1. Community
  2. Operations and surgical procedures
  3. Hip Replacement

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

Prev Next
  • AnnieK
    AnnieK

    Posted

    From my research into the muscles/tendons that support the hip when on one leg that keep the hip from dropping, I believe that I have tears in one or all of the following, which serve that function: gluteus minimus tendon/muscle, gluteus medius tendon/muscle, iliotibial band and/or the tensor fasciae latae muscle. I think there has been either severe partial or complete tearing, because of my complete inability to properly weight bear on the surgical side. I suspect my injuries there were received during surgery, because I have never been able to do it since surgery. Before I could do it with not too much trouble - some pain from OA hip, maybe, but no inability to balance on that leg.

    If I am right, I'll need surgery to repair the damage. It has been 27 weeks now, post-op, and I am no better. I get around using a rollator or crutch, as I don't want to aggravate anything by not using aids and limping, putting extra pressure on my other leg and maybe doing more damage to the surgical leg. And, yes, there is pain, too. I have been showing this inability to balance to everyone all along, my PT, the surgeon, his PA, the physiatrist, and none of them said anything about what could be causing it. It blows my mind. It only takes a simple google search to find out what is needed to support your hips, and these 4 professionals should know it from their studies without having to look it up.

    I had a MARS MRI yesterday and will get written results soon online, and will see the original surgeon next week for him to give me results. I pushed for the MRI, which he didn't really want to order. I asked if other scans could be done, and he said no. Further research on my part shows that ultrasounds are done all the time to diagnose soft-tissue injuries in hips, legs and all over the body. There is also the bone scan which can be done to check the integrity of the hip prostheses. So either he doesn't know about these things, or he just didn't want me to have them. Either way, no matter what he says next week, I have lost faith in him. He even said, in response to my question, that tendon/muscle tears are never repaired with surgery. That's wrong, too, since surgery is frequently being done on hip tendons, just like for shoulder rotator cuff injuries. 

    I looked at the CD of my MRI scans and saw many images where there is evidence of tearing. I was able to compare my scans with ones I found on the internet that show both healthy and torn tissue. Fascinating to see!

    Since my original surgeon has not been helpful at all in helping to figure out how to help me, or even acknowledge that I have a serious problem, I am going to see a different surgeon, one who does THR's and arthroscopic surgery on gluteal tendons and has written numerous articles about it. I will go armed with the MRI results for my lumbar spine and hips, and my list of symptoms and everything I’ve got. Whatever he discovers, I hope there is a remedy and I get answers soon.

  • lyn1951
    lyn1951 AnnieK

    Posted

    hello again Annie - I have been reading you post, and you are describing what I have.

    I too cannot balance on my left hip, thats also the hip that they gave me extra length on.

    The last couple of weeks I have changed my right heel lift for a higher lift, and that is giving me some relief with the general pain in my leg, and the feeling as if I can walk better.

    I am now 50 weeks since my hip replacement, and today managed to walk around the supermarket, without leaning on the trolley the whole way, but hip feeling very tired after that little expedition, and found myself unable to lift left foot off the floor without really going slowly, and draggin toes of left shoe.

    • AnnieK
      AnnieK lyn1951

      Posted

      Hi, Lyn! It's good that the higher lift is giving you some relief. Are you working with a professional to help you through this and give you any other ideas for improving your quality of life? I can't even imagine walking around the food store without leaning on a shopping cart. Sounds like that really set you back. Hope you get your left leg/foot going well again. 

      I am wondering what "they" think is the reason for your inability to balance on your leg. It could be because of some muscle/tendon weakness/tear. The anatomy around our hips is so complex, and so much can go wrong.

      I have you in my thoughts, Lyn. Keep me posted.

  • linda96952
    linda96952 AnnieK

    Posted

    Hi again Annie,

    I last spoke to you when I was due for my op for gluteal tendon reconstruction on 8th Jan,which was unfortunately cancelled and is now going to be next week on 5th Feb.

    I really just want to get on with it,it has been 10 months since my fall and THR and I desperately want to be mobile again

    I see that you have done a lot of research,good for you ! I'm just sorry that your consultant is not very open  to your suggestions.

    I am grateful that my consultant suggesed this surgery,although he was quite straight with me that it was a fairly new procedure and may not be successful.Although I don't really want to be experimented on and just want to return to normal,so have to give it a go.

    I will post on here with an update

    Good luck with your new consultant I hope he is more co-operative and you can hopefully get some results

    Linda

    Q               

    I see that you have done a lot of research,good for you.

    I'm really sorry though,to hear that your consultant is not very responsive to your suggestions.It seems to me from what you have said that you have the same problems as me.I am very glad that my consultant has suggested this surgery,although he has told me straight that it is quite a new procedure and   it might not be successful.I just feel that although I don't want to be   experimented on,I don't have an option as I am not happy to continue on as I am.

    I will post on here with an update.In the meantime,keep pushing until you get some action.

     

    • AnnieK
      AnnieK linda96952

      Posted

      Dear Linda,

      I have been wondering about you and whether you'd had the operation yet. Good luck on Feb. 5th! I very much get that you want to get on with things. The longer that I am in this condition, the worse it seems to be getting - feeling new pains all the time. I want to get better instead of declining. 

      I've been researching gluteal tendon surgery in case that's what I need. The worst I have read about it is that it may not work. The best sounds pretty good, with full recovery and getting strength and mobility back. May that happen for both of us!

      Love, 

      Annie

    • AnnieK
      AnnieK linda96952

      Posted

      Linda, I hope your gluteal tendon reconstruction went as planned on Feb. 5, and that you are recovering well. I, too, have gluteal tendon damage and will have to have surgery to repair it. You were so right on when you commented on my thread about how my situation sounded similar to yours! Thanks so much for commenting, as you set me on the right track to figuring out what was wrong and then finding a doctor who confirmed it and can do the surgery.

      I am forever grateful to you! 

      Hoping the best for you as you recover, and that you will get your full strength and mobility back soon.

    • linda96952
      linda96952 AnnieK

      Posted

      Hi Annie,so glad to hear that you finally got some results from your new doc.I thought all along that you had a very similar situation to mine.

      Thanks for your good wishes.I had my op on 5th,and according to my consultant,all has gone well and he expects me to be mobile again in due course,although only time will tell.He did say right from the start that it was fairly experimental surgery and that there's no guarantee of success but I felt I had no option as I couldn't stay as I was.

      FYI if you need to tell your doc,he did a gluteal tendon reconstruction and reattachment of the gluteus medius and and minimus using the LARS technique. !!!!!

      I am currently back on two crutches and both the doc and physio say I shouldn't bother with physio exercises but try to walk as much as I am able.

      It's still early days as yet but I'm feeling quite positive and hopefully next time I post to you I might (fingers crossed !! ) have some good news that you can pass on to your doc.

      I will keep you updated with my progress

      Best wishes to you,I am so glad I could help

      Linda

       

    • Rocketman_SG6UK
      Rocketman_SG6UK AnnieK

      Posted

      Annie, Linda

      That says it all for me, two people with similar problems, helping each other through the process.  It is wonderful that we have this facility do enable us to communicate effectively.

      Best wishes

      Graham - 🚀💃

    • AnnieK
      AnnieK linda96952

      Posted

      Linda, I am thrilled to hear that you are over and through your repair surgery! May you get through the recovery phase with the ability to walk correctly again! 

      I've done a lot of reading about this surgery and recovery for it. Info on my surgeon's website says 6 weeks with two crutches and only toe touching for the surgical leg, which I assume means no weight bearing. It sounds like you are weight bearing. I can't imagine 6 weeks of having to swing my body weight around on two crutches and one leg. I also may have to wear a brace for 8 weeks to help make sure I don't do too much and tear out the sutures from the tendon. I'll try not to worry until I get specific directions from the doctor.

      Thanks for the detailed info. I will pass that along to the new surgeon. He is a pioneer in techniques for reattaching and repairing gluteus minimus and medius tears via minimally invasive techniques, so I have great confidence in him. My big worry is that I have to have a revision also. Then I will be sliced open big-time again. 

      I'll be updating my new thread which is called "Facing surgery to repair gluteus minimus tear & revision"

      Looking forward to those updates from you about your progress, Linda!

    • AnnieK
      AnnieK Rocketman_SG6UK

      Posted

      Oh, yes, Graham, and especially when it is a fairly uncommon complication that many orthopedists aren't even aware of. For example, in my research I discovered a study that showed that 45% of orthopedic surgeons in France aren't even aware that gluteus medius and minimus muscle/tendons can have tearing injuries. My own previous OS seems to be equally unaware, or thinks that it is a minor issue, and that surgery is never needed to repair such a thing. I mean, come on, if there is a part of the body, it CAN get wrecked. And when that body part is one of the couple of body parts that does a very important function, when it is torn, it is a big deal. My old OS doesn't even admit that it is torn, but that it only has a "mild strain" at worst. They should learn their anatomy and do their jobs right.
  • linda96952
    linda96952 AnnieK

    Posted

    Sorry about the duplicated text,it dissapeared and I thought I'd lost it so did it again

    Technology !!

  • AnnieK
    AnnieK

    Posted

    Update: 

    My issue is pain in the hip/thigh/buttock and inability to balance on my surgical leg for more than 1 second, and that is with hip drop, flailing, and then leg gives way. I am 7 months post-op.

    I had a hip MRI, and results show only a mild strain at gluteus medius tendon, and a slightly larger strain at the obturator externes, a muscle that covers the outer surface of the anterior wall of the pelvis. I know there is more going on in my hip than that. I've done a lot of research, and I know something about the hip anatomy that controls the ability to balance on one leg. MRIs don't always show the full extent of gluteal tendon tears.

    The surgeon who did my THR, says to take steroids and get PT, no need for more scans, couldn't possibly need surgery, can "strengthen" and get better. So far it hasn't gotten better on its own over the last 7 months, only worse. Time for second opinion.

    I went to a different surgeon's practice today, had an exam, and got new orders for (1) a new specialized hip MRI (my third MRI in a month) that will focus on the hurt area and scan in more detail, (2) a bone scan (to see if there is infection and/or prostheses loosening) and (3) blood work (to look for signs of infection).  Will then go back, see the new doctor, have an exam, and see what he says. I had deduced from my research that it is most likely a gluteal tendon tear that may need surgery. And the nurse practitioner agreed that is a strong possibility! I'll know more in a few weeks when these new tests are completed and I see the new doctor. I am so excited that this practice takes seriously my inability to hold my weight on the leg. 

    This new doctor has pioneered arthroscopic surgery for gluteal tendon tears, and has a number of wonderful, scholarly articles about what exactly my problem seems to be, and what can be done about it. And he is just a couple of miles from my house! I am ecstatic!

    It is SO nice to finally be taken seriously about a definite disability, which isn't getting better over time and seems beyond "strengthening" to me. Breathing sighs of relief. I've already scheduled the bone scan, will schedule the MRI tomorrow!

    • anna65476
      anna65476 AnnieK

      Posted

      Hi AnnieK,

      You've certainly done your research and now, it seems , you're being taken seriously. That must be such a relief to you. I know that when I was told that I'd fractured a bone, I was pleased in a strange way because I'd been trying for so long to tell the physios that I was fine before my stick skidded! But nobody seemed to believe me.

      I do hope that all your scans go well and that eventually something can be done to mend whatever hoad gone wrong.

      I've asked for copies of my Xrays and yesterday the hospital rang to say that they had mislaid some of them. I'm hoping they turn up somewhere in the system.

      Good luck with everything!

      Love, Anna x

    • AnnieK
      AnnieK anna65476

      Posted

      Yikes! Hope they find the x-rays. 

      They SHOULD believe us, and it is wrong when they don't. In my case, it wasn't even a matter of "belief", as it is obvious that I have a complete inability to balance on that leg, and that strengthening simply cannot help. I fault my doctor for not knowing his hip anatomy. But the other doctor's team recognized it immediately. Doctors are far from infallible and have gaps in their knowledge, just like the rest of us. 

  • Dmann
    Dmann AnnieK

    Posted

    Hi I'm using a TENS unit for physio as well. I had THR 10 weeks ago and still have a lot of pain and also have movement in the joint when I put weight on it walking. Doctor said that the movement was not from the prosthetic joint bit was my pelvic bone moving because the muscles are so atrophied from a spinal fusion I had last year. Has anyone had this problem? I'm in the US.
    • AnnieK
      AnnieK Dmann

      Posted

      Hello, Dmann. I am not familiar with that kind of problem, and don't know what to think. Why don't you start your own thread and put this question out to the whole forum? Perhaps someone else has had this situation. I assume your surgeon has done an xray to check on your prostheses. Sometimes loosening is visible on the x-rays, and you should be able to see them as well.
Back to top
Prev Next

Report or request deletion

Thanks for your help!

We want the community to be a useful resource for our users but it is important to remember that the community are not moderated or reviewed by doctors and so you should not rely on opinions or advice given by other users in respect of any healthcare matters. Always speak to your doctor before acting and in cases of emergency seek appropriate medical assistance immediately. Use of the community is subject to our Terms of Use and Privacy Policy and steps will be taken to remove posts identified as being in breach of those terms.