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Facing surgery to repair gluteus minimus tear & possible revision

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AnnieK
AnnieK

I had a THR in July 2015, and have never yet been able to walk without a limp/pain. I had no limp pre-surgery. My previous thread was titled "22 weeks post-op, still can't walk unaided...". 

My orthopedic surgeon has been unable or unwilling to figure out what is wrong, or to even admit that there is a serious problem. He sent me to a physiatrist who ordered a lumbar MRI (no problem found) and did a sacroiliac joint steroid injection (no improvement). Went back to orthopedist and he ordered an MRI, which I had to push him to do, and the radiologist's report said there was a mild strain in the gluteus medius. I told the ortho that I thought I had an actual tear in my gluteus medius or gluteus minimus, and asked about surgery. He says surgery is never done for that. He said to take prednisone and go back to PT to strengthen the weakness in my hip/thigh.

I was unhappy with this, as I know that there is something wrong. More exercise only makes it worse. If it were a mild problem, it would have corrected itself by now. I do walk a fair amount, considering that I use a crutch or walker, and my healthy leg muscles are in good shape. I did a lot of online research about what my problem could be and to find a new doctor.

I saw a new orthopedist yesterday, one who has pioneered methods of gluteal tendon surgical repair. He ordered a bone scan, to rule out prosthesis loosening and infection, and another, better MRI. Again, the radiologist who read the MRI didn't see much, but the orthopedist looked at the scans and DID see evidence of a tear in the gluteus minimus. He says a "tear" is the same thing as "non-healing". The gluteus minimus and medius have to be separated during surgery in order to do the anteriolateral approach that was used on me.

The new doc says that my tear won't get better on its own. It requires surgical repair. He is also wondering if the positioning of my prosthesis might have prevented the healing of the muscle/tendon. So he is sending me to a revision specialist for a consult to see whether he thinks a revision is necessary to reposition things. I see him on Tuesday.

Steeling myself for further surgery. I am tired of being debilitated for 7 months now. Plus I have had a rotten head cold/sinusitis for the past 3½ weeks that has me really down. I had two orthopedist appointments on my birthday, while really sick with this cold, hardly able to speak. I hope I won't need a revision in addition to the tendon repair. Will know soon. Sigh.

Main takeaway: keep pushing for answers if something is wrong.

13 likes, 168 replies

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  • Rocketman_SG6UK
    Rocketman_SG6UK AnnieK

    Posted

    Annie,

    How awful for you to be possibly facing more surgery, but well done for persisting until you got an answer.

    Keep us updated on your progress.

    Graham

    • AnnieK
      AnnieK Rocketman_SG6UK

      Posted

      Will do. I know you got through another surgery, so whatever gets thrown at me, I know I will be able to cope, too. I just hated, though, how awful I felt for those first two weeks post-op. Was really the worst thing I have ever been through in my life. If it's just the muscle/tendon repair, maybe that won't be as bad. A revision, however, has me shuddering.
    • Rocketman_SG6UK
      Rocketman_SG6UK AnnieK

      Posted

      At least the surgery will not be as bad as THR, they don't need to wrench your leg around to dislocate it this time.

      Graham

    • AnnieK
      AnnieK Rocketman_SG6UK

      Posted

      But, Graham, I am almost panicked about having to have a revision surgery, too. I will find out next week. The thought of a revision plus the tendon repair where I would be non-weight bearing for 6 weeks at the same time has me in a tizzy. Will try not to worry about what hasn't happened yet. I am not generally a worrier, but I felt so awful those first 3 weeks after the THR that I am dreading going through that again.
    • Rocketman_SG6UK
      Rocketman_SG6UK AnnieK

      Posted

      Annie, 

      You can do it - I had to too, just 10 weks after my first recovery.  It sucks, big time, it's unpleasant, but we can do it.  Just think, they opened me up, and still didn't do anything useful, so I have had to go through a second recovery and all for nothing at all.

      You need that tendon repair, which will take a while to repcover from, so anything else they do will be small potatoes, and should not hold up your recovery any more than just the tendon. (Glass is half full, not half empty!)

      Remember, we're all here to help you through it - let off steam on this forum, it's the place to do it, we understand.

      Best wishes

      Graham - 🚀💃

    • AnnieK
      AnnieK Rocketman_SG6UK

      Posted

      Thank you so much, dear Graham. I had heart-to-heart talks with all of my closest loved-ones yesterday, sister, husband and daughter, and I am convinced to go ahead with whatever needs to be done. When I went into my THR, I had almost NO knowledge of what I was in for. I took the informational class at the hospital, and that was it. I had not found this forum, or other forums. I knew no one who had gone through it. I went in with my eyes closed. This time, I am going in with eyes wide open! 

      I will be able to do many different things to prepare better this time, but my dread has to do with just the overall feeling of weakness, helplessness, pain and awfulness that is there for the first 2 to 3 weeks after surgery. I felt so trapped! So unexpected. As my wise daughter pointed out, perhaps part of the reason I felt so badly was because my implant was in the wrong place. Who knows. Maybe I don't even need a revision, but just the tendon repair. I need to take a deep breath and try to relax for now.

      And, Graham, I have told my whole family your story and we just sit there shaking our heads at the uselessness of it all and feeling so badly for you. All of that risk for nothing! You have a great attitude and I am sure you will recover well and will be extra careful, knowing what you know about your prosthesis. Wish things could have been different for you.

    • Rocketman_SG6UK
      Rocketman_SG6UK AnnieK

      Posted

      Annie

      Thanks for that.

      You mentioned something thare that most people don't think about.  

      When you have a revision, you are subjected to all those risks again, and if it's because of something that was done to you, it is you taking the risks again, not the person who caused the problem in the first place.

      Graham - 🚀💃

    • My2boys
      My2boys Rocketman_SG6UK

      Posted

      Hi Graham,

      I don't mean to pry but am fairly new to this forum so I don't know ur situation. Why did they go back in a 2nd time and not be able to fix anything? I can't even imagine having to endure the pain and rehab again for nothing. You have such a positive outlook, despite everything and it's both refreshing and inspiring.

      Lori

    • Rocketman_SG6UK
      Rocketman_SG6UK My2boys

      Posted

      Oh what a story - are you sitting comfortably?  

      I have a web page devoted to Total Hip Replacement, the address is in my personal information on here at 

      https://patient.info/forums/profiles/rocketman-sg6uk-907025

      Someone here suggested I write a book, but I opted for a free to access web page instead.

      OK, well, it goes like this ..........

      2012 - whilst riding my motorbike, I had pains - turns out to be OA in my hip.  Get referred for replacement.  Fast forward to 2015

      28 October, have my hip relacement operation (spinal, fully awake), and start recovery.  

      26 November, At 4 weeks now, I was called in by my surgeon to be told that the ceramic insert in the acetabular liner is 'misplaced' (i.e. he put it in wrong), and he wants to open me up again 10 weeks after the first operation to remove and replace it.

      07 Jan 2016, at 10 weeks, the second operation (should last 30 minutes he says) takes place (spinal and fully awake again).  Lots of hammering for about an hour, then when Iwas in recovery, the surgeon tells me that he, and another surgeon had hammered as hard as they dare, and couldn't shift the ceramic insert.  It won't go in and sit in the right place, and they cannot get it out either.

      I am now at week 16 from the first operation (week 6 for the second one), and recovering again.

      At no stage has the problem with the insert caused me any pain or problem walking.

      I did meet someone locally who had the same problem with a differnt surgeon at a different local hospital, and he said there was an almighty big bang and grinding noises when his insert broke, but it wasn't painful.

      Well that's me - you can see my blog on my website - follow the blow-by blow account of my two operations and recoveries.  Lots of information for pre-operation hippies, and answers to many hippie questions.

      Best wishes  

      Graham - 🚀💃

    • madla39168
      madla39168 Rocketman_SG6UK

      Posted

      Graham you u are so positive I really admire you. You are waked for operation and you have so much trouble and still positive

      and so helpful to every one. I try be positive for my next hip replecement and hope when is hapen hopefully soon all will go OK.

      How you doing Graham ?

      Big hug Madla💗

      PS you deserved huge huge one.💗

    • Rocketman_SG6UK
      Rocketman_SG6UK madla39168

      Posted

      Madla,

      I've just retired - had a great send-off from my old colleages.

      The leg is not too bad, I think the commuting 2 hours each way to London actually helped.

    • Marianhw
      Marianhw AnnieK

      Posted

      did you have surgery on your tear? how did it go? did you have good results? would you recommend it?

      thanks

      Marian

  • rose0000
    rose0000 AnnieK

    Posted

    I am glad for you Annie that you know what is happening, and you have a definite dianogsis, it is always a struggle to try and 'prove' there is something wrong, and I know how much worry it is causing you.

    Sorry the solution involves more surgery though....but hopefully with the repair to the muscle you can then finally get on and get better. There will be nothing holding you back then. I am not sure what is involved repairing a muscle but I hope for you it is much easier than the replacement. 

    Well done for sticking with it Annie, and for keeping on at them. You will get there I know you will x

  • AnnieK
    AnnieK

    Posted

    Thanks, Rose! I've been reading about recovery from gluteal tendon repair surgery, and it involves 6 weeks of crutches with only toe touch of surgical leg, no weight bearing, which is much harder that THR, where I was weight bearing immediately. And there are 8 weeks of wearing a brace. Muscle strengthening doesn't start until 12 weeks afterwards. Apparently the sutures for the repair are firmly anchored in the bone, but they can easily tear out of the tendon, and until the tendon is healed, you must be very, very careful. So it won't be easy at all.

    And if I have a revision of the hip replacement at the same time, then it will be even worse. Hoping I don't need that.

    Feeling kind of depressed about it all right now, but very glad to have a diagnosis for the tendon tear. Waiting to hear about the revision.

  • Hailea
    Hailea AnnieK

    Posted

    Hi Annie

    I am so glad you have kept pushing to get put right what you know is wrong. I really hope once this is all sorted out you get your life back on track. We both know what it is like to be held back. I am so happy that you have at last found some one who is listening to you although it really should not have had to come to this. I hope you don't have to go through a revision but if you have to then even if you do not want to would you not want your hip in the correct position? 

    I hope you you will be speaking legal advice. It seems to me you may have a good case here. 

    • AnnieK
      AnnieK Hailea

      Posted

      Yes, I definitely want it fixed, even if a revision is necessary, but my experience with hip replacement was so awful that I am hating the idea of going through that again. So relieved, though, to have physicians who know what they are doing! If I do anything legal, it would be way down the line. Can't even think about that now.
    • Hailea
      Hailea AnnieK

      Posted

      I hope you do not have to have it done Annie. You know that I too have had a hard time of it and I know where you are coming from. But if they do have to do it again so you will be walking correctly without the pain you are suffering from now even if you are a little worried is that not the best out come?

      look at what Rocketman has gone through also and he is speaking legal action. Oh yes I understand what you are saying. You have 3 years to start legal action if that is the way you want to go. At least you are now getting taken seriously. I am so glad you have found some one who will listen

      I really hope you get the outcome you deserve this time

      xx

    • AnnieK
      AnnieK Hailea

      Posted

      I know you have suffered horribly, Hailea, and am so sorry for it. It is inexcusable that you had to wait so long for your THR, and all the bad things that happened in the hospital before and after the surgery, and lots more besides. Thanks for the heads-up on the 3 year time limit. I'll keep that in mind! I will go ahead with whatever needs to be done. I have 3 family members who very much want me back in good physical shape, and even if I feel like giving up, I won't be letting them down.
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