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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

168 Replies

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  • Kate53CornUK
    Kate53CornUK AnnieK

    Posted

    Oh Annie, one part of me is wrapping you in a hug and the other is applauding. I know you don't want to face any kind of surgery again, but you kept sight of a 'normal' for you and pushed until you found answers.

    I believe that knowledge is power and knowing what is wrong and what the answer is will help improve everything, stress makes everything worse.

    You are right, this is a mega op, but you got through it and you'll get through it again.

    • AnnieK
      AnnieK Kate53CornUK

      Posted

      Thanks so much, Kate! With any luck I won't have to have the revision, but I think I will, since something "catches" occasionally when I move in a certain way, which lends credence to the new orthopedist's suspicion. I will get through it, no matter what. I would much rather know what is wrong and have options for repair than to still be in the dark.
  • colinTN17
    colinTN17 AnnieK

    Posted

    Thanks for letting us know about your situation which sounds a lot like the problem I have but in a different place.  I can imagine how awful you must feel and a nasty cold doesn't help.

    Im giving my consultant the benefit of the doubt for the time being and will persevere with the new set of exercises that I have been given to do by the PT. 

    please keep us in the picture about your progress  Annie as I'm sure ther are others in this community that have similar problems and have consultants that are reluctant to admit there is a problem.

     

    • AnnieK
      AnnieK colinTN17

      Posted

      Sure thing, Colin! I have linda96952 to thank since she posted on my original thread about her gluteal tendon damage and how she needed surgery to repair it. That set me on the right track to figuring this all out. I am so grateful to her. If anyone can learn from my experiences, I will be very happy. We are all here to help and support each other!

      Hope you get your situation properly diagnosed and treated soon. We all have the same goal, to improve our mobility and strength and be as pain-free as possible so we can live our lives to the fullest.

  • My2boys
    My2boys AnnieK

    Posted

    Hi Annie,

    I'm so sorry to hear that you are going through all of this. It sounds as though you have already endured quite a bit. Kudos to you for being persistent and finding some answers. I hope you do not need more surgery. Please keep us posted.

    Wishing you well,

    Lori

    • AnnieK
      AnnieK My2boys

      Posted

      Thanks for those good wishes, My2boys! I will definitely keep you all posted. I have at least one surgery in my future, for gluteal tendon damage, and possibly a hip revision at the same time. Maybe just the one...time will tell!
    • My2boys
      My2boys AnnieK

      Posted

      Hi Annie,

      Well I am hoping it is only one surgery as you have already been through enough. Either way, I'm glad you persisted in finding the problem and possible solution. It sounds like you are ready for whatever comes your way.

      Wishing you all the best.

      Lori

  • littleone66
    littleone66 AnnieK

    Posted

    How awful for you, well done for being persistant! We can only hope that the further surgery will finally correct everything! I think it takes a certain type of doctor to actually care! It took 23 years and numerous trips to see different doctors about the problems with my hip before one doctor finally realised something was actually wrong! 

    Keep pushing until you get the answers you need! 

    • AnnieK
      AnnieK littleone66

      Posted

      Unbelievable, littleone, that it took 23 years for you! I am so glad you are finally getting the help you need. What was wrong with all those previous doctors, I wonder? You must have suffered so much, and I am sorry for that. May there be better days ahead for both of us. Thanks for your positive comments!
  • AnnieK
    AnnieK

    Posted

    I saw the second new orthopedist (partner of the other new one) today and he agrees with the need for gluteal tendon repair surgery. On the positive side, he doesn't think I need a revision of the THR. Hurray! However, he wants to completely rule out the possibility of an infection around the prosthesis. A blood level was elevated, and so I am going to have a procedure in which they aspirate some fluid from around my hip and then check it for all possible infectious agents. If infection is found, then both of the prostheses have to be removed and replaced. If not, then I just go ahead with the tendon repair surgery. 

    I have to wait two weeks for the aspiration since I was on an antibiotic that ended on Sunday, and that could complicate results until its effects are gone. 

    So more of a waiting game for me, but that's become a way of life. I asked why the gluteus minimus/maximus didn't heal after they were separated for the THR surgery and then repaired before closing up, and he said there was no way of knowing. It apparently happens about 10-15% of the time in the anteriolateral approach which was used on me. Age can be a factor, with older people having less successful healing. Sometimes people can injure the tendons with activity that is too vigorous and re-tear them after they heal. There was no accident/fall or injury  in my case. Sometimes they just don't heal well.

    I have to wait about 3 weeks to find out about the next step.

    • Rocketman_SG6UK
      Rocketman_SG6UK AnnieK

      Posted

      Annie,

      Sounds like you have a good pair of ortho's there - all very positive, it has been explained to you in terms that you can understand, and you can see the path ahead of you.

      Best wishes, and let's hope there's no complications of infection.

      Graham - 🚀💃

  • diane91105
    diane91105 AnnieK

    Posted

    Annie, How are you doing? What has become of your tear ssue? I'm facing tendon repair and removal of wire from femur.

    • AnnieK
      AnnieK diane91105

      Posted

      Diane, I've been kind of a mess. Everything keeps getting worse, as I've been using a walker or crutches for over a year now and getting weaker.

      I had surgery scheduled for Aug 15, Monday, to repair the gluteus medius and do exploratory surgery. Then, 3 weeks ago I had a compression fracture of a thoracic vertebra. Back spasms, very bad pain, doctors, meds, and tests later, I am scheduled for a balloon kyphoplasty on that vertebra next week. They will put cement in it to stabilize it. No way could I go through with the hip surgery without a strong back, since I will be 20 lb weight bearing on my surgical hip leg for 6 - 8 weeks. So the decision was made yesterday to postpone my hip surgery again. I hope to have it in October after my back gets organized.

      I just started being able to sleep sitting up in bed a couple of days ago. Before that I had to sleep sitting up at my dining room table, hunched over on pillows with my feet on the floor. 

      I am just wiped out and worn out.

      Hope your surgeries will go well. Do you have a date yet?

    • diane91105
      diane91105 AnnieK

      Posted

      Saw my orthopedic doctor yesterday and scheduled surgery for Sept 12.  He will remove the wire and repair the tendon.  He said he was kinda excited to go back in as he's never had this happen to any of the thousands of THR he has done in the past.  First time for everything and seems the weird things happen to me.  LOL  The incision will be large again due to needing to remove wire and explore to make sure there are no other issues lurking in the back ground.  Hate that part....

      Hope you are able to get relief soon.

    • AnnieK
      AnnieK diane91105

      Posted

      Thanks, Diane. Wishing you well on September 12. I can easily believe that those wires can cause irritation to soft tissues near them. Hope that after this surgery you will be much more comfortable!
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