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THR Trendelenburg Gait and recovery

StefanieW

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Jan 19, 2025
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Hello Bonesmart. I have had terrible problems since my Right THR 31/10/23. I discovered after having an MRI & EMG that I had a tear in the gluteus minimus & medius and nerve damage, which has caused the Trendelenburg Gait. What I have been struggling to find out is the reason for this damage. After researching for months it seems that the Lateral Incision as opposed to the Posterior approach could be the reason as the muscles have to be cut from the bone as opposed to the Posterior approach whereby the muscles are clamped away from the bone. Two surgeons have concurred with my theory and they do not recommend surgery to repair the damage as less than 50% success rate and could make it considerably worse.

I have been doing all the physio that has been recommended and more. I swim twice a week (doing physio in the pool) and have been doing all the exercises in addition, plus I recently had Shock Wave Therapy from Pure Physio in Norwich. I can bike as no pressure on my R leg but all my normal activities have been affected like housework, gardening, shopping, dancing, Table tennis because I hobble without a stick and makes my back ache from the abnormal gait.

I have complained to Spire Norwich where I had the surgery and they said that there is no way of knowing how the tear happened and in their opinion it was not because of the Lateral approach and the surgeon said he could be certain that it wasn't caused by the operation. I replied and said I can be certain that I didn't hobble or need a walking stick before surgery.

I was assured that I could do any exercises after the 7 week follow-up but when I didn't improve I asked to have the MRI & EMG which revealed the damage. My desire now is to find out how many patients who have had the Lateral approach have been left with Trendelenburg Gait and if they limped & needed a stick before the operation, because if they are pain free post op, they may not ask for further MRI & EMG to investigate, as they are grateful to be pain free; whereas I feel I am worse off than pre-surgery.

I have tried to approach solicitors for No Win - No Fee but 3 will not take on my case as medical negligence cannot be proven. I have been turned down for a Blue Badge twice.

So you can imagine my desire yet hope now in finding a community that may know just how I have been struggling and hopefully find out how many more patients have been left with a disability (possibly from the Lateral approach) and what we can do (with enough evidence) to stop this happening to other people.

Any advice would be gladly received. A 'support' to wear if anybody has tried one and long term effects of Trendelenburg Gait as I now get groin pain when walking for more than 15 mins with stick and my 2 knee replacements are getting residual pain from the hobbling.

Thank you so much for reading my experience which has been traumatic. Stefanie
 
I had a revision done of a resurfacing and the surgeon ruptured my Gluteus Medius. He did not tell me, or state it in the surgical report. I told him things weren't right, I couldn't walk up stairs, had a limp, etc. Well, I dislocated just sitting in my car. MRI showed full tear of Gluteus Medius. I was then converted over to a THR, and the new surgeon found an attempted repair with holes drilled in my femur and stitching material. The tendon had to be reattached and the surgeon wasn't sure if it would hold, but it did. I was on a walker for 6 weeks with about 40% weight bearing and had to be super careful.

Is it a full tear? If it is, you need that fixed or you will be crippled for life. My operation was done posterior.
 
Hello Stefanie,
I am sorry of all you are enduring.
You will likely receive a better response in regard to your particular situation on your own thread. Linda, who's thread you originally posted on has not been on the forum for nine months, so there is a good chance she won't see / read your post. I will leave a link to a SEARCH on Trendelenburg Gait and you can read through all threads where its been mentioned, if interested.

I wish you only the best on your journey and hope you receive some supportive feedback here.
Thanks for joining us.

@StefanieW
 
Thank you so much Layla - this forum seems the ideal place to compare experiences & give each other support - I hope I can navigate the website to its full potential but any pointers would be appreciated- Stefanie
 
Hi again Stefanie,
I will leave a link to How to Use the Forum where you'll find many articles.
If you have any questions, just let us know.
 
Many tears to the gluteus muscles can be repaired. So if you have been diagnosed with a tear (even a full tear), I encourage you to continue to seek consultations outside of the location where you had your surgery. You may have to travel to see a doctor with this expertise, but it would be worth it. I’m going to tag one of our former senior staff members, @Jaycey, who is in the UK to see if she can help you find some options for hospitals and/or surgeons. All the best to you and please let us know how things go. We will be here to support you.
 
Hi Jamie - I had my surgery in Spire Norwich Mr David Calder then went to Bury St Edmunds BMI hospital Mr Samuel Parsons then Mr Andrew Manktelow at Spire Nottingham - both said they couldn’t guarantee an improvement less than 50 % success & could make it a lot worse. But any other specialists I would be grateful to hear about -Stefanie
 
Hello Bonesmart. I have had terrible problems since my Right THR 31/10/23. I discovered after having an MRI & EMG that I had a tear in the gluteus minimus & medius and nerve damage, which has caused the Trendelenburg Gait. What I have been struggling to find out is the reason for this damage. After researching for months it seems that the Lateral Incision as opposed to the Posterior approach could be the reason as the muscles have to be cut from the bone as opposed to the Posterior approach whereby the muscles are clamped away from the bone. Two surgeons have concurred with my theory and they do not recommend surgery to repair the damage as less than 50% success rate and could make it considerably worse.

I have been doing all the physio that has been recommended and more. I swim twice a week (doing physio in the pool) and have been doing all the exercises in addition, plus I recently had Shock Wave Therapy from Pure Physio in Norwich. I can bike as no pressure on my R leg but all my normal activities have been affected like housework, gardening, shopping, dancing, Table tennis because I hobble without a stick and makes my back ache from the abnormal gait.

I have complained to Spire Norwich where I had the surgery and they said that there is no way of knowing how the tear happened and in their opinion it was not because of the Lateral approach and the surgeon said he could be certain that it wasn't caused by the operation. I replied and said I can be certain that I didn't hobble or need a walking stick before surgery.

I was assured that I could do any exercises after the 7 week follow-up but when I didn't improve I asked to have the MRI & EMG which revealed the damage. My desire now is to find out how many patients who have had the Lateral approach have been left with Trendelenburg Gait and if they limped & needed a stick before the operation, because if they are pain free post op, they may not ask for further MRI & EMG to investigate, as they are grateful to be pain free; whereas I feel I am worse off than pre-surgery.

I have tried to approach solicitors for No Win - No Fee but 3 will not take on my case as medical negligence cannot be proven. I have been turned down for a Blue Badge twice.

So you can imagine my desire yet hope now in finding a community that may know just how I have been struggling and hopefully find out how many more patients have been left with a disability (possibly from the Lateral approach) and what we can do (with enough evidence) to stop this happening to other people.

Any advice would be gladly received. A 'support' to wear if anybody has tried one and long term effects of Trendelenburg Gait as I now get groin pain when walking for more than 15 mins with stick and my 2 knee replacements are getting residual pain from the hobbling.

Thank you so much for reading my experience which has been traumatic. Stefanie

Hi Stephanie
I had my left hip replaced in Aug 2023 and recovery has been slow. My main issues has been gluteal tendiopathy and SI joint issues (the latter was likely present before the operation). A recent visit to see my consultant also noted a slight Trendelenburg Gait, although not the main issue. I have an MRI of my lumbar spine, SI & left hip booked for April.

I too have been having physio and from what I've been told, the issue is uneven hip movements which means certain tendons & muscles over and under work. I don't have any tears (at least a recent ultrasound didn't find any) but I was told that most do heal, but that it can take a long time because there is limited blood flow to these muscles.

I wish I could give you good news. But from reading posts on BoneSmart I can tell you you're not alone. Have you tried PRP therapy? I think that's what it's called. My consultant suggested it, only it's not provided on the NHS so you would have to pay. It's where they draw your blood, take out all the bad stuff, & then inject it into the torn tendons in order to promote healing. I don't know how successful it is, mixed results probably. But the fact my surgeon suggested it hopefully means he thinks there's a chance it would have a positive effect? I do hope you find an answer. It's horrible having these issues.
 

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