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Illiopsoas Impingement on acetabular component

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christine2107
christine2107

I have been posting here on and off for 10 months after THR in Dec 13. I have made slow progress getting rid of a lot of problems and exercise and physio has helped - so thats a key message....

HOWEVER

I have had intractable from of hip and bottom pain. Mosr recent ultrasound shows tendonopathy on the ham string and glutes. Physio has given me exercises to try to address this - will keep you posted,  The pain from bottom stops me sitting

WORSE

Is the front of hip pain. The ultrasound suggests this is due to the illiopsoas tendon "tenting" over the acetabular component. Physios have tried to loosen it off by bouncing on my prone hip but this has produced excruciating pain and stiffened the hip. My consultant has told me my pelvis has been tilted due to the angle he implanted my hip - so I am not sure exercise can ever sort this out - as the mechanics will drive the 2 things together.

Has anyone else has this problem and if so how was it resolved? I have had an injection during the ultrasound but it has not lasted.

I was 50 when this all kicked off - delays meant I didnt get a replacement until 51. I am 53 in July. Getting old and fed up - I am slim and fit. What else can I do?

1 like, 6 replies

6 Replies

  • ian97093
    ian97093 christine2107

    Posted

    Hi Christine all sounds as though you are getting there but with complications setting in, things to be wary of, thanks for sharing, I was fine at 50, and have never been away from the Doctor since then, I just want my life back as it was, my mobility has deminished and I have to nearly lift my leg off of the pavement to get into the car, luckily work has been very supportive letting me sit down to work, I work in a Casino, as a supervisor, dealer, now mostely a sit down dealer for Poker and BJ, waiting for the operation that will I hope sort me out for the next decade through to retirement, I am trying to loose a little weight and only have a little to loose, and watching several blogs learning all the time what is ahead of me this year, thanks for posting here and I will watch and learn from your expieriences. Hope that you are feeling better soon.

    Kind regards Ian.

    • christine2107
      christine2107 ian97093

      Posted

      hi Ian

      Sounds as if you are having a rough time too...can I ask if you have had a diagnosis to support the operation they are going to do to you and if they have told you it is pretty successful?

      Click here to view image

  • sknapper33
    sknapper33 christine2107

    Posted

    Hello Christine,

    I am very sorry to hear about your problems and i don't have any advice. But if possible I would like to know a little more about the pelvic tilt and the angle. I ask because I have a pelvic tilt that is creating a 1" perceived leg length difference (3 mos. post Anterior THR). I know the new stem of the ball is longer then the original stem. My new hip is offset so I assume the angle must be different as well. Is that what happened with your surgery or did the doc just do a poor job? Thanks, and I feel bad for you - I'm fit and in my 50's also and was hoping for what i thought was going to be a standardized surgery without complications.

    • christine2107
      christine2107 sknapper33

      Posted

      hi there

      My consultant knew I was sporty and had dysplasic hip. So in order to prevent it from dislocating he - in his own words - "put it in a bit tight - with a high offset". In effect my pelvis is pushed up and forwards which is what causes the contact between the very big tendon illiopsoas and the acetabular replacement. That contact was not there before the operation. I too have a leg length difference - which he admits is not just apparant but also true. I could put up with that if the pain would go away.

      My consultant "over did" a job to make it as good as possible but overshot perfection to put me in permanent pain. I am told that the body adjusts to a leg length difference below a certain amount - but mine is 1.75cm-2.5 cm dependiing on who is measuring and has not really changed since the operation. If your body does not adjust they will give you a shoe lift which does help. Its if you get pain then you need to be on the case.

      Only now I have the ultrasound infromation can I properly research and my outcome is an uncommon one - but there is a building body of research about it. 

      Top tip - if you are going for ultrasound to see if there is inflammation - stay off your antiinflammatories for a week otherwise you will suppress the evidence.

      Cheers

      Chris

  • ian97093
    ian97093 christine2107

    Posted

    Yes Christine I had an Xray and both my hips ar worn out and need the operation yesterday, but still 3 weeks to just even see the consultant, then a wait after that and I can hardly get about at all, dropping off so fast it is scarey...Darn it!!!

    I hit one hell of a downer on Saturday night, but got over it with the prescribed blue tablet, just waiting like this is making me depressed. 

    Kind regards and thanks for posting.  Ian.

    • christine2107
      christine2107 ian97093

      Posted

      Ian - thing to remember is that for most people it is successful. Its like childbirth tho - no experience is the same and there is nothing clever in forcing yourself to recover too quickly -is is not a race and not a competition. So be patient and use these waiting weeks to do things you would not usually do because you would consider them idle - I caught up on all the series of a UK drama called Made in Halifax on my ipad. Enjoy sleeping on your side as you wont be able to do that for a while - take lovely long baths for the same reason. Write letters to friends. Buy some massage oil to attack the scar once you've had the operation. Fill the freezer with home made food - just ideas to inspire you. I also bought a prepayment prescription certificate which has saved me a lot of money in the past 12 months. 

      Promise me you will follow all the precautions afterwards that they give you? You are much more likely to end up dislocating or with problems if you dont. Now I was as good as gold and still had problems so its no guarantee but you want to do everything to avoid a revision.

      These weeks will pass quickly - and if you know the date of the clinic its worth phoning up the day before every week to try to bag a cancellation - I have done that lots of times.

      Take care, dont fret - and remember whilst its hard - there will be kids on orthopaedic wards dealing with infections in their bone cancers and possible amputation and /or death as the next step. Seeing these kids being brave put my woes into perspective. x

       

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