Hip Replacement - muscle not re-attached

Hello Jean,

I have the same problem as you. I haven't walked without using a crutch since a second hip revision op in October 2015. I've recently found out it is due to bone thinning caused by my osteo arthritis and the muscle never reattaching after the operation. I have just been put on the waiting list for bone grafting on the area and a muscle patch. I was told the patch acts like scaffolding for the muscle to attach to. There is a 50% chance of the operation being a success and I won't see any improvement for possibly 18 months. I feel it's worth a shot as my leg collapses when I try to weight bear and I cannot lead with that leg as I go upstairs. I'm more disabled now than I've ever been. I'm 59. 

hi suzanne -

warm welcome to our hippies forum ...

I am so sorry to hear about your problem ...

Perhaps you can start your own discussin (see green box) so nore forum members will be able to respond to you .. you are not alone -

right now your post is limited to members who have responded to the original post a year ago ...

Big warm hug for now

renee

Hello Helen

I have an appointment to see the surgeon 5 May, I was thinking an MRI scan would be helpful and wonder if this is worth having before I see him to pre-empt the ineviatble. How did the surgeon discover you had bone thinning? I would agee the opeartion you are proposing is worth having.

Hi Jean,

I had an MRI and X Ray's, not sure which showed up the bone thinning, but possibly a combination of both.

 

Hi Suzanne I'm also in the same boat as yourself I had a 2nd hip revision (3rd hip replacement on the r hip) In January this year after my 2 Ms hip replacement gave way and snapped my femur in two I had big problems in the operating theatre 9 1/2 hour procedure then 3 days in high dependency ward and 2 blood transfusions my thigh bone had to be cut open for the the old stem to come out and this will take 4 months from now to heal properly. After the operation the surgeon hold me I only had 30% muscle left and that it had been badly damaged by the first two ops so at a check up last week I told him I'm in excruciating pain in my lower back and he said I'm not surprised you no longer have any muscle left in your hip and there is nothing that can be done with the spine as that is taking all your weight now he also said physiotherapy is no good as you have no muscle to build up so the actual hip surgery has been a success but unfortunately the pain in my lower back is so bad I can hardly walk at all without severe back pain also I had a epidural and a anaesthetic now my left thigh is numb as the epidural has damaged my nerve endings but I was told the risk before he administered it so I knew the risks unfortunately I'm a self employed taxi driver and I now need to give up my job so I will now need to claim benefit for the first time in my life I'm now 57 and have been working for the last 41 years but the questions I'm being asked to claim benefit is unbelievable and when I see some of the people who can walk for miles and have never had a job it's laughable they have benefits coming out there ears and yet I'm being asked to go for medicals etc and I genuinely can't walk !

Hi Jean, I had a mars MRI and it showed I have atrophied muscle and tissue, I also have pain and trouble walking. I'm 65 and really don't want any more surgery. Doc is sending me to a gait specialist. I don't see what that will do to teach me to walk different it is because I have so much pain that's how I walk far from normal. Doc wants me on Celebrex has anyone been on it ? Also wants X-rays of both hips. I'm also dealing with depression I want to jump out of my body pain is so bad.

Pam, if it ends up that you do need surgery for gluteal tendon repairs, I want to tell you that, for me, that surgery was much easier than the hip replacement. I had much less pain, and after the first couple of days when I was getting IV pain relief, I only used acetaminophen. Never needed opioids, although I used plenty of them after my THR.

The recovery is different, in that I was on 20 pound-flat-foot weight bearing for 6 weeks, and it has taken 6 months for me to feel even close to normal when walking, but I keep on getting better every day. It was so worth it to me to have this done. I am planning my first vacation in 3 years for later this summer. I am walking farther and with much less discomfort that I was before my THR 2 years ago. After my THR, I was sure I'd never want hip surgery again, but soon realized that these tendon tears were limiting me severely. I'm 69 and, like you, I want to be able to walk and enjoy life for a long time to come!

Hugh, your situation is terrible! So sorry that all of these bad results have happened to you. So the surgeon told you there is no way you can ever get better or, at least, get some relief from the pain? Is it possible for you to get a second opinion from a different surgeon? Hoping something can be done to help you to live a better life.

Thank you so much Annie, I would have the surgery knowing it should be easier than the thr. I will definitely bring that up to the doctor. I'm tired of limping around in constant pain.

Pam, just thought I'd reach out and respond to what you said about your problem. Atrophy of a specific muscle often means something is wrong with the muscle itself or the connection of that muscle to bone or other muscles. And medical science has advanced to the point where those kinds of things can be fixed by surgery, if they don't heal on their own in a reasonable amount of time.

Here is my situation, as an example. After my THR, my gluteus medius and minimus tendons both tore. After the THR, I was never able to do the single leg stance on my surgical leg, even though I could do it before the surgery. I had a severe limp and pain. My original surgeon said it was "weakness" and I should do more PT, and this was 5 months post-op and after 22 sessions of PT. Even after I got him to order an MRI, the atrophy of the those two gluteus muscles was very evident, but neither he nor the radiologist could see any reason why. That surgeon told me that it was impossible for a gluteus medius to tear, and so, of course, repair surgery was impossible, too.

I had to find a second opinion orthopedic surgeon, and he DID see the tendon tear on the scans, which he had highly suspected after a physical exam and hearing my history. He performed the surgical repair 5 months ago, and I am almost recovered now.

Have you gone for a second opinion to someone who knows about hip muscle/tendon issues? I strongly recommend it. It is what turned me from a person who needed a walking aid at all times to a person who is close to packing all of those aids into storage!

hi annie..i have been following these threads with great interest as i have exactly the same problem as yourself.i had my THR july2016 and i knew within a week there was something not right.unfortunately 24 hours after the op i had a bad exacurbation attack as i have copd and my oxygen levels dropped to 76 and i can remember collapsing and waking up with machines beeping around me.When i tried to stand up i was in a lot of pain from my hip and knee.They kept me in hospital for 8 days mainly because of my breathing.After 4 weeks i went back for post op check but never got to see my surgeon but one of his team.I told him i was in a lot of pain and something wasnt right but got fobbed off saying i still needed time to heal but to go back 6 weeks later.This i did and still in pain.I then went for an X ray and returned a further 4 weeks to be told to now have a ultra sound.again i returned to be told i had fluid around the hip and the femur and to be then sent for an mri 2 weeks later.3 weeks after mri i finally got to see my consultant to be told i had muscle detachment of the gluteus medius and the minimus anterior third.He was so adamant that he did not really want to fix and that if he did he could only repair it the once but just kept insisting it wasnt the thing to do this as he thought the pain i was getting was from my back as i have severe lower back problems and therefore made an appointment for me to see back consultant.After seeing the back consultant who agreed i do have severe back problems that could possibly need surgery that my back was most definately not causeing the hip pain.So once again i have to go back to see my hip man which is in 2 weeks time.My own doctor has been very good and has said i am to stand my ground with my surgeon when i see him and tell him i want it sorted.I am so very depressed about it all and have been on crutches since july 2016 and the pain is unbearable some days.What questions do i ask him? I cant force him to repair the muscles and if i do get them repaired what is the outcome and do i have to wear a hip brace .I live on my own and have only help from a friend and finding it all very daunting at the moment.i am just 60 years old and cant imagine the rest of my life on crutches.

Andrea, you should NOT have to spend the rest of your life using walking aids. Gluteus med/min tendon repair surgeries are being done more and more all the time, and are equated to rotator cuff surgery of the shoulder. No one would suggest that people should spend the rest of their lives with an arm that doesn't work, when there is a surgery to correct it. Same for the leg/hip.

I am sending you all of my sympathy! It's got to be so much harder for you with you living on your own. If I were you, I'd seek out a different orthopedic surgeon, one who has experience with gluteus medius/minimus repairs. I wouldn't want a surgeon working on me who doesn't know how to do that procedure and/or is reluctant to do it. Look for another orthopedic surgeon who is experienced with this. I googled to find my new surgeon. I was very fortunate to find one a few minutes from my home, who is in an excellent orthopedic practice, who has great credentials and has even pioneered surgical techniques for glute med/min repairs. 

Once you find the right physician, things get easier, as they take over with the diagnosis and treatment, and you are not feeling all alone and helpless. I went to a wonderful rehab center for 2 1/2 weeks after my repair, so as to be able to stick to the 20-pound weight-bearing rule more easily. If I had gone home right away, I would have been tempted to do too much. There was a full 6 weeks of 20 pound weight-bearing and I had to wear a brace 24/7. It wasn't too uncomfortable. I was able to get adequate sleep.

I'll be happy to message you the name of my surgeon in a Chicago suburb, and another surgeon in the Milwaukee area who does this kind of surgery, if you like.

Here are the links to my threads here on Patient, if you want more info.

https://patient.info/forums/discuss/having-gluteus-medius-repair-surgery-possible-hip-revision-tomorrow--543982

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

https://patient.info/forums/discuss/22-weeks-post-op-still-can-t-walk-unaided--490578

thankyou annie for replying so quickly and thankyou for the offer of the name of your surgeon but i am in the UK..i will update in 2 -3 weeks time after i have seen my consultant again

Looking forward to your update, Andrea. I must say it again, there is no reason why torn gluteus medius and minimus tendons that don't heal on their own in a reasonable amount of time, and whose degree of injury can even been seen in MRI, should not be addressed surgically. A remedy exists. That remedy makes a person mobile without aids, and not in so much pain, and able to work and be a productive, happy member of society, as opposed to being disabled.

If your surgeon does not know how to do glute repairs, then you should be referred to someone who does! Best of luck to you.

Hi Annie, Thank you, I did make an appointment with another doctor. Hopefully I will find out something new. Like you, it's so disheartening to hear of so many people suffering when there should be a solution.

Wow, good to hear that you are better now. Doc only saw atrophy of the muscle and tissue but I am seeing another doctor . What kind of doctor did you see that specializes in muscle/tendon issues ?

He is an orthopedic surgeon who is familiar with gluteal muscle tendon ruptures and also has gluteal tendon surgery as a specialty, in addition to other hip/knee surgeries. In a hip MRI, when you can see only one or two muscles atrophied with many fatty inclusions (indicating non-use of the muscle), and it has been some time without improvement in pain and disability, that is a very good indication of a tendon tear (or tears). 

Hope your new doctor can help!

hi annie .. well surgeon has decided to go ahead with hip exploration,excision bursa and repair of abductors..though he was still stating that he didnt want to do it but i insisted i did not intend staying with crutches for rest of my life..so a waiting game now to be called in for surgery..will keep updating ..thanx

Excellent! He isn't the one who has to live with crutches forever, so I am glad he finally agreed to help you.

Hi Andrea.  Same issue, no muscles after hip replacement.

    My surgeon also believes that the muscle/tendion  repairs and painful for the patient, give temporary relief, and often dont help.  His exact words were, “ in my opinion it is a waste of time”

you can always see another surgeon, or more than one more.  See what other Docs. Think and read, read, read, to get informed yourself. It’s one reason I am on this site. 

  I am facing a total hip revision in 12 days ( having no pain but keep dislocating the hip)  I am concerned that I will end up with the pain you are discussing and no longer able to garden. 

hi brenda..Good news for me..i had muscle repair done finally 4 weeks ago.Its still quite painfull at the moment but i can feel its getting better.Sometimes when i lie down and move in a certain position it feels like im tearing it again but my doc has said its the muscle stretching. it also feels like i have muscle cramp in back of my calf but my physio has said in time that will go away but overall im pleased with the outcome.i go back end of february to see the consultant and a scan .I shall let you know what the outcome he says.i know its going to be a few weeks mayby months before i can finally throw the crutches away but i feel positive.