THR THR on 3-21, right surgical leg is almost 1/2 inch longer than the left

[Wheatsiebat]

Hi all!
I finally had my right THR on 3/21. That day everything seemed to go smoothly. When I got home I noticed my surgical leg was definitely longer. I could put my iPhone 15 Pro Max under my left ft which leveled it even. That is .33 inches. I am 5 ft 4” so this is a significant difference.

I was able to talk to the PA on Friday evening. He said there was nothing to worry about, because the surgeon does precise measurements. And then he said he wasn’t sure if it was me or another patient that my surgeon had said he needed to add 1 mL which is closer to .61 inches. Also there could be swelling.

This difference is very significant and I am worried about it.

This is my 3rd THR. The first one didn’t work but even then there was no leg discrepancy.


I will contact the surgeon on Monday.

Has anyone experienced this?

 

[Jamie]

Hi, Wheatsiebat…..I’m so glad to hear you finally were able to get your right hip replaced, but sorry you’re worried about the feeling of leg discrepancy. I hope you’ll feel better soon knowing that this is a very common complaint for people after surgery. It is usually not an actual problem with leg length. Surgeons are very precise when they do the procedure to ensure this doesn’t happen.

But what does occur, is the surgeon gets your body instantly back in proper alignment with the new hip, which can cause it to feel like your legs aren’t even. When hips go bad, it’s normally a slow process over time - years even. Your body compensates for the joint deterioration by tilting your pelvis to “level out” your legs. It’s something you don’t notice as it develops because it’s so gradual and it keeps you moving more comfortably. So when the new hip is put in the correct position, your tilted pelvis must slowly readjust to the change and get itself back to a normal position. This takes time - maybe 6 months to a year.

During your recovery, it’s best not to try and interfere with this process by using a lift in your shoe unless the difficulty walking or any resulting pain makes walking painful. A lift will not allow your body to completely correct itself. But I do understand that feeling. I had it myself with my hip. In my case, I also had a twisted SI joint in my spine that contributed to the leg difference. I was limping and had lots of soft tissue pain. Because of that, I did need to use a series of lifts for a few months to gradually allow my body to readjust and get back to normal. Once I worked my way down to a 1/4” lift, I was able to use no lift to finally get my hips level again. All that took me over a year with about 9 months of working with a therapist to get things just right.

So please try not to worry about this right now. When you see your surgeon again, if he doesn’t take an X-ray (that would be the normal thing he’d do), ask for one if you’re still feeling that length discrepancy. Then have him show you the status of your hips. I’m betting if you still feel the length difference, it will be obvious on the X-ray that one hip is higher than the other.

I’m disappointed in the PA. It was irresponsible of him to say something like that to a patient who was obviously worried about this feeling of leg length discrepancy without knowing for sure that you were the patient who had a length adjustment made during surgery. If you felt like it, it would be good to let the PA know how that made you feel and that it was not something he should have done without knowing all the information. Doctors and PAs sometimes need a little feedback when they do things like this.

I also appreciate that you joined the Insiders Club right away so you have access to everything available on BoneSmart. This enables our experienced staff to quickly respond to any concerns or questions you may have. Don’t hesitate to ask if something comes up or you just want to vent a little. That’s what we’re here for.

 

[Layla]

Hello Wheatsiebat,
Welcome to the healing side of the forum. I am sorry you have concerns so early on. Please know that we're here for you and keep us posted on your situation. I will leave our Recovery Guidelines below -

HIP RECOVERY GUIDELINES
(Administrative Note: For those reading here, please be aware that these links are a premium service and only available to Insiders Club Members).

As you begin healing, please keep in mind that each recovery is unique. While the BoneSmart philosophy successfully works for many, there will be exceptions. Between the recommendations found here, your surgeon's recovery protocol and any physical therapy you may engage in, the key is to find what works best for you.

1. Don’t worry: Your body will heal all by itself. Relax, let it, don't try and hurry it, don’t worry about any symptoms now, they are almost certainly temporary.

If you want to use something to assist with healing and scar management, BoneSmart recommends hypochlorous solution. Members in the US can purchase ACTIVE Antimicrobial Hydrogel through BoneSmart at a discount. Similar products should be available in the UK and other countries.

2. Control discomfort:
rest
elevate
ice
take your pain meds by prescription schedule (not when pain starts!)
3. Do what you want to do BUT
a. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you
b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.
4. PT or exercise can be useful BUT take note of these
BoneSmart philosophy for sensible post op therapy
5. At week 4 and after you should follow this
Activity progression for THRs
The recovery articles
Pain management and the pain chart
Healing: how long does it take?
Chart representation of THR recovery
Dislocation risk and 90 degree rule
Energy drain for THRs
Pain and swelling control: elevation is the key
Post op blues is a reality - be prepared for it
Myth busting: on getting addicted to pain meds
Sleep deprivation is pretty much inevitable - but what causes it?

Nutrition is of paramount importance. Available here are dietary tips, nutrition basics and additional food supplements. These articles are both general advice on food and specific guidelines aimed at people both pre- and post-surgery.

BIG TIP: Hips actually don't need any exercise to get better. They do a pretty good job of it all on their own if given half a chance. Trouble is, people don't give them a chance and end up with all sorts of aches and pains and sore spots. All they need is the best therapy which is walking and even then not to excess.

We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery. While members may create as many threads as they like in a majority of BoneSmart's forums, we ask that each member have only one recovery thread. This policy makes it easier to go back and review history before providing advice.

 

[Wheatsiebat]

Hi, Wheatsiebat…..I’m so glad to hear you finally were able to get your right hip replaced, but sorry you’re worried about the feeling of leg discrepancy. I hope you’ll feel better soon knowing that this is a very common complaint for people after surgery. It is usually not an actual problem with leg length. Surgeons are very precise when they do the procedure to ensure this doesn’t happen.

But what does occur, is the surgeon gets your body instantly back in proper alignment with the new hip, which can cause it to feel like your legs aren’t even. When hips go bad, it’s normally a slow process over time - years even. Your body compensates for the joint deterioration by tilting your pelvis to “level out” your legs. It’s something you don’t notice as it develops because it’s so gradual and it keeps you moving more comfortably. So when the new hip is put in the correct position, your tilted pelvis must slowly readjust to the change and get itself back to a normal position. This takes time - maybe 6 months to a year.

During your recovery, it’s best not to try and interfere with this process by using a lift in your shoe unless the difficulty walking or any resulting pain makes walking painful. A lift will not allow your body to completely correct itself. But I do understand that feeling. I had it myself with my hip. In my case, I also had a twisted SI joint in my spine that contributed to the leg difference. I was limping and had lots of soft tissue pain. Because of that, I did need to use a series of lifts for a few months to gradually allow my body to readjust and get back to normal. Once I worked my way down to a 1/4” lift, I was able to use no lift to finally get my hips level again. All that took me over a year with about 9 months of working with a therapist to get things just right.

So please try not to worry about this right now. When you see your surgeon again, if he doesn’t take an X-ray (that would be the normal thing he’d do), ask for one if you’re still feeling that length discrepancy. Then have him show you the status of your hips. I’m betting if you still feel the length difference, it will be obvious on the X-ray that one hip is higher than the other.

I’m disappointed in the PA. It was irresponsible of him to say something like that to a patient who was obviously worried about this feeling of leg length discrepancy without knowing for sure that you were the patient who had a length adjustment made during surgery. If you felt like it, it would be good to let the PA know how that made you feel and that it was not something he should have done without knowing all the information. Doctors and PAs sometimes need a little feedback when they do things like this.

I also appreciate that you joined the Insiders Club right away so you have access to everything available on BoneSmart. This enables our experienced staff to quickly respond to any concerns or questions you may have. Don’t hesitate to ask if something comes up or you just want to vent a little. That’s what we’re here for.

Thank you for your reply. That helps so much
I wish the surgeon had mentioned his plan.

I am also having sharp pains on my thigh when I walk with the walker or try to sit down or stand up.

My first hip replacement my femur broke so I am hyper sensitive to what might be happening.

 

[TIC1015]

Hi all!
I finally had my right THR on 3/21. That day everything seemed to go smoothly. When I got home I noticed my surgical leg was definitely longer. I could put my iPhone 15 Pro Max under my left ft which leveled it even. That is .33 inches. I am 5 ft 4” so this is a significant difference.

I was able to talk to the PA on Friday evening. He said there was nothing to worry about, because the surgeon does precise measurements. And then he said he wasn’t sure if it was me or another patient that my surgeon had said he needed to add 1 mL which is closer to .61 inches. Also there could be swelling.

This difference is very significant and I am worried about it.

This is my 3rd THR. The first one didn’t work but even then there was no leg discrepancy.


I will contact the surgeon on Monday.

Has anyone experienced this?

I had my left hip replaced on Thursday 3/20. My doctor stopped by before the surgery and told me that he would be purposefully extending my leg slightly so that when he replaced my other hip later in the year, the numbers would be exact and my measurements would be perfect.

It freaked me out a little, but he did both of my knees and he is highly regarded as one of the best. So, I have to believe he knows what he’s doing. Maybe your story is similar.‍

Good luck
T

 

[myglasshalffull]

Welcome & leg shorter or longer is very common, mine was a little shorter but evened itself out.

 

[benne68]

Welcome to the Healing Side, @Wheatsiebat

Has anyone experienced this?

YES!!!! I had a huge difference in leg length right after my THR and I was really freaked out. My surgeon told me it would even it with time -- and it really did. (In my case, the difference was more than 1/2 inch. But, as I recovered, it diminished until one day, I realized it was gone.)

As Jamie explained above, our bodies get out of alignment over time when we are dealing with a bad hip. It's not just the bone, but all the soft tissues, that are affected. Post surgery, it takes time for the muscles, tendons and ligaments to "reset" to the new, corrected alignment.

I know it's scary, but please try not to worry. And try not to compare this recovery to your other hip because every hip is different -- even two hips in the same person. Stick with us, we are here to support you and share our own experiences.

 

[Eman85]

I understand your worries especially after having problems with your other hip. There are a lot of people that feel they have leg length discrepancy and it goes away over time. I hope this is what your experience will be, No matter, at this point there is nothing anyone can do except wait and see. I don't think any of us are perfectly symmetrical from the factory to start with, we just adapt to what we have and that's our normal.
As far as the pains it's very early and we've all had pains so it's hard to say anything about what you're feeling. I know that my 2 hips were different with different pains, and of course I always thought the worst. Rest and ice and try not to let the worry win.

 

[Deni444]

I just wanted to second what @TIC1015 said regarding how good surgeons are at getting the measurements right now. Similarly, my surgeon is planning to add a little length to my hip on 26th to facilitate a better eventual outcome when I get my right done. At first the leg length difference you experience will be what they call 'functional' (musculoskeletal imbalances or compensatory mechanisms, despite the legs being structurally equal in length). This is to be expected post surgery due to everything that is upset by surgery. As you heal and walk with a good gait it should resolve naturally. A good surgeon gets the length right far more often than they get it wrong.

 

[Wheatsiebat]

Welcome to the Healing Side, @Wheatsiebat

Has anyone experienced this?

YES!!!! I had a huge difference in leg length right after my THR and I was really freaked out. My surgeon told me it would even it with time -- and it really did. (In my case, the difference was more than 1/2 inch. But, as I recovered, it diminished until one day, I realized it was gone.)

As Jamie explained above, our bodies get out of alignment over time when we are dealing with a bad hip. It's not just the bone, but all the soft tissues, that are affected. Post surgery, it takes time for the muscles, tendons and ligaments to "reset" to the new, corrected alignment.

I know it's scary, but please try not to worry. And try not to compare this recovery to your other hip because every hip is different -- even two hips in the same person. Stick with us, we are here to support you and share our own experiences.

even two hips in the same person.

Thank you for this! I was definitely thinking about the other hip joint. For instance I started feeling sharp pain in my thigh yesterday and today when I felt like this last time it turned out my femur was broken because the stem turned out to be loose.

I will call them first thing tomorrow.

 

[benne68]

Please let us know what you learn, @Wheatsiebat. Hoping they are able to reassure you.

 

[Eman85]

In the meantime, ice and rest. If you see an improvement with ice and rest it usually indicates soft tissue pain and the implant is fine.

 

[Layla]

Thank you for this! I was definitely thinking about the other hip joint. For instance I started feeling sharp pain in my thigh yesterday and today when I felt like this last time it turned out my femur was broken because the stem turned out to be loose.

Hi Wheatsiebat,
Wondering how you're doing the past couple days and whether you heard back from your surgeons office.
I hope the pain has eased.

 

[Wheatsiebat]

Thank you for this! I was definitely thinking about the other hip joint. For instance I started feeling sharp pain in my thigh yesterday and today when I felt like this last time it turned out my femur was broken because the stem turned out to be loose.

Hi Wheatsiebat,
Wondering how you're doing the past couple days and whether you heard back from your surgeons office.
I hope the pain has eased.

Hi Layla,
The surgeon’s office made an appointment for me to come in this Monday, 3-31 and X-Ray. They could not confirm that the surgeon’s intention was to make my leg longer. (The PA had suggested that I might be a patient that the surgeon had intended to add length)
They generally do X-Rays at 6 weeks. This will be 10 days.
They also could not give me information on the X-Ray done after the surgery. I saw it while in recovery.
I just stood on one leg looking in a mirror and then stood on the other leg. It is a big difference in height! I can’t measure it but I can see it.
My pain levels are better. Although my anxiety over the length difference is just the same if not worse.

Just trying to focus on healing by icing, elevating, and resting. Breathing too.

 

[myglasshalffull]

Boy, some PA's say dumb stuff to patients don't they? Why would PA say that? My PA had stupid reply to some of my concerns one being that my leg was a little shorter than the other.
Good luck with XRay & you have a right to take the XRay with you (or at least a copy).

 

[Wheatsiebat]

I appreciate everyone’s replies to this.
I am a bit concerned about the surgeon’s office response. I am glad they made the 2 week appointment with X-Ray. But the only other thing they said was to continue focusing on healing. They didn’t say that my X-rays after surgery looked good etc.
There is nothing else left for me to do but try and remain calm. I just worry because of my last experience.

 

[Layla]

They generally do X-Rays at 6 weeks. This will be 10 days.

They likely got you in quickly to hopefully reassure you all is well after the last experience you had with the broken femur / loose stem. They may not have said anything about your x-rays after surgery because there was nothing remarkable. Especially if they advised you concentrate on healing. So please try to remain calm because if there is something amiss, you will deal with it just as you did the first time. I know that sounds like cold comfort, but the anxiety you're feeling is stress on your body and that can negatively impact healing. Do some deep breathing and gentle movements and hope for the best. Know that we're here for support always and wish you an uneventful recovery above all else. Prayers for your peace of mind and some reassuring news soon.

 

[benne68]

They didn’t say that my X-rays after surgery looked good etc.

My surgical team didn't say anything about my surgical X-rays either, but i found a notation in my surgeon's report in my patient portal online. I find it helpful to go back to look at the reports and X-rays whenever I've had a question or concern.

Does your surgeon or hospital have a patient portal where you can access your reports?

 

[Wheatsiebat]

That is an excellent suggestion! I will do that.
I was able to speak to a nurse who said the X-rays after surgery did not indicate anything about leg length. They would be looking into that on my visit wit them on Monday.

 

[benne68]

Great! Let us know what you learn.