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22 weeks post-op, still can't walk unaided...

Posted , 14 users are following.

AnnieK
AnnieK

I've been lurking on this wonderful forum for awhile, and have decided to share my problem. I am impressed with the compassion and knowledge shown here! I am 67 and had a right THR 22 weeks ago. Had bone-on-bone OA, and could walk without a limp despite the pain, was very active. Recovery has been mostly uneventful, except that I still can't walk unaided without pain and a bad limp. I am in the U.S. with excellent insurance, so can see my surgeon and any other doctor whenever I want. I had 22 sessions of physical therapy, and I did all they asked of me.

Surgeon did more x-rays and a thorough physical exam and doesn't think that the prosthesis is loose, says everything looks fine. So I am seeing a phsyiatrist (doctor of physical medicine), and had a steroid/anesthetic injection in my sacroiliac joint a week ago to see if that would help. No change. Still have nasty pain in right thigh/hip area, and complete inability to put all my weight on the surgical leg. Leg just gives out on me when I try to balance on it alone. Going back to doc in 2 weeks, and we will try other treatments/scans to try to figure out the problem.

I get around very well with a crutch outside the house and a rollator walker in the house, although I fatigue quickly. Don't have pain while sitting down or just standing on both feet. I am discouraged.

Has anyone had this kind of situation? I tried to search for similar threads. Any comments or links to other threads would be appreciated.

7 likes, 56 replies

56 Replies

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  • anna65476
    anna65476 AnnieK

    Posted

    Hi AnnieK,

    I also can't stand on my operated leg without it collapsing.

    I had a THR last May, had 1 physio session and was told tp get on with my exercises, which I did, and everything seemed fine. But unfortunately 6 weeks after my op I managed to skid with my stick on a damp paving slab and slammed my operated leg down hard. The pain was awful.

    4 days later I was taken into A and E as I couldnt move my leg at all. Xrays showed no fractures or dislocation but that it was a soft tissue injury. My gp told me to rest the leg for 4 weeks which I did.

    I didn't seem able to contact my physio department so I opted to go privately. She was excellent and gave me all the exercises I needed to do to help strengthen my abductor and gluteal muscles.

    But after a few more visits to her, I really havent progressed at all. I'm still walking with one crutch. I'm not in any pain but its just very frustrating not being able to walk again.

    If I lie on my unoperated side, I can't move my operated leg upwards more than a few inches and that takes an enormous amount of effort!

    I'm now trying to exercise in a private swimming pool and i have my routine follow up appointment with my consultant next week. I'm hoping that this might lead to further investigation!!

    Thanks for listening!!

    Anna x

    • AnnieK
      AnnieK anna65476

      Posted

      Anna, I certainly hope it will lead to more investigation! It's good that you have no fractures or dislocation as a result of your fall. I am being so incredibly careful about falling, and now we are in winter with ice and snow everywhere, and I have to go very slowly. Don't want to make things worse.

      Your situation does not sound good. Hope they can come up with a diagnosis and treatment for you. I am sure you will be giving your consultant an earful next week.

      I am not doing any physical therapy until I have a proper diagnosis. It also is possible that time will heal whatever is wrong with me, and I'll eventually be ok. But in the meantime I am going to get every possible scan to try and find out what the problem is. I thank my lucky stars every day for my incredibly good health insurance that allows me to see doctors whenever I want and to get all of these diagnostic scans in short order.

    • anna65476
      anna65476 AnnieK

      Posted

      Hi AnnieK,

      Yes, I shall certainly be asking a lot of questions! But I feel I'll only be seeing my consultant's houseman, not the the consultant who did my op.

      But I feel it was the slip that caused my probs.

      By the way, since my op, I've seen a podiatrist who has told me that my operated leg is 2cms longer now!

      Good luck with your scans and I hope you get back to full health soon!

      Anna x

    • AnnieK
      AnnieK anna65476

      Posted

      Thanks, Anna. You will have to be extra careful with your recovery now that you have uneven leg length. That alone, without trying to recover from surgery, can cause problems. You may need an insert or built-up shoe on one side to keep your legs even so that you don't cause problems in other joints. 

      Take care!

  • AnnieK
    AnnieK

    Posted

    Progress Report! I am now 26 weeks post-op. 

    - The MRI of my lumbar spine showed no significant problems.

    - Physiatrist wanted to do another sacroiliac joint injection, but I said not now.

    - So I went back to my surgeon. At this point, it is obvious exactly where the most tender spot is, and it is on the ligament over greater trochanter prominence on my femur. Pain also radiates down the ligament about 6 inches.

    - Tentative diagnosis:

         Greater Trochanteric Pain Syndrome (GTPS)

              and/or

         Iliotibial Band Syndrome (ITBS). 

    - Next step is an MRI of my hip, which the surgeon says will probably be fuzzy right where we want to see because of the presence of the titanium prosthesis. But I want it done anyway. I have an appointment next week.

    - After that, I'll probably get a steroid injection into the greater trochanter area, which is one of the recommended treatments for GTPS and ITBS.

    My ability to put full body weight on the surgical leg is improving slightly over time. I can now hold it for 4 or 5 seconds, surgical side hip dropping, before leg gives way.

    Supposedly GTPS and ITBS are fairly common with hip replacement surgery, and I can understand why. There is so much necessary trauma to the tissues surrounding the bones that I would be surprised if things like this never happened.

  • lyn1951
    lyn1951 AnnieK

    Posted

    Hello again annie - I too finally got to see the physio Dept at the hosptial after a very long wait, they opologised for the wait, appaarently not classified as urgent, or even classified as one of their THR patients.

    Good news is all the swimming I have been doing has been good, and I am to keep going swimming.

    Very impressed with my overall strength, my ablility to do a sit up from lying flat postion, without aiding myself with my hands, she then got me to push and pull with my legs, and flex inwards and outwards at the knees, again impressed with my strength.

    Found I was a little weak with my clam shell exercise, I have been doing it but not using the correct muscles, or so I am told.

    2nd issue of my now damaged lower back, arthiritis of spine showing up earlier than it would have normally,  again she was shocked at the hospital giving me soo much extra length, and apprently missing the natural leg length discrepancy, and not taking that into consideration, she gave me some strengthing exercises for my inner core muscles. 

    She agreed that back surgery is going to be needed in the future somewhere, not looking foward to that prospect.

    • AnnieK
      AnnieK lyn1951

      Posted

      Hi, Lyn. hope that the core strengthening will help you deal better with the leg length discrepancy. Too bad about needing surgery in future on your back. That would be very worrying to me, too. I am impressed with your strength and your swimming ability. I would have trouble getting myself into a swim suit and then getting to the pool (with a crutch) and then into the pool. Just get tired thinking about it. Keep up your good work and best of luck.
  • lyn1951
    lyn1951 AnnieK

    Posted

    Annie - I refer to my exercise regiem as swimming, as I don't know what else to call it.

    I get in the local heated pool with diffuculty, once there I use a water Log or Noodle as we call them to help me float.

    I then row myself, or a sort of modified breaststroke without the kicking, backwards and foawrds across the narrow width of the pool, thats hard work, exercises my shoulders which are inclined to get stiff and stubborn about moving, also I belive helps with carido/lungs, as I can work up quite a sweat doing this. then add some stretches, physio most impressed with my flexibility, never considered myself flexible, then tread some water, all in I do about an hour now, just keeping moving the entire time, no weight bearing wonderful.

    I started swimming when I coudn't walk at all before my first hip replacement, was very impatient to get back in pool after first surgery, and again, after tore cartlege in second hip, and then surgery, again, couldn;t wait to get back in pool. Believe it or not I don't swim, never had, always been a little bit frightened of the water, thats why I like the noodle for support. Crazy that my husband was picked for the Olympics when he was young, would have been up against Mark Spitz at Munich, could he have beaten him, A type personality, would have given it a really good try, he wa an amzing swimmer.

    Did a close to world record 50meters in his 40's, at the Masters olympics here in QLD, some years ago now, had the entire stadium on its feet screaming in delight, would have never been recognized though.

    • AnnieK
      AnnieK lyn1951

      Posted

      Amazing that you started swimming when you couldn't even walk! My husband keeps thinking that it would help me. I will need to find a place for therapeutic swimming, since I will be afraid to use my crutch to get from the locker room to the pool and back again - afraid of slipping. And then how do you get into the water if you need an aid for walking? I am sure that pools set up for therapeutic swim have that figured out. 

      I have always been an enthusiastic swimmer, doing swim, diving and synchronized swim teams. Maybe it would be a good thing for me. You husband must have been a really great swimmer! Does he go in with you?

    • lyn1951
      lyn1951 AnnieK

      Posted

      Annie - I'm sure it would help you, our pool has wheelchair access, and a lift for disabled.

      Can you contact your local pool and see what facilities they have available, ours even have a changing room toilet, for privacy of yourself and your helper if thats what you need, before my first surgery, I really struggled too, and husband used to help me, get in and out of swim suit, and get dressed afterwards.

      You should see some of the most profoundly disabled, make me ashamed of myself sometimes from the local public hospital floating around, and having a ball with their helpers, quiet inspiring.

      Yesterday one of our most disabled was singing Twinkle twinkle, with his carer, and the whole pool joined in, very special, he loved it, he even tried to sing with us, just a squeal to our ears, but it didn't matter, you should have seen the smiles, we all felt special, even the pool staff, and lifguards were singing along.

      Husband was an incredible swimmer, but since he has developed his heart failure, not good news last week from our cardio, but he just gets in the pool and hangs on the side rail, and floats, still can enjoy the warm water.

      Soo sad to see him failing, The Dr suggested last week they may be able to give him a heart regulator device, sort of like a pacemaker, but has to be approved by the senior staff of the hospital.

      If approved will probably happen fairly quickly, other than that he would need a heart transplant, and we are only too aware that it is not going to happen for somebody past 60, we live in hope for this device that will give him better quality of life or so we are told.

      Thank goodness in some ways we live in australia, because we survive on invalid benefit's and have no insurance's left, the Govt picks up most of our costs, including prescriptions, just a $6.00 admin fee, and after you run up a couple of hundred in those $6.00, it then becomes free for the balance of the year. You are not discriminated against by being not able to pay your way.

      Australia has one of the poorest organ in the world donation rates. Such a waste.

      Last week we saw a young guy killed in the local streets, and his family were brave enough to donate his organs, they now have 10 more family members, but you would still wish that he had not been killed.

  • lyn1951
    lyn1951 AnnieK

    Posted

    Annie - I swim at Dolphins leagues club complex, Redcliffe Queensland. you may be able to find some pictures, very nice indoor pool, gym, physios, stadium for the football. We also have beautiful beaches, but to be honest I wouldn;t swim in the ocean, although you can, its safe.
    • AnnieK
      AnnieK lyn1951

      Posted

      Sounds like a fantastic complex. I'm not big on swimming in the ocean. I live near Lake Michigan, which you can swim in for about two months of the year, in July and August. Right now, it is frozen!
  • NanaT2
    NanaT2 AnnieK

    Posted

    Annie, I feel your pain -literally! I am almost 25 weeks post op and have your exact symptoms. It's been determined that my flexer and abductor muscles were compromised from the surgery (lateral approach surgery after a THR after a bad fall). Started PT/OT right away in my home, and then out-patient. Instead of getting better, I suffered from terrible pain on the outside and inside of my hip. A follow up with my surgeon revealed that my bursa were inflamed ( these are the "sacks" that act as a cushion so that the muscles can glide over the bone when walking). I was told to take a month off from PT and then start back in on strengthening and stretching exercises and work out on an anti-gravity treadmill. My first day back is tomorrow.

    I still go up steps, leading with my good leg, can't tie my left shoe, can't lay on my left side, and can't stand on my left leg without pain and weakness. I'm still using a cane most of the time and most steps are painful. 

    I have followed owed this wonder and supportive forum for months and recovery results vary wildly. I think the very best thing you can do for yourself is to give yourself some grace and 

     

    • AnnieK
      AnnieK NanaT2

      Posted

      Nana, I am so sorry that those muscles were compromised during your surgery and that you have been suffering so much. As I had mentioned, I am unable to balance on my surgical leg for more than a second or two, all the while my surgical side hip is dropping and then leg gives way. Are you able to put your full body weight on your surgical leg alone? Don't try it if you think you will hurt yourself more, I just wonder if you, like me, cannot! I strongly suspect gluteal tendon or other muscle tendon tears in my case.

      In your case, if you cannot properly balance, and you are still having so much pain, your injuries may be beyond healing on their own and might need surgery. Do you know the extent of your injuries? Have any of the tissues been completely torn?

      I am no expert, but am learning more all the time. I hope to hear more from my new doctor next week. I have just posted again with a fuller update.

  • anna65476
    anna65476 AnnieK

    Posted

    Hi AnnieK,

    I'm so pleased that you're improving.

    Unfortunately, when I went to see the consultant, he told me that I did actually have a fracture of the greater trochanter. Can't understand why it wasn't spotted in A and E way back in July.

    Apparently there's nothing that can be done, except physio. Not a happy bunny at the moment, but have bought myself some jazzy coloured crutches!

    I'm managing to go swimming in a heated privateool, which is lovely and I can do some exercising there too.

    You keep on improving!!

    Love, Anna x

    • AnnieK
      AnnieK anna65476

      Posted

      Anna, a fracture through your greater trochanter! What a blow, and with you suffering all this time. So do they expect it to fuse on it’s own then? Do they have any idea how long that will take? 

      I am actually NOT getting better, if anything worse. I just posted here again with the latest info on my saga. Thanks for you kind words! I wish you all the best in your recovery. Wish they could do more for you.

      Love, AnnieK

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