Psoas Impingement after THR -research

Hi Dean and to all those who have so far responded. As my issue took 2 1/2 years to diagnose I am trying to gather info on the average diagnosis time. I find out tomorrow if mine can be just sorted by a psoas release or a revision. It is beginning to seem like a serious problem whereby consultants in certain areas deny any responsibility.

I am based in Birmingham and had my surgery at The Royal Orthopaedic. My journey has been a nightmare and I’m sorry to hear you’ve also had a bad experience.

Good luck with the research and the appointment tomorrow. I'd be interested in hearing what you find out about diagnosis times. I'm beginning to find that there are quite a few people who've had a hard time after surgery, and it seems that (certainly in my hospital) staff are reluctant to acknowledge that something has gone wrong, even when the patient knows from the start that something isn't right

Thanks Dean. My sister works at a hospital in medical stats. She will be doing a paper on diagnosing psoas impingement  as part of her PHD and any info will be of great help. My journey has been a nightmare and eighteen months in I was sent for the most barbaric procedure on my spine. My hip consultant convinced me it was my back causing the hip pain. I was sent to have the nerves fried in my spine without any sedation. I’m a tough cookie but this was so awful I went into shock. It’s now appararent that it was not necessary. From the first few weeks of having my left hip replaced I felt something was wrong. I’d previously had my right one replaced and that had been a success. It’s taken me so long for my consultant to admit there’s a problem. I was sent for an ultra sound scan two months ago which confirmed the psoas problem but it also flagged up the cup was overhanging. My consultant said “Oh the radiographer always says that but I will send you for a ct scan to eliminate “. I go tomorrow to get the results of the ct scan and fear the worst. If we can change the way this issue is diagnosed then others will not suffer.

Hi Dean 

So sorry to read about what you have been through. 

I pray that you will find comfort soon. 

Hi Carolyn,

Best of luck on your appointment. Sorry that you have gone through this for so long. I know the feeling. 

Prayers for a great outcome and no more pain. 

Thank you. It’s not been a good day but I will update when I’ve come to terms with things. 

C x

Hi Chrissy, I hope your recovery goes well. It seems the average waiting time for diagnosis is six to twelve months. I’m hoping we can get this changed somehow. It’s taken nearly three years for my consultant to inform me :-(

Best wishes

Carolyn

So sorry that it has to take this long. Orthopedic surgeon should be able to recognize this right away I think they just don't want to mess with it and it takes a special arthroscopic surgeon to do it. The surgery for me has been extremely painful. Today is 14 days after the psoas release surgery and I am still seeing very little benefit. It will take on an average 6 weeks to realize improvement and then 3 months to get function back. So it's a long long journey..i want to make sure every one knows what to expect.. Another person on one of these boards had pain relief in 2 weeks but it varies for everyone..hope this helps.

Thank you for your info on your recovery and I hope you feel the benefit soon. Sadly my consultant is one of the few that can do this op but he’s now sending me to another consultant to review all my scans. I think because he knows I’m not happy then he’s walked away.

Hi Chrissy, I picked up on your post as you had your surgery in Florida. I'm so sorry to hear of your bad outcome from THR. I too had this surgery seven months ago in Jax Fla.

My first three months post surgery seemed to go pretty well, then reversed. I had increasing groin pain which has now become pretty debilitating. An intensive Google search led me to believe that I have a psoas impingement.

My surgeon in Jax Fla. has an excellent reputation and I like him, however at my last visit, one which I instigated, he seemed nonplussed. He took an x-ray which showed the prosthesis to be in place and said to wait for three months and then see how things were going.

I decided to start physical therapy again and after a few weeks my very nice therapist said that the situation was ridiculous that it seemed to her that I clearly had an impingement and need a scan. She called my surgeon and two days ago I went down to see his pa. She agreed with my assessment, (carefully put forward so as not to give away any hints of the dreaded self diagnosis) and I am now awaiting an appt. for a CT scan. 

I was wondering did you try steroid injections before your surgery? Apparently they work for about 50% of patients but my experience with having imagery guided injections in my back was that they did nothing other than cause pain at the time that they were done. I can see that the idea would be to reduce inflammation but don't understand how  that would initiate a permanent cure.

You mention that you have found an arthroscopic surgeon? who is capable of fixing the impingement and had had the psoas tendonotomy surgery several months ago. 

I don't know if you are allowed to post names or recommendations on this board but if so, I would be very grateful if you could let me know who performed your surgery and if you are happy with the outcome.

I hope by now you are feeling much better.

Best wishes,

Penelope.

 

Hi Penelope, i tried many cortisone injections via ultrasound which everyone has found to be totally non effective...the only way is through flouroscopic cortisone injection to reach lesser trocanter....There is another forum on here search for it, i believe its under psoas tendonotomy....you must find a surgeon to do an arthrocopic PARTIAL release or you will be crippled for life...you can read their stories on that board... My dr was Dr James Ross in Deerfield Beach...I would check and see if your insurance covers him. He has done several people from these forums successfully....

Its a very hard road I will say...If i had know this was a possibility I never would have had hip replacement.

Hope this had helped...Chrissy

BTW, hearing stories from patients is the only way to judge what is right for you. Psoas release takes min 3 months will full ? healing at 9 months....its no walk in the park and very painful...

Chrissy, I really appreciate you taking the trouble to reply, thank you so much! '...crippled for life'..Arggh that is a dire warning. I will check out the psoas tendonotomy forum and look into Dr James Ross in Deerfield Beach. My surgeon was Dr Heekin at the Heekin Clinic St Vincent's Riverside, Jax. The one thing I know, is that he does a great many THRs. and has good ratings but one has to know where to look and dig deep. Not so sure how to do that.

I will let you know how things go. 

You have been most helpful. Thank you,

Penelope.

My surgeon was Dr Preetesh Patel at cleveland clinic and after things went bad and i started with groin problems they wanted nothing to do with me....in fact I never saw Dr Patel after surgery, just his PA...They should have told me that this was a possibility and i would have re considered having hip replacement....The groin pain is worse than having a bad hip.... Dr. Ross has done several people on these forums and they all turned out well...I am almost 4 months post op, no more groin pain, just dealing with last issue which is pinched nerve....so 2 years later I am almost free!

I was told that I would have to wait at least six months for a hip op if I had had steroid injections. I am not sure why but as I am on oral steroids anyway my orthopaedic surgeon was worried about actually operating and wanted me on zero. In the end he agreed to operate on 5mg. 

Thanks again Chrissy,  I did check Dr. Ross but see that he's about 400 miles from where I live. Not really doable, since my husband has to drive me back and forth (another story, medical not legal!) I will try to find someone in Jax or Savanna. So glad to hear that you  now free of the groin pain, which as you say is worse than the initial pre op. pain!

If anyone in Jacksonville Fla or Savanna Ga has recommendations for a great surgeon that can do the arthroscopic partial release for the psoas impingement I would love to hear from them.

I hope that pinched nerve resolves for you then you really will be free!

Hi Ptolemy, I'm afraid that I don't know much about pre hip surgery injections, mine will be seven months post op. However I did have steroid injections shortly before back surgery several years ago with no problem. Seems odd for your ortho to insist on a whole six months after steroids. Have you tried a second opinion.

It is not my orthopaedic surgeon who insisted on the six month rule particularly, it is in the guidelines somewhere or other, my GP mentioned it too. It is also on the Arthritis Research site as they are worried about increased possibility of infection which seems a major worry with hips. That is the reason my surgeon wanted me to give up the oral steroids except I would have been in agony without them. Steroids also increase healing time. 

Chrissy apologies. I just sent you a pm, also a post, not realizing that I had contacted you before. You can disregard my latest moan. I cannot get to Dr Ross unfortunately.

Hope you are 'all better' by now!

Best,

Penelope.