemdamon

gemdamon

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Hi all,
It's been awhile since I've been on here but I am looking for information/feedback/suggestions on my THR from 2 1/2 years ago. It honestly, never fully healed, and by that I mean, I still am unable to lift my leg to put on my socks/pants, climbing stairs hurts, getting in the car hurts, sleeping hurts, walking after 1 1/2 mi hurts...it just seems to always hurt. And about 1/2 and 1/2 between a sharp pain and a constant dull pain. I've gone to PT 3x and my doctor is finally suggesting I go to a pain doctor who recommends a 1. steroid injection x2 over 3 months if that doesn't work than 2. cauterizing the nerves that go through that area? Help, does this sound right? I feel like I just keep getting put off just to be fixed by a bandaid.
Thank you in advance, Tamara
 

Celle

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HI @gemdamon - It's good to see you back, but not because you have a problem.

Has it been confirmed that you have iliopsoas problems?
We have an article about it that might prove helpful:
Iliopsoas syndrome
The iliopsoas muscle is quite deep and access can be problematic..

Another area that might also be affected is the iliotibial band (ITB)
ITB (ilio-tibial band) issues and treatments


By the way, I've found your old thread and merged your two threads.
This is because:
  • That way, you have all your information in one place. This makes it easier for others to go back and review your history before providing advice.
  • If you start new threads, you miss the posts and advice others have left for you in the old threads, and some information may be unnecessarily repeated
  • Having only one thread will act as a diary of your progress that you can look back on.

Please keep all your questions and updates on this thread. We won't miss your new question as, between us, the staff read all new posts each day.
If you need an urgent response to a question, tag a member of staff.
Tagging other members and answering tags

If you prefer a different thread title, just post what you want and we'll get it changed for you.

Here are the instructions on finding your thread, How can I find my threads and posts?

A helpful hint - Many members have found it useful to bookmark their thread so they don't lose it.

Best wishes,
Celle
 
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gemdamon

gemdamon

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Thank you for merging my threads for greater clarity to all. The reason I got the THR was to be active again. I can't imagine not being able to hike and walk long distances and I felt like I gave it the time it needed to heal. I see other people after a THR, even without PT, jump (almost literally), back into regular life again and they were older than me. It just upsets me. I in no way want a revision surgery or to be poked and prodded again, but I do expect to be 'normal' again after this many years. Did I mention not being able to simply put on my pants?!!! I am taking all of my pictures, surgeon reports etc. to another surgeon and get his opinion. What are your thoughts on that as a next step?
 

Celle

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I am taking all of my pictures, surgeon reports etc. to another surgeon and get his opinion. What are your thoughts on that as a next step?
I think it's a good move.

You might even want to get more than one "second opinion".
You'll need to see a surgeon who specializes in problem hips and who does revisions, if necessary.
These specialists see hips with problems every working day and they can sometimes spot a problem and suggest a solution that has escaped the original surgeon.

To get a completely independent opinion, you need a surgeon who has no contact, either professional or recreational, with your original surgeon. You may have to be prepared to travel to see the right person.
 

Jamie

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I agree with Celle. It's time to get some new eyes on your hip to start eliminating things that could be causing your pain. Don't get shook by the idea of seeing revision surgeons. You don't necessarily need a revision. It's just that these specialists are better equipped to deal with problems following a primary surgery.

Please let us know how things go.
 

Pumpkin

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In this article Celle left for you Iliopsoas syndrome, the two strengthening exercises. The one in sitting and the straight leg raise, you will want to let your leg down slowly. Recommend you do not use weights to start, if anything causes more than discomfort means you are not ready for that exercise.

I agree a second opinion from a OS specializing in revisions and complex joint reconstruction can help to determine what is going on with your painful hip.
 

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