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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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  • michaelglut
    michaelglut AnnieK

    Posted

    AnnieK - I know exactly what is your problem.  Firstly you are not mad or difficult of just making it up.  Your problem is real and more importantly it is treatable.  It is not a loose prosthesis, it is not a leg length inequality and it is not an infection.  I see an deal with this problem in my practice all the time.  You have a problem with the gluteal tendons in your hip.  I have done over 1000 reconstructions for this problem and many patients  present like you with persistent pain after an otherwise uneventful hip replacement.  Your hip prosthesis is probably perfect; well placed, solidly fixed, good geometry and equal leg length.  You need a hip tendon (gluteal tendon to be precise) reconstruction and your pain will be resolved and you can get on with life.  This can be done in the presence of a hip prosthesis if the correct technique is used.  I have described this in the peer reviewed literature.  Hope this helps.
    • AnnieK
      AnnieK michaelglut

      Posted

      Michael, thanks for your comments, which are very accurate! As I said above, I had suspected a gluteal tendon tear, and it was confirmed with a MARS MRI as interpreted by my new orthopedic surgeon. I have repair surgery scheduled for August 15, in about 3 weeks, and I can't wait. So sick of this pain and disability.

      I talked about this in my subsequent threads. 

      https://patient.info/forums/discuss/will-have-2-surgeons-for-my-exploratory-gluteal-tendon-repair-surgery--505113

      https://patient.info/forums/discuss/facing-surgery-to-repair-gluteus-minimus-tear-possible-revision-498750

      From my participation on this and another hip replacement forum, I think that this is a very underdiagnosed, and hence undertreated, problem for many people, whether post hip surgery or not. I am glad you are involved in correcting this in so many people!

       

    • michaelglut
      michaelglut AnnieK

      Posted

      Hi AnnieK,

      For you to reply to this at this hour suggests you are not sleeping so your pain must be quite a problem for you.  It is daylight here now in Australia.  I am delighted you have found someone who can get a handle on your problem so it looks like this is under control now.  May I recommend you ask your surgeon if he/she intends to use a ligament substitute to do your repair.  I ask this because I am in the process of writing a paper on how to deal with failure of repairs of gluteal tendons repaired with artificial ligaments.  I never use them myself.  My only association with artificial ligaments is to take them out and redo the whole operation again because the artifical stuff breaks down and causes a lot of surrounding tissue damage.   I see gluteal tendon problems like this of the worst kind after hip replacement and always attempt to get a biological repair like how it was before the problem started.   Good luck with your surgery.

    • AnnieK
      AnnieK michaelglut

      Posted

      Michael, yes, I have been having lots of trouble sleeping. I was doing fine until about 3 weeks ago when I hurt my lower back and had to start sleeping in my lift recliner. Ugh. Last night I actually returned to my bed, slept 5 hours, and was able to get out of it myself very early this morning. Had another hour or so of sleep in the recliner. My left ankle and knee and hip are protesting, too, from the overcompensation for the bad right leg after all of this time. I hurt all over!

      I am seeing one of the surgeons for pre-op this week, and I will ask that question, about the ligament substitute. The surgeon never mentioned using anything artificial, but will ask. From looking at the MRI scans that I had done in February, it looks like my gluteus medius muscle is fairly wasted and has lot of fatty inclusions, and that's got to be from lack of use, due to the tear. They don't know if the muscle will be able to do the work, and they might have to "pull" some of my gluteus maximus "through" somewhere and anchor it to have it act in the same way as the medius would.

      I will private message you the website of the surgeon who will be doing the tendon repair, in case you are interested. He has written some papers about it and pioneered some techniques. He has his patients wear a brace to limit movement for about 6 weeks, and restricts weight bearing to 20 pounds to give the best chance for effective healing that stays healed. I had an antero-lateral approach for my THR, and I wonder if using those same two restrictions could have prevented my tear.

      Once again, thanks for your interest in spreading the word that these issues can be repaired. Too many people end up limping around in pain for the rest of their lives when they could be back to normal.

  • michelle87539
    michelle87539 AnnieK

    Posted

    AnnieK if you are still on this forum I would be very interested in your outcome...many thanks
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