“Severe Pain After a THR”

Posted , 8 users are following.

I had an anterior THR the 1st of November 2017.  I was up walking in the hallways 6 hours afterwards.  I did quiet well.  It was only painful getting in and out of bed for the most.  The next morning I noticed while in a supine position I didn’t have the strength to raise my right leg.  Not even an inch.  The pain was just too intense.  I was reassured by the nurses and my Dr. that this was normal and only temporary.  I walked the halls alone thereafter many times a day.  In fact, I was up and about so much to the point to where I didn’t even need the pressure stockings that help prevent a DVT, etc.  Two days later I was discharged home.  The coming two weeks, PT came to my home 3 times a week for two weeks.  I did great.  However, I began to notice a different type of pain like none other to the top of my thigh, the buttock, groin and where it wrapped around the thigh and effected the knee.  PT had to alter some of their exercises that irritated the thigh and other areas just described.  After two weeks I would go on to PT on an out patient basis for 2 to 3 weeks.  By that time I was still unable to raise that leg while lying down.  Shortly thereafter I developed a large hematoma to the top of the right thigh.  My Dr. was able to extract 140cc/mls of blood.  I vented my concern of the pain that was still effecting the top of my thigh etc.  He told me to stop going to PT for awhile.  Over the next few weeks, this new pain that made itself known shortly after surgery was worsening.  I kept going back to see the Dr. who performed it, and he would just take a quick X-ray and tell me everything looked good.  During an exam, a tender spot was noted in my lower back.  An MRI showed that I had a protrusion of my L5 and S1 disk.  They felt certain that it was this that was causing me the excruciating pain in my thigh/leg.  Over the coming few months I would go on to have 3 epidurals to the L5 and 1 to the S1.  None of which helped at all.  I was having to use a walker when I awoke in the mornings then as the day progressed, I was either using crutches or a cane to get around.  I was referred to a Neurosurgeon and he ordered an EMG.  The Dr. who performed it told me that he was 100% certain that the L5, S1 or any other disks for that matter was not the cause of this pain.  He said that it was due to something “structural.”  I took this info back to my Orthopedic Dr. for him to review.  He said that it sounded like the Stem of my new device might be slipping in and out.  A CT scan would need to be done to confirm it.  I had one and everything appeared to be normal.  I was praying that it would yield something that needed to be corrected so I would at least have a diagnosis and a solution to resolve this problem.  Even if it meant having to go back in to have it repaired.  But now I’m back at square one.  I have an appointment the 1st of June to see a new Ortho Doc.  I have got to find out what is causing me this pain.  I’m either in bed or laying on the sofa 22/7.  The small and benign activities of daily living that we all take for granted have become major tasks for me to carry out.  I can’t even shower standing up because I can’t bare weight on the effected leg long enough to wash the other.  I can’t even slip on a pair of underwear, and I have to sit on the bed to put on a pair of shorts or pants.  I’m not even able to tie my shoe because it’s too painful to bend the leg and stretch far enough.  All if this has taken a major toll on me with a vengeance.  I’m hoping that some of you may know of additional tests that are available to asses the functioning of a hip device (Zimmer & Fitmore.)  Or, any other conditions that may be causing me the symptoms as I’ve described.  I would love to hear about any similar stories like mine. 

DJ~RN

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  • Posted

    Oh gosh, this sounds awful. Seeing a new Ortho Dr is a good step in the right direction. Could it be muscular - maybe a muscle or tendon catching on the new joint device?  Torn or cut ?  I have unexplained groin pain that has kept me on a cane for 12 mos. I totally sympathize with your pain and frustration.  One of my points to my Dr was even if everything looks ok, those tests do not reflect what is happening when I walk. He agreed - I'm facing revision anyway. Posas pain maybe?  I developed Posas tendonitis after trying to regain glute and quad muscle strength. My PT put a stop to every exercise I was doing and I had to follow his routine. I couldn't lift my leg without that horrible pain in the groin. It's been 4 mos and I still have slight pain from it. Have you ruled out infection?  I had a MARS MRI and it showed everything ok. X-Rays were ok.  I'm assuming they have ruled out any fine fractures?  

    • Posted

      The EMG ruled out neuro muscular diseases. I’m just at a loss and don’t know what’s causing this pain. I can barely walk at times. Thank you. 
    • Posted

      There are tests that any Dr or good PT can do to help determine if it's your Posas. Very simple but require you to raise your leg. Since you can't do that, that sorta makes me think the Posas might be involved. I've also read the Anterior approach can lead to a knicked or cut Posas. Do some research on that and see if it matches your pain. And I did have Posas muscle release done by my PT guy. He does it many many times a day. Not something I'd let just anyone do on me.

    • Posted

      Ty. I’m at a loss. The EMG ruled out all neuro muscular diseases. I just know I wasn’t like this until after my surgery. The pain is excruciating. I too will most likely have revision surgery. They can only tell so much with a CT or MRI. Ty again. 

      DJ

    • Posted

      The EMG test won't reveal any issues with your Posas muscle. The Posas is a very long muscle that attaches to your spine then runs down to your groin. It plays a huge part in helping to move your legs.

      Mine felt like a stabbing knife in my groin. I still have it but it's much better since I learned I had to stop exercising. But it sounds like yours - if it's the Posas, could have been compromised during surgery, but there is no way of telling. A MARS MRI might show damage to the muscle. 

       

    • Posted

      Ty. I’ll check into it. I’ve been an RN for 30 years and have never heard of that word. When I googl ed it it pulled up nothing. Are you spelling it correctly. 

      DJ

    • Posted

      I remember it now. I think that muscle runs through your belly to the lower back. My pain is More top of the thigh. 
    • Posted

      I think it is the POS Posterior Oblique Subsystem, I believe it is actually a group of muscles which are pretty important and are the largest in the body. 
  • Posted

    DJ-

    As frustrating as it sounds you will be best served relying on a doctors advice even if you need to hunt around for better doctors.  That said, the pain you describe, its location and appearance when you lift your leg from supine does suggest a problem with the psoas muscle.  That muscle connects at the juncture of the upper thigh and the torso.  Take a look at some anatomy muscle charts to see if they help you locate the area most effected.I'm wondering if the pain also occurs when you bring your knee toward your chest [but don't break any 90 degree restrictions you've been given].  That would also indicate psoas.  That muscle passes from its attachment at the upper thigh/pelvic juncture, under the abdominals and wraps around to a connection in your lower back.  Lower back pain can often be relieved by a psaos release from a good deep tissue massage therapist.  Not all MT work on the psoas or work on it well.  If the pain feels more muscular than bone it might be a good idea to locate an MT to get some deep tissue work done.  As the other poster mentioned, it sometimes happens that the prosthesis can be interfering with either the muscle or tendon of the psoas which can cause irritation, pain,tendinitis and that in turn can cause referenced pain to other rotator and leg muscles.  They all influence each other and when one is out of whack they can cause difficulty too.  Personally I would be requesting pain medication to help manage this until you get it sorted out.  Pain as you know wreaks havoc on every aspect of our lives when it becomes chronic, and medications can allow us a window of relief to help get us through the physical difficulties, including the necessary recovery exercises, as well as the emotional impacts of life being a state of pain.  I wish you the best of luck finding a more insightful medical team and a return to health.

    Jim

    • Posted

      The EMG I had ruled out everything you spoke about. Thanks 
    • Posted

      I appreciate it very much. I’m trying to find if there are any tests that can be done to visually look at muscles or the Stem on my new Hip device in real time as you bend or walk to give you a visual of whether or not my stem is slipping in and out of the femoral bone. Do you know of any? I didn’t have this problem until after surgery. The surgeon either did something or there is a flaw in the Zimmer and Fitmore device they used on me. I’ve been in bed or sofa 22/7 for 7 months. Have an attorney. 

      DJ RN

    • Posted

      DJ-

      The other just misspelled it leaving out the "s", it's psoas muscle sometimes referred to as the illio-psoas  because the two muscles lie right next to each other and work together. "The illiopsoas joins to the femur at the lesser trochanter and acts as the strongest flexor in the hip"  Wikipedia. I am not familiar with any imaging technology available for real time motion studies.  Most of the physical testing done by doctors and PTs is deductive- if a particular function shows symptoms the relevant muscles/tissues are concluded to be the underlying problem.  The location of your pain [which I share incidentally as a primary symptom although I have not yet had surgery] indicates possible tissue problems.  If it's possible for you I would recommend a massage therapist able to work on this with you.  It may only relieve the symptoms and not fix the problem but I have found it has helped me to isolate at least one of my physical difficulties so I can address them prior to surgery to get as much strength and flexibility as I can.  If I may ask- where did you have your surgery done/how experienced was your surgeon and what surgical approach did they use?  Wishing you the best of luck getting this fixed.

      Jim

  • Posted

    And I thought I had problems .......... that is an awful state for you to be left in following your surgery that was supposed to improve your condition.

    I have no ideas about what you can do, but when you do find out what and why it is wrong, I'd be thinking legal action for putting you through all this.  My advice would be to keep a careful log of your pain, symptoms and what you are told by the medics, you will need that if you ever want to pursue a claim.

    Best wishes to you

    Graham

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