THR Trendelenburg Gait and recovery

[Gray Horse]

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.

Hey gray horse, I seen your X-ray images on another thread, was your revision on the cup of your resurfacing where these injuries occurred done in Seattle by chance out of curiosity? Looks like the same cup I might have in my resurfacing and have been having significant pain in my buttocks even a year out

yes, Seattle,

 

[Morgan Le Fay]

Hi @Stefa

How are you doing?

 

[misia]

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

Hello Stefanie,

I have just read your story, and I was very interested because I have a very similar problem.

I am from Kraków, Poland, and I have had multiple operations on my left hip since 1999, including two Gamma nail procedures, removal of the hardware, and eventually a total hip replacement.

I have had a significant limp and a waddling/Trendelenburg-type gait for many years. I do not have significant pain, but walking is still very abnormal and has a major impact on my quality of life.

An ultrasound in 2021 showed severe atrophy and scar-related changes of my gluteal muscles, with findings suggesting damage to the hip abductor mechanism.

I have received different opinions from orthopaedic specialists. One doctor mentioned that tendon reconstruction might potentially be possible, while others advised caution because surgery could make things worse, especially if there is severe muscle or nerve damage.

I am currently trying to find out whether there are specialists anywhere in the world who have experience with complex hip abductor deficiency after multiple hip operations and total hip replacement.

I would really appreciate it if you could tell me:

1. Have you had any further investigations or treatment since you wrote this post?
2. Did your MRI show the degree of muscle atrophy or fatty degeneration?
3. Did you ever see a specialist who performs abductor reconstruction or gluteus maximus transfer?
4. Have you found anything that has helped improve your gait?
5. Do you know of any other patients with a similar problem?

I would be very grateful for any information you can share.

I hope your situation has improved since you wrote your post. Thank you for sharing your experience.

Best wishes,
Beata

 

[Layla]

Hi misia,
Thanks for joining the community. We're happy you're here. It sounds like you've been through a lot so far and continue to deal with challenges, for that I'm sorry.

I'm letting you know that, StephanieW, hasn't been on the forum since March 2025, so I'm not sure you'll receive a response from her.

I'd like to encourage you to join as an Insider.
As a Basic BoneSmart Member, which is your current status here, you have access to core features of the forum, but some areas and functions are reserved for upgraded memberships. For an enriched experience including the ability to start your own threads and engage in discussions with members and staff about your specific concerns we invite you to join the Insiders Club. Upgrading not only unlocks full access to all forum features, but also provides valuable services like assistance with locating a surgeon, helpful downloads, and entry to the BoneSmart Library filled with videos and in depth articles to support you on your joint replacement journey.

Here is a link to check out basic membership vs Insider Club membership -> Become an Insider

Feel free to use the SEARCH feature at the top right of the page to type in key words / phrases such as gluteus medius tear or Trendelenburg gait and all threads where those topics were mentioned will pop up.

I am going to move your post to, Gray Horse, to her thread. She hasn't visited the forum in nine months so I'm not sure you'll hear from her either. Please join us as an Insider. We'd love to support and encourage you on your journey.
@misia