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[THR] Worried I may have infection<<

Discussion in 'Hip Replacement Recovery Area' started by Jws., Apr 6, 2018.

  1. dapplega

    dapplega member

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    @Jws - just my 2 cents (which is probably worth less than that)... If there is an impingement issue couldn't it be clearly shown/demonstrated and not be subjective. If the impingement occurs during sitting you'd think an xray could be taken in that position validating the diagnosis... I hope you get some positive news...
     
  2. Josephine

    Josephine FORUM ADMIN, NURSE DIRECTOR Administrator

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    I'm so sorry - it seems we were both understating the information! That article (and more, the xrays in it) were VERY helpful.
    I incorrectly jumped to the conclusion that this referred to the greater trochanter when in fact, it was the both the lesser and the greater trochanters! You can see in the xray here

    lesser troch impingement.JPG

    The reference to the cup exchange would be about the greater trochanter coming into contact with the rim of the cup. Likewise the lesser trochanter can make contact with the ischial tuberosity but I think that would be unlikely unless you were in the habit of crossing your legs a lot! But it should be noted that the lesser trochanter is also the attachment for the psoas tendon, as you can see here.

    Psoas.jpg


    I think you might find this article helpful when wanting to quote snippets
    How to use the quote feature
     
  3. Jws.

    Jws. junior member
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    Josephine, are you saying now that you have heard of "trochanteric impingement" and IS it a viable theory. More importantly have you heard of it "mechanically" causing groin pain and is the "fix" (changing the liner) one which is relatively easier to do than a full revision. I really value your opinion, after I received that diagnosis. I asked two OS's and they say that in theory it makes sense but they have not come in contact with a case.

    Have you come in contact with a case similar to this and would you go ahead and do it if you were in my position.

    Others have said to first try the intra-articular shot of cortisone in the groin as the more conservative treatment (is there a possibility of infection with shot?) and give it until a year (it's been 9 months) and see if it gets better. (they believe I will still be left with some pain).

    What recommendations do you have for conservative treatment? or ??

    I know you speak directly and don't hold back and that's what I need...I keep getting the runaround from the OS's here in LA.
     
  4. Josephine

    Josephine FORUM ADMIN, NURSE DIRECTOR Administrator

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    I'm saying it is possible in theory.
    I'm afraid not.
    Changing the liner would never be easier to do than a full revision. Changing the liner IS a revision.
    Well me neither!
    Never
    There is a phrase in medicine which goes "little guns first" which mean, always try the simplest treatments first. I'd say that was a pretty good maxim to use here.
    Not if the injection is carried out under strict sterile conditions. There shouldn't be any more risk that with the original surgery.
     
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  5. Jws.

    Jws. junior member
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    @Josephine I am now 11 months post hip. I still cannot tie my shoes and put my socks on but I have no pain sitting or standing. In just the last month my groin pain went away (miraculously) and most of my limping went away. I am able to spin for an hour and a half with no pain (love spinning) where I couldn't go 10 minutes without groin pain, and walk right after for an hour NO PAIN

    HOWEVER , EVEN THOUGH ALL WAS GETTING BETTER, the last two days my right leg is stiff as hell and my leg and hip are like "peg leg" without any pain just the whole area hip top thigh ,peg leg ...(not exactly a limp when walking but difficult not "FREE FLOWING".)

    Josephine my concern is, even though things are improving, am I still healing or am I stuck with this stiffness and "peg leg " syndrome. It took me 11 months to heal this far. Don't know if that's it or could this tightness work itself out or is it a psoas thing that I can get a steroid shot for.

    Josephine please, your thoughts. I don't want to go back to that miserable emotional and physical place I was 2-3 months ago. Anybody else. Thoughts would be appreciated.

    BTW it generally happens with soled shoe (not sneakers and more restrictive jeans)

    thanks
     
  6. Layla

    Layla FORUM ADVISOR Forum Advisor

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    Hi,
    Sorry you're struggling somewhat and have questions. Josephine is away from the forum
    for a few days but she will see your tag and address your concerns once she's available.
    Please check back periodically.
    Wishing you comfort and a pleasant weekend.
    @Jws.
     
  7. Mojo333

    Mojo333 FORUM ADVISOR Forum Advisor

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    :hi: I still think at 11 months out...and with your issues prior...an hour and a half spinning is too much and may be causing some of that stiffness.
    It never hurts until we stop.
    If there is an issue...impingement or otherwise...then it certainly would have to aggravate it I would think.
    I know you want to be well and fit..but can still be a matter of overdoing it.
    I'm sure Jo will have thoughts but please do take it easy in the meantime.
    Hope today is a better day!:console2:
     
    Last edited: Jan 11, 2019
  8. Harryn1

    Harryn1 member

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    Hi @Jws. Sorry to hear you’re having issues.

    My own personal experience with spinning classes (especially the 90 minute ones) is that they were too demanding on My new hip. The violence of the sprints, the constant standing and sitting, and compliance with the demands of the instructor just put me into pain - it was too jarring at the time (I was about 4 months post op).

    I have no issues at all with just cycling, whether indoors at home or outdoors; it is very forgiving and wonderful. I ride most days but Sadly, have stopped spinning completely for the time being. Maybe forever.

    Also, here’s another thing. A month or 2 ago, I just felt weirdly lazy. Normally, I come home from work and ride my bike, mostly indoors. But for 2 weeks or so I hardly exercised. It was after that fortnight that I realised that the last of the twinges of post operative hip pain left me. I ascribed it to arriving at the 6 month milestone, but in retrospect, I think my body also just needed a break from exercise.
     
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  9. Josephine

    Josephine FORUM ADMIN, NURSE DIRECTOR Administrator

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    I think you see here cause and effect. How often have I said that over-activity will result in aches and pains.
    I can do no more than refer you to this oft posted comment of mine:
    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.
     

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