Tenotomy of the iliopsoas ( tendon release )

I’ve had the damn release ! Release!!! What a euphemism ! They cut it & yes mine is weaker and I have no idea how this will improve! I’m nearly 12 weeks post revision & joint is fine but psoas so weak. This seems like a permanent disabity to me! 

I’m bloody furious!

Oh god, inhal03672, I'm so so sorry to hear that's where you're at! Did your surgeon warn you at all or tell you how long it would take, and what you'd have to do, to get the strength back?  If he/she didn't warn you, I'd say get an attorney fast. It surprised me that I hadn't seen anything about it,or heard anything from prior surgeons, and that it wasn't until I was in process of pursuing with a new doctor that I heard this. It's not a mystery apparently, but it's also not being presented to patients as a significant risk, or worse, certainty. I'm going back to another surgeon who said this was right surgery, and I'm going to ask him about it. Maybe there's different kinds of psoas release surgeries - I don't know. yet. I'm praying for you. Your doctor should have given you a 'this is the recovery process, timing' conversation before picking up a knife. Did he say anything about expected recovery? 

Would you mind terribly is I asked your age? and exactly how does the weakness affect you? I have to make a decision as I am in constant pain over this.

My heart goes out to you!  Chrissy

It is doing my head in Maysie8717!!

The conversation I had with the surgeon doing the revision was; 1. I can release the psoas tendon but it will be weakened 2. I can replace the cup

I chose option 2.

During revision surgery he had to do an extensive bone graft, put screws in place AND he decided to do a psoas release.  I get that once they open you up things can be very different to Xray & MRI & Ultrasound and that things can change and decisions have to be made on the spot.  My concern is that I didn't discover the damn psoas release until I asked for a report!!! aargh! God give me strength.  So I've asked for him to call me to discuss further.  I do beileve revision surgeon is good, he did my right hip 6 years ago and it's been perfect from week 6! 

As soon as he calls me I will fire away my questions and believe he will answer me truthfully.  So frustrated that surgeon who did my left hip stuffed it up!!! Revision surgery is not all it's cracked up to be. Once they have to go in again everything is compromised.

My worry is that the left hip will never be right.  I'm 51, fit and active and a Personal Trainer!!!! 

Hi Chrissy

I'm 51. The weakness means I can't go for a nice long walk of over 25-30 mins without referred pain down the front of my leg. It means also any lateral movements are weak. I also can't do alternate leg lifts like say hopping from one leg to another.  I can balance on my left leg and I can walk around incidently ok. It's just not strong on that leg like the other one.  Squatting with light load is also hard to do.  

Is your surgeon saying a psoas release is the solution  to your problem? I'm guessing you have bursitis then if surgeon is trying to get the psoas out of the way.  I'd be asking what is impeding the psoas from working as it's meant to. In my case the psoas that was "released" was connected near the iliac crest. 

Wishing you al the very best. 

sorry for delay in responding. its a  little hard to work this form on my phone,.lol

I don't get referred pain...but walking is a problems...i would love to do 20 minutes!!

no bursitis.

I just had a cortisone shot in adductor tendong and that has greatly allievated one of my problem areas.

to the poster who questioned why we aren't posting doctors names:  i agree I think we should!!

I posted several negative reviews online about my doctor to prevent anyone else from going through this..I believe as long as its factual and not malicious lies we are ok to let others know who did our surgeries..My doctor is Preetesh Patel at the Cleveland Clinic, in Weston Florida...His reviews are good on the hospitals site which is just plain marketing but when you did, as I should have before surgery, you learn the truth!

This surgery can be done 2 different ways. I have learned a lot in the past week. Dr. Halawi in CT told me psoas release surgery was a full cut, with 40-50% permanent weakness.  Dr. Coleman in NY told me 3 days ago, that he does the surgery with multiple but small cuts to the psoas, higher up than the full release. This results in lengthening (after healing) the psoas. It is never fully "released" from the bone, so the psoas can heal, and patient can recover their strength fully. I asked him why the other doctors I'd seen didn't suggest the same thing, as it sounds like a much better approach. I mean, getting out of pain is one goal, but being sedentary already gets me out of pain, why would I possibly do something that would permanently reduce function? He said it's a newer approach, and there just aren't that many surgeons who do psoas surgery anyway. I believe him, and have scheduled surgery with him.

Everyone, please make sure you know which of the 2 ways the surgeon is planning. One will allow recovery fully, the other way will cause weakness permanently.

Thank you so very much! That is such important information that I did not know and I'm sure everyone needs to know. I have adductor tendonitis along with the psoaa problem, after a cortisone shot to the adductor tendon it was useless. That doctor did tell me that if he could release the adductor tendon the prospect of getting back to a hundred percent was not good. I am still in search of a doctor who can help me. Had I know all this about the outcome of anterior hip replacement I never would have done it. I would love and to find an attorney to help all of us. Please let us know if the doctor you just found is specializes it orthopedic surgery arthroscopically or?

Ironically, I had my THR (anterior) done at HSS by a colleague of the surgeon who will be doing my partial psoas release. This definitely gave me pause when I first saw the psoas guy last summer. (my THR was in 2012).  I don't know that there is a case to be had against anterior THR overall, though when I get through this mess, I sure intend to find out.  Dr. Coleman is doing this arthroscopically. That is one of his specialties. I seem also to have adductor tendonitis to match. fun. What the doctor told me just last Wednesday was that it makes sense. The adductors have been  overexerted to compensate for the psoas inflammation, very likely. His approach will be to first see if 'fixing' (partial release/fractural lengthening) the psoas ultimately allows my whole 'off kilter (my words) system to recover. Yes, I agree, I wanted to share this with everyone fast, before someone goes under the knife for the wrong surgery.  I can't swear what my outcome will be, I'm praying of course it will be great, but one way or the other, everyone on this board needs this information to at least be coming at their decisions from a point of knowledge about the surgery variations.

Maysie..i have had 2 cortisone injection s for psoas and 1 in adductor tendon.. Nothing has helped! the last doctor I saw doesn't think it's a psoas. The crippling pain I have is in the adductor and way down deep in the groin at the very bottom. my pain is not at the top of the thigh. Where is your pain?? I think my doctor who did my anterior hip replacement, dr. Patel, was such a greedy b*****d, he couldn't wait to get next to his hip replacement and he's zipped on by not taking care of all the tendons. This same doctor I found had gotten Payola from Stryker over $98,000. I basically can't do anything, I can't work, just lay around all day because of the pain. You bet I'm going to try and sue him

I'm heartbroken for you, from a point of knowing what it's like just at my level of pain and debilitation, which sounds less than yours. I'm almost always in pain, but I can still work. My post surgery injections didn't do any good either. The pain for me is both deep down in the groin, as you describe and also near the top of the thigh area. It also travels sometimes down from the groin on the inside of my thigh about half way down to my knee. It can be sharp or deeply aching, usually both. There is no "if I do this it hurts" clear cause and effect.Sitting can make it worse, but then again walking can too. Basically, unless I'm lying on my back or lying on my stomach, I'm exacerbating the problem. I think a lot of these surgeons are greedy and unethical. I think hip replacements are a cash cow for them, and they can get off the hook for outcomes like this because soft tissue is so hard to diagnose or be accountable for. Where are you? If you're like me you've already spent an ungodlly amount of money on PT, second opinions and the like. I won't know for a while after the surgery if my new surgeon will finally solve this for me, but I promise not to drop off the dialogue if I do find the magic solution. Right now, I'm in a lot of pain and the position I'm sitting in is puzzlingly bad. Are you near NYC?  I think you said Illinois somewhere along the threads.

Wow! Game changer.

Thank you for the share.

I’m

Definitely going to clarify with surgeon who did my release to find out which he did. I’m hoping he did partial & that this is why he’s confident I will gain full strength back. 

So Maysie your thoughts on my set of circumstances would be greatly appreciated so I can get my head round why I find myself in the predicament I am in.

Do you think it’s the anterior approach itself coupled with an inexperienced or poor surgeon that compromises our psoas & is the cause of the pain, bursitis & constant rubbing of the psoas?

Thank you & all the very best to you.

Maysie I'm in South Florida. Walking, sitting makes pain worse. What helps is lying down...I've already tried staying off leg for 3 weeks and that did nothing. My pain is constant..

problem is finding a doctor on my Medicare plan that can do this type of surgery without crippling me. I already met with one who said he could do the adductor tendonotomy but my outcome was fair, said I would lose 40 to 50% and still the pain might not be gone. And the man was rude to begin with so I'm never going back and I did write a powerful negative review on him. Its been 10 months now and i cannot find someone to pinpoint this and repair it

I definitely think the anterior approach is a problem. One major surgeon in south Florida said hes no longer doing anterior approach because of problems associated with it. He only does posterior approach.

I definitely think these greedy doctors do it because its fast to do, has faster recovery and is a huge money maker..there should definitely be a class action suit against these drs who are seeing the related problems and still keep doing surgery without regard to patient... This psoas injury is a life long disabilty.

certainly hope your dr did it the correct way!! Please let us know what he did. We will all be waiting and have you in our prayers

Hi inhal, I'm not convinced one way or the other about anterior. For me, this mess actually started with a hip replacement I shouldn't have needed. I was 45 years old, fell down a staircase, and tore my labrum cartilage. I'm 55 now. I had the hip replacement at age 49. There's more backstory, courtesy of insurance not wanting to pay for labrum tear surgery, and over-cortisoning me until I was bone on bone. Then at that point, I did need a THR. I spent 6 months on crutches prior to the THR. I fell down those stairs and tore the cartilage exactly 4 years and one day prior to the THR. Now it's been 5 and a half years since the THR. Within 4 days after the THR, in PT, the therapist and I were trying to figure out this groin pain.

So, I'm at 9.5 years since this mess started. I don't know if it happened during surgery. 

We're all at a disadvantage here, we can't know who all has had a "settlement" with their surgeons. We can look online for whether a doctor has malpractice suits, sanctions or board actions - but we can't check for settlements. And settlements generally require the victim's silence. Think about the same thing with sexual assault settlements, the victim receives a financial settlement in exchange for their silence. How are we supposed to know if our surgeon had multiple settlements?

That's a fight I'll need to fight for all of us patients someday. 

Oh Maysie my heart goes out to you.  You make some valid points regarding being silenced. 

I’m still waiting on APHRA to make a judgement on whether there was negligence on the part of the surgeon. 

Interesting about settlements. I would think that just having a few lawsuits, whether they are settled or not, would keep people from going to that surgeon. Tip of iceberg as far as trouble. My doc is revered here in Rochester..couldn't find one bad thing, not one lawsuit or settlement, except one long remark about him being rude. Colleagues and patients loved him.He was and continues to be a jerk, ever since the hour surgery was done and I complained about my entirely black and blue knee.Now it's horrible groin pain, and I'm only going to talk to him if it's through a lawyer. Still trying to get those ducks in a row.

Yes I am so so sorry as well! How dreadful. Who ever decided this was a viable option in any case?

Just curious, How long do you have to wait for this surgery with Dr. Coleman? How long did you have to for your consult?

Thanks

Hi Marcy - sorry it's taken me so long to get back to you. I saw him about 2 weeks ago and I'm scheduled for 12/12.  The holidays probably play a part. So, maybe 5-6 weeks from time I said yes to setting it up.  I got a consult very fast, like within a week of asking. I probably wouldn't 'have been able to gather my X-rays in operative report that fast, but he had it already because I'd seen him last summer once for a consult. He's pricey, if you don't have the insurance he takes, but I'm sure you know, this isn't a 'shop around' scenario.  

Did you have a hip replacement? Why would your knee be black and blue? Although, they do dislocate your hip during a hip replacement, and that requires putting leg into a dislocated traction. ugh. I took the approach that I'd rather get more info before doc lawyers up, but it's such a tough call to know what to do. With me, there's no smoking gun of something surgeon did wrong. 

inhal - I don't know what APHRA is (thought I could google it, duh) but I'm interested in the questions of surgeon being held accountable on negligence. I think that may be something I should look into. Honestly, I try to tell myself that I'm fortunate it's not worse, when i see people with far worse problems, but then again, I'm deeply p****d off about the sedentary years of my life I'll never get back, and money gone on this. 

Hi there, I hope this helps.....I'm in South Florida, too. I can completely understand what you are going through. I had hip arthroscopy for FAI, cam impingement and labral tear in Dec 2013, hip replacement in  Dec. 2016. My psoas was getting chronically irritated....more activity made it hurt worse. Trouble climbing stairs, getting dressed, in and out of car ect... Kept going back to my surgeon. He agreed this was probably the problem. I believe he said about 4-5 percent of people get this. Sent me for a 2nd opinion just to be sure. Then to have ultrasound guided cortisone shot to test the diagnosis and record symptoms. Then when all things did indeed point to my psoas being impinged, he sent me to and orthopedic surgeon who does this. I had my psoas released on 2 days ago so I cannot tell you about my outcome, but my surgeon who performed the release is Dr James Ross out of Boca Raton Regional Hospital. The way he explained it is that the psoas tendon is cut, but the muscles around it stay intact (iliopsoas complex). He and the 2nd opinion dr as well as my hip replacement surgeon all said the weakness is temporary and that the muscles will take over to so the job. All agree it should take about 6 months for a full recovery. As I said, I'm 2 days out. I have to wear a hip brace for 2 weeks. I can walk without a walker today and have very little pain. I hope this helps ))

Thank you. That helps so much! Unfortunately dr. Ross is not in my insurance plan, they won't cover him. They won't cover his surgery. He doesn't take my insurance.

Can you tell me if you had an improvement from the cortisone shots? They did nothing for me. Can you also tell me who did your original surgery? dr. Patel from the Cleveland Clinic did mine that messed up big time

I messaged you privately.

 

I messaged you privately

Hi Marcy, I replied to you on a different thread, so not sure if you got it. I found out that he does this surgery (fractional release) about 25x per year, and only about 1-2 of those are post THR. I'll be one of those. I'm concerned about the folks on this board having the full psoas release, and then forever weaker. I want everyone to wait until I can report back after full recovery, but I know that would feel like a long wait to most people. They say I'll be on crutches about 10 days and then a few months physical therapy.  Still, I hope everyone will make sure to see if they can do fractional instead of full.

I am 60 years old.I had a labral tear years ago and had surgery to repair in 2013 with Dr Phillipon in Vail. The surgery was the worst, long recovery with a ton of PT. 2 year later did a THR by Dr Swanson in Vegas (he retired immediately after my surgery and went into the Weed business -cant make this up!) I had recurring pain in groin wrapping around my back. Went to another Hip doc and had a Lidocaine and cortisone injection under fluoroscopy which alleviated all the pain! 3 months later the cortisone wore off and did another cortisone shot that only lasted 6 weeks. Then did Botox injections into the Psoas muscle in the back which helped but also gave me weakness. Did that 2x 6 months apart. 6 weeks ago I was in outpatient surgical center in Santa Monica where I was going to have a Psoas Release by Dr Gearhardt. We warned him prior to surgery I have an issue with the anesthesia tube due to my neck being fused. He said it won't be a problem. Long story short was being wheeled in for surgery and the Anesthesiologist refused to allow surgery to happen in an outpatient facility due to my past problem with it. Gearhardt never came in to discuss with me and never called so  I was done with him! I researched psoas release and was going to have Dr Phillipon who is one of the top hip surgeons in the World to do it. After researching some more (we just bought a home in Boce Raton) I decided to see Dr Ross and am going to have the psoas release with him mid March. It has been 5 years of this nonsense and I am hopeful this fixes the problem once and for all

Hi Randy..i just had the psoas release on wed, 5 days ago with Dr. Ross..so far i cannot lift my leg which i am sure it takes time to get full function back..What concerns me is that3 days after surgery the same thigh groin pain from before is back! How was your recovery?? Thanks#

Maysie. I had the psoas release lengthening surgery Wednesday which is 6 days ago. At first the normal surgical pain was there which was mild then Sunday the same old groin was back. I am beyond hysterical...now i cant lift my leg AND i have the same groin pain..i called drs office . i am not scheduled to go back for another week for suture removal..his nurse said this sometimes happens and will get better with therapy...i was hoping having this surgery meant i was free of this horrible pain....what has your result been?. Tx. Chrissy

I am going in on 3/21 to get it done. I know 100% it is the Psoas as when I received my 1st cortisone injection I felt like a new man! If this doesn't work no clue what I am going to do.  More I read about this more concerned I am getting I think just  the cup and changing the angle of device might be best way to go. Not reading many sucess stories on here unless I am missing something?

Hi Randy. I just had it done 6 days ago. Good dr..he said my cup and implant were ok when i saw him day after surgery. The psoas was lengthened which is cut and sewn back together which im not sure what thats supposed to achieve. See what others say...my original inner thigh / groin pain came back Sunday afternoon and I am back to being bed bound so unless it gets better for me this certainly was not worth it. I will keep everyone posted. Please see what the others have to say

Not good to hear. Please keep us posted with updates. Ive done much research on this and I am really torn about doing this. 

I will keep everyone posted. There are a few people have had good results. My doctor is very good and known for doing these so I know he did the best he could. I will see doctor next week and I will post it as soon as I meet with him. I would say wait till you get results from more people. I did read an article from another doctor where it takes 6 weeks for you to see relief that the Pains come and go. So this is not a quick recovery

Oh Crissy, my heart is wrenching for you, to work up the nerve to do this is hard enough, but not having the sense that you're coming out better, is beyond awful. I haven't done it yet. I've hemmed and hawed, partly because I have to pay for it myself, doctor doesn't take my insurance, but also because the doctor who said he could do it, didn't do diagnostics, and when I asked for paperwork to send to my insurance appeals folks at my company, they sent over a letter stating that I had done a diagnostic cortisone on June 15th (never happened) and that I'd had a positive response to it (never happened, even with other doctors 4 years prior doing cortisone diagnostic).  So, kind of lost faith in that doctor, at HSS in NYC, and now even though I live in NYC area, am looking to start a new effort around this with a doctor in Chicago.  Can you tell me if your doctor is in NYC?  And that aside, I'm going to pray for you, and keep on doing research for both (all) of us on this board.  

Hi Maysie,,,we have much to talk about...But don't count me out yet...back of groin/thigh pain is a lot less today, almost gone but still there, now front groin in swollen....i believe these are all part of the healing...Don't give up...!! Mine wasn't that it hurt whenever i did this or did that. My deep thigh pain was constant! So i have more headway to make up...I read on the internet it takes 6 weeks to start seeing positive changes. My Dr is in South Florida

I also had to go out of network to get this doctor in South Florida who is well respected for doing this and one of the very few...these say only 5% of people who have anterior hip replacements get this but i believe the numbers are much much higher...its just such a good money maker.

I had failed 3 ultrasound cortisone injection test before but Dr. Ross said he has never seen one done correctly where it gets all the way down to base of psoas so he sent me for Flouroscopic cortisone shot where within a week i noticed 40% improvement then up to 70% which lasted 2 weeks.

I cannot lift my left after 6 days but use end of cane to lift up leg...today i am going to get in car see if foot can move between pedals since its right leg....Not being able to lift leg is normal for this procedure.

I don't know what insurance you have, i have a medicare supplement backed by United Healthcare so i went out of network to use my Dr and his hospital nurse worked miracles to get everything approved for me...The approval to go out of network was granted next day after i requested it.

If there is another way to get back to normal i would love to find it...My concern in doing psoas release is that since its cut and resewn back together that this can happen again. That is a question I am going to ask dr when i see him next week for suture removal so I will let you know,.

My life had been stopped by this for over 1 year and 1 year previous hip replacement by severe hip pain...so i will do whatever it takes to get back to normal..

I hope I have been of some help...Thank you for your prayers...keep em coming please and will do the same.  Chrissy

It is true I had my first cortisone and lidocaine injection done by guided fluoroscope and my psoas pain was gone was for 3 months never felt better! After that I was going to a Doctor in LA and he was doing it by ultrasound and it never worked. Had 2 botox injections that helped but caused weakness in legs. Throwing in the towel with injections and getting psoas cut by Dr Ross on 3/21 in Boca Raton,FL. I read it can take 6 months to notice the difference but recovery is simple and quick. By the way Dr Ross said I do not need hip brace just crutches after surgery. Bottom line if you are having psoas pain after THR do get cortisone or botox injections done only by fluoroscope 

Hi Randy, this is Chrissy. Dr. Ross just did mine 6 days ago so you are in good company. He also did Kshippychick...While each patient has a different history it does give you inside scoop.

I only used walker in overnight hospital stay..The nurses only let me get up next day and then i only used walker at home cuz of my paranoia otherwise i did not need...I will give you a good tip...since you will not be able to lift your leg i used the curved handle part of cane to put under my foot and lift leg into bed....Hospital beds are much lower than normal beds and i have a high bed to start so this did the trick just fine.

Groin pain came back on sunday but lasted 2 days then is going away. He said pain will come and go for up to 6 weeks...

When you are ready i will give you my tip on how to cover bandage so you can shower! I remain very hopeful, faithful and determined to get my life back! I hope you do the same

Amazing good news. Please keep in touch and post updates. I will do the same

I am just over 6 months post psoas release. Was going great with incremental improvements but last weeks have been quite painful. I started to have shooting pain down my leg, then innocently standing at the fridge turned to my psoas released side, not sharply or anything & got deep groin pain, couldn’t lift my leg well lying down & since it’s swollen on the side & there is constant dull pain.

Aaaargh!!!!! 

Don’t know what to do😔 left a message for my surgeon & waiting to hear back from him. 

crap Inhal you were one of our psoas success stories...don't wait for surgeon to call you back, set up an immediate appt and keep us posted please...That leads me to the concern that this psoas problem can happen again if the psoas is cut and sewn back, which is lenghtening..

Please let us know asap..There are people here getting ready to have surgery done and I just had mine down 1 week ago!! so sorry to hear this!! Take care.

Good luck!

Will get on it straight away. 

Hi Randy,  thanks for the info. Are you having a full cut? If so, did this doctor give you any prediction on whether you'd get full strength back? My understanding at this point is that a full cut means you can't get a full strength level back ever and so they suggest multiple partial cuts, "fractional lengthening". I'm thinking there's maybe some "in between" option that I hadn't heard of yet. 

How has your doctor described the procedure?  Maybe I need to go to your doctor! 

Oh I just saw this reply Chrissy. Wow. You did the lengthening, I'm impressed, but feeling like it didn't work must be really upsetting. I would think that the way this surgery works, it might take a while to feel better.. just because the pinched point wouldn't be relieved until the psoas is stretched by the activity of physical therapy. I hadn't thought of that before, but seems logical, of course I'm just guessing. I didn't do the surgery yet, several reasons, one of which was the paperwork from surgeon was inaccurate, and felt fishy to me that they were saying I did a diagnostic procedure that I hadn't done. Felt like veering into insurance 'misleading' and I want no part of that, much less having my medical history forever wrong. I've seen how that works out... a doctor puts down something inaccurate, and every time you're readdressing the physical problem going forward, you have to keep trying to tell new doctors that this one was inaccurate.. then they don't believe you. That's a mess, so I just stepped away from that surgeon. I doubt I'll go back to him for my surgery, even if he is supposed to be great. 

Is Dr. Ross in Florida? I think that's what you've said.. but a lot of threads here. Now that it's been 8 days since your last post, are you feeling any better? Or maybe doctor has provided more information to you about how long until you would feel better?  I'm crossing my fingers for you!  

Hi Maysie, my dr is excellent...my results have been slower then wanted because i overdid it, since i am single i had to do a lot for myself, crappy immune system and that fact that i found out one of the meds I have been taking Crestor causes muscle Pain, (i believe this added to pain)

you are right, it does take time to heal...Most patients see pain relief within 6 weeks, healing takes 3 months....my groin pain is gone, just buttock deep muscle pain is left.

My dr is excellent. several people on here have already had this done by him and got excellent results..everyone's body heals differently and I am 63, you have to take age into consideration. His name is Dr. James Ross in Deerfield Beach, FLorida...maybe he takes your insurance?

This was an option i had to take as i felt there were no other alternatives and the pain had totally derailed my life..now I am looking forward to being pain free and getting my life back....It feels better for a day or hours then it gets bad again then better...that's just the way healing this thing works... 

I certainly would not let a dr who had not done a ton of these operate on my tendon. Kshippychick on this forum used same dr...so it would be good to get her input as well since its been several months for her....

I will keep you updated!! promise!  One thing check if you are on a statin and if that's adding to your pain...I hope i have been of some help...if you need Dr. Ross # number let me know. You're right you have to be your own health detective, manager and advisor today!

Hi Maysie.  This is Susan.  I’m the one who is considering another opinion at HSS and asked if you could share

any additional info.  I also saw that on another post you were asking about ways to access malpractice claims.  In NYS, the insurance companies are required to disclose either all settlements or settlements over a certain  dollar amount to either the State or something called the National Practitioner Data Bank.  nYS then adds this information to the Physician Profile which all Doctors are required to complete. Unfortunately other than the amount of the settlement, there is no detail about the lawsuit. In NYS there is no way to access a information about official complaints against a doctor unless the Board has disciplined the physician. misconduct complaints can also be filed but in NY and probably every other state, unless the physician is disciplined by the Board that info is not public.  It seems like word of mouth is the best way to find a good doctor. It’s particularly frustrating for those of us who have already had one bad experience.

Hi Susan, I'm just drifting off the sleep and remembered I hadn't gotten back to you. Working too much lately. The two brothers drs. ranawatt, I feel pointed me in wrong direction early, when I only needed labrum tear surgery.. i learned later. Then doc Buli did my THR, and though thankfully the implementation is positioned well and, the see soft tissue issues with psoas have been something he seems unable to accurately diagnose. Another hss doc, colemam does this surgery, he's at HSS also and I might do with him but he doesn't take my insurance. I've intentionally slightly misspelled to avoid appearing via web search, but you can guess close enough if one of those is doc you're considering.

Thank you so much Maysie.  I have seen both ranwatt brothers and was not to happy with either.  I saw the younger brother for a very debilitating complex tear in 2009.  He didn’t want to do surgery because of the degree of arthritis.  Had second opinion with mat bsm (not correct spelling) who agreed that at some point I would need THR in the future but there was very little downside to the labral repair.  The recovery was very easy and I had no pain for 4 years and then the pain gradually returned.  Because I had such a good experience with Dr. Mat B., I am considering going back to him.  His practice has changed somewhat in that he no longer does arthroscopy and his specialty appears to be complex revisions as well as posterior THR and knee replacements.  He also refers some patients to dr. Bly.  My biggest issue is I don’t quite understand how it can be determined what is causing the inflammation.  My surgeon in N.C.does not know why the tendon is inflamed.  He thinks the X-rays look fine. He sent me for a diagnostic Injection done under ultrasound but that doctor couldn’t even identify the structures correctly,  He withdrew 20 cc fluid but was unsure whether he withdrew it from the bursa or the hip joint. Had an MRI which of course showed nothing at this stage (I was a little over 3 months post THR).  So my thoughts are that the cup possibly be rubbing on the psoas or I could have injured the psoas either through over stretching or over exercising. I happened to look up Dr. Coleman,s physician profile and saw he had one settled medical malpractice of $10,000.  It’s so hard to trust any doctor.  Having worked i the health care industry I know there is very little information that is open to the public.  I would at least hope that I could get a diagnosis from HSs.  I would hate to have revision if the problem is not related to the cup and would hate to have a risky tendon surgery if the problem is with the cup.the only test I know of that shows both bone and soft tissue is an mRI.  My thoughts are that An X-ray shows bone but not soft tissue and an ultrasound shows soft tissue but not bone.  Do you know if there is any other test other than mri that would show both?  I’m hoping at least thAt HSS would have better diagnostic equipment and diagnosticians but maybe I’m completely wrong.  It’s so hard to know what to do and it is so disheartening to see how many people have had the same complications and that so many are so young.  Another thought about malpractice information is that many people who have hip replacements are older and retired and therefore do not have a loss of income.  If damage to the psoas tendon is  known complication and it is a retired person, I wonder how many attorneys would eve take the case because even if there is an award it would more likely be a small nuisance award. Thank you again.  Susan

So, I haven’t been on this  site in over a year but I am one of the original  psoas posters.  I had tendinitis for over a year and now have a slightly weakened muscle from a year and a half of protecting my tendon. As for the MRI, the standard is to place your ankles together with ur feet in a somewhat pointed position. This particular view will never give you the info you need if the psoas is rubbing on the cup. Ask for an active MRI if this is the route you are pursuing. Most surgeons, even the most caring, will not go down the active NRI road with you. It’s not part of their lexicon. 

Hi Wlee.  Thank you for the information.  It’s one more thing that I will ask about.  I have some problems with using this site.  I use an iPad and instead of going in chronological order, it will flash and I’ve lost my place.  Anyway, I tried to respond to you sooner but that same problem occurred and I’m not sure if the post went through.  I saw that you frequently corresponded with Tracy.  She had some type of psoas tendon release and would be about one year out but it looks like she stopped posting.  Do you know how she did? What surgeries have you had. I am hoping that at the Hospital for Special Surgery will have state  of the art diagnostic studies along with excellent interpreters.  Certainly will not proceed with any surgery until pretty certain about what the cause of the problem.

Hi Inhal.  That is a bummer. I thought you were doing so well.  So your psoas was released and then reattache.???

Hi.  I am going to Florida next week and hope to get a consultation with Dr. Rossi.  I'm very confused.  I'm now almost 6 months post anterior THR.  Did well for about 6 weeks and then started to have more pain primarily groin.  It was impossible to get an appointment with my surgeon or his PA.  I was sent to a differentvery young and inexperienced sports medicine physician. I continued to do PT exercices and walking over the next weeks until the pain was so unbearable I stopped the exercises but continued to walk. The surgeon finally saw me after the sports medicine doctor withdrew about an ounce of blood tinged fluid from the groin.  He felt that I had an ileopsoas tendonitis secondary to overdoing it.  I  had a steroid injection, completely rested, and  took an NSAID for a month. The pain decreased but I began to feel stiffness, pulling,  and strange crawly sensations around my hip, front thigh, butt, and even abdomen. Walking feels funny.  When I have these sensations, it feels like my leg weighs 100 pouunds and I feel unbalanced.  The only time these sensations disappear or decrease are when I am lying down or sleeping. I think these sensations, but I would like other opinions, are being caused by the psoas muscles tightening.  I stretch the psoas muscle frequently and these sensations decrease for about 2 minutes and then come back. If I sit, it is much worse (of course the hip is flexed).  Did you ever feel these sensations.  When I try to explain them to my surgeon, he right away thinks it's the back and not the hip.  I know my back is fine and just to make sure this was confirmed by MRI.  Many years ago, I had a similar situation with my shoulder and the muscles across my back tightened.  Ultimately I ended up  with a rheumatologist who told me about "muscle memory" and said once muscles tighten like this, it's permanent.  I didn't believe him at the time, but it was true and I have had to live with this half of my adult life.  I'm afraid the same thing is now happening with the psoas muscles and can't bear the thought of living with this.  I know there are a number of people who have had some version of psoas tendon surgery.  Inhal is one of them and after reading his postings, I am very fearful.  You seem to have had the best results.  Chrissy seems to be having a lot of ups and downs.  If I'm correct, you had the tendon cut and Chrissy had the tendon lengthened.  It sounds like the lengthening is more of an uncertainty. I think I read a prior post of yours that you had the tendon cut but that the muscles remained intact and that the strength should not be affected.  Now that you are quite far out, do you have any pain, muscle tightness, or weakness?  I'm also going to post to Chrissy.  I feel the longer I wait the tighter the muscles will become.  Thank you.  Susan

Hi  Chrissy.  I sent a long post to KS Hippy Chick also with my long history.  I also had posted some of this on a prior posting.  Although I have less pain per se (depending on activity), I feel a lot more of what I believe to be muscle tightness which has its own set of issues.  Having experienced and having to live with something similar occurring to my upper back after a shoulder injury, I'm very fearful that this is now happening with my leg.  I think KS Hippy Chick had the tendon cut and I believe I saw that you had the tendon lengthened.  I saw earlier postings from you that relfected a lot of ups and downs.  Now that you are months out, how are you.  Are you feeling any pain, muscle tightnes/numbness or tingling.  I hope to see Dr. Ross in a couple of weeks if I can get an appoinment.  The thought of living with this is terrifying and horribly depressing and the thought of more unsuccessful surgery is even more terrifying.  Please tell me how you are doing.  Thank you.  Susan

Hi Randy.  I am hoping to get an appt. with dr. Ross in the next couple of weeks.  You should be about 6 weeks out.   What exactly did you have done, release, tendon cut, fractional release??? How are you doing.  

Hi Susan. Yes kshippychick, Randy and i all had psoas surgery by Dr Ross in Deerfield beach. Im almost 3 months post op. No groin pain. I do have a pinched nerve in the back and down my leg but that's a whole nother issue. Dr. Ross very good make sure to mention the Forum here he knows we all talk, use my name if you want. Feel free to p.m. me. I still can't put shorts on the regular way with this leg but that takes time. So he's done a good job I think with all of us. It is a painful surgery and it does take time. But wait and see what the other is tell you because everybody has got very specific problems. Each surgery is different for everybody, mine was more of a roller coaster ride for several months, it still does hurt some if I overdo it but better than staying with that pain. I had a partial release, it takes the tendon three months to heal so figure on that as your healing time and it will take 6 to 9 months to be 100% again. I think your surgeon is an a****** ridiculous that he didn't see you again, which as I say that keep in mind that my surgeon at the Cleveland Clinic I never saw her again after my surgery. I only saw his PA. It's really just shameful that this is what happened to the medical system. I hope this helped

Thank you very much for your response.  A partial release means you have little holes punched in the tendon so the tendon can stretch and then heal in a more stretched position?  I agree that it is absolutely shameful that both of our surgeons wouldn’t see a patient with problems.  I did get an appt with Dr Ross.  Does he know you by patientzero007?  Thanks again.  Susan

Tell him Chrissy Smith, Randy and Katie..hes done more on here but they never reported back on how they r doing. Take care

Hi Susan

My heart goes out to you. My experience is this.

I am now 9 months post posterior hip revision with a full psoas release ( they cut it & it repairs back)

June 2016 THR anterior approach

First 10 weeks wasn’t too bad

Then my world came crashing down

During the next 12 months I had steroid injections, draining of the bursa- twice 😔physio therapy , massage....NOTHING improved.  I couldn’t walk, I was limping & I had constant pain. Surgeon was either not able or unwilling to own up to the fact that the acetabular cup he placed was protruding & hitting & rubbing on my psoas which resulted in bursitis. 

My research has shown that the anterior approach due to its very narrow approach to your hip does not allow surgeons the space to ensure the cup is placed correctly ALSO surgeons are putting in bigger cups.

A second opinion gave me the answers I needed. Hence the revision surgery. This is no easy path & not to be taken lightly. 

Now I can walk an hour every day & whilst I’m not 100% I can do this at a good pace. Downhill is not 100% and I have to concentrate, but each time gets a little easier.

My leg still feels heavy, I can’t run.  I can lunge, squat & deadlift but not heavy.

The burning sensation in my groin has gradually decreased but it’s not completely gone.

I literally could not have gone on without the revision. I would have been disabled. Although I’m not 100% and I’m not sure I ever will be as soft tissue (psoas) is very hard to repair, I am hopeful that the small improvements will continue.

In my opinion this is t something you’ve done, no matter what the surgeon says. I believe you have some sort of psoas impingement. I would seek a specialist who can review your X-rays, ultrasounds & MRI’s correctly. No amount of stretching will fix such a mechanical problem.

I hope I’ve answered your questions.

All the very best💕

Hi Chrissy!  

I hope your recovery is going well - I can't believe I hadn't seen or read your super helpful reply before. I work a lot and often am reading this thread once every month or so, usually at night half asleep on sofa.  It's REALLY useful information you shared, thank you so much. It's been years for me. I'm coming up on 9 years since I fell down a staircase and tore the labrum, and 5 years since the hip replacement that should never have been needed, if they'd just done the labrum tear surgery instead of incessant cortisone.  Speaking of cortisone, it's very interesting that you had non-response injections (so no conclusive diagnosis) until your doctor did it. I've had the same situation, and HSS Hospital for Special Surgery in NYC is supposed to be all impressive, but so far I think they're masters at marketing more than anything else. Anyway, it's truly interesting to hear that maybe the cortisone diagnostic was just not performed right, possibly. How are you doing now? 

lnhal, wow. that's a lot to go through. I'm surprised and interested to hear that your doctor has said the psoas repairs, but I guess that is either you had a multiple small cuts (lengthening) approach, or as I'm reading, some people have a cut and sewn back together. I'd only heard of two approaches: cut and then permanent loss of a lot of strength, or multiple small cuts that never fully sever the psoas from the bone but does allow for full recovery.  I'm curious what else you can tell me about your procedure, since it sounds like your doctor has done a form that should give you full recovery. 

I hope your doing better each passing day. Thank you for sharing great info. 

Maysie

Susan, oh, i'm so interested to read what you wrote to patientzero007. I'm finally catching up reading more of these posts. The doctor at HSS in NYC that I saw was also telling me about lengthening, which i've read is called 'fractional psoas lengthening' with little cuts, or as your doctor states punching little holes. I wonder if little cuts vs punched holes makes a differrence.  Nonetheless, I may also be heading for Dr. Ross. Thank goodness we all found this board to compare notes and stories. It is shameful how some of the surgeons have treated us.

Hi Maysie. Im glad to help so u know what the reality is not the easy surgery doctors present...im no longer sure i needed to have hip replacement. I went to see an ortho about butt pain, ischial tuberosity and they found i have really bad arthritis in lower spine which pinches nerves in hip and presents as hip pain!!! If i hadnt had hip replacement i would not have needed psoas release...U r right its all about dr $$. Thats whats wrong with medical system - greedy doctors...im having an mri on spine and meeting with specialist...it would be great to sue my hip replacement dr for the quality of lufe he stole.

Hi Maysie. In response to cortisone question. My had been done under ultrasound and i had no reaction no relief. When i first met with Dr Ross he asked her they were done and when i told him, he said he had Never seen anybody get positive response that way. It has to be done in hospital under flouroscopy with dye and long needle to get to lower trochanter...that way i got 40% relief in 3 days then almost 80% within 10 days...didnt last but 2 weeks but it was proof positive...hope this helps. Chrissy

I’ve emailed my surgeon and will get back to you. At my one month follow up I asked him what he’d actually done to my psoas as it wasn’t planned. He said he’d cut it, I said partially or fully. He said fully. My question wasn’t probably the best question😔 

Leg still feels heavy, ie I can’t lift that leg to put it into my shorts etc i also still have a burning sensation that has moved from the groin to further round the outside of my hip. I’m hoping this means things are healing and repairing. I see surgeon again in August. 12 month mark. 

I have reported the surgeon who stuffed up the hip to our Australian medical board. They take for ever to decide. They are currently asking an independent surgeon to decide if the surgeon was indeed negligent. In my opinion surgeons stick together! So frustrating! 

Hi Inhal.  My heart goes out to you also.  I couldn’t agree more that once soft tissue like tendons and muscles go into spasm it’s a hard and posssibly impossible fix.  I went through this with my skelene muscles after a shoulder injury over 20 years ago trying everything including steroid injections, Botox injections, myofascial release, stretching, acupuncture, and probably others and found that improvement was very temporary.  For the skelene muscles there was no surgical treatment but I’m hopeful that a type of release can help the psoas even if there is not a full recovery. Im not sure where the skelene muscles attach but I know the muscle tightening began with the rotator cuff and while I still have skelene muscle tightness, the rotator cuff is not tight anymore so there is some hope that the psoas can Improve.  The psoas is just such a complacated tendon! After all this suffering it does sound like you have improved.  My second opinion in North Carolina (the doctor I should have used for my hip replacement) looked at my MRI which I thought showed nothing because it was so soon after surgery. When asked about whether the cup was rubbing against the psoas, he said it wasn’t .  Of course, I will be seeking other opinions and any other diagnostic tests available before I jump into another surgery but I am preparing myself for the likelihood of some type of psoas release.  I will be thinking about you and all of the people on this site that have to go through this.  I know there are risks with all surgeries but so many of us had similar issues of surgeons who did not do the right thing and then just dumped their patients, including yours and mine.

I definitely will.  You take care too.  Susan

hi Maysie.  I think I just used the term punching little holes rather than little cuts.  I have not talked yet to any doctor about surgery on the psoas tendon.  Dr Ross will be my first.  I would really like to ear from kshippy chick because I believe she had the tendon cut and was told that the muscles remain intact so there would not be a loss of strength.  I don’t quite understand this but from her last post she was doing very well.  I think I will also see Dr Bostrom at HSS.  I was very happy with him when he did the labral repair in 2011.  Prior to that I had seen one iof the Dr ran.... at HSS.  Dr. R told me the labral repair would not work because I would need a TKR in 3-5 years.  Dr Bostrom felt the labral repair would help and that the risk was very low.  He was absolutely right.  The recovery was easy and I got 5 years of total relief and still decent relief right up until I had the hip replaced.  I only had the THR because I wanted a tka replacement and two surgeons advised me to do the  hip first because it’s an easier procedure with fewer complication.  Ha!  They should come to this forum.   I Know what you mean about HSS being a lot of hype.  There are people on this site that went to Cleveland Clinic, Steadman Hawkins, and probably other centers supossedly known for their excellence.  It always comes down to the individual surgeon.  I had my first surgery done at HSS on my foot.  The surgeon butchered me but another wonderful surgeon ay HSS put me back together.  I also had shoulder surgery there with a good outcome.  Because there is no information available to the public in N YS and probably anywhere else in the world that accurately and fully discloses, all you really have is word of mouth.  It’s very scary.  I’ll post here after I see Dr Ross.  I feel like I need more diagnostic imaging.

Inhal, i can't lift leg to put on pants either, i have to sit down...I don't think its because of lack of strength because you work out a lot, i don't know if that's something we'll ever be able to do...Wish someone that's further ahead would answer and let us know...I just found out I have pinched nerve in back that is making my leg heavy, could that also be why your leg feels heavy... I do know Dr. Ross only does partial release, the next person going in should definitely find out...Stay well.. Chrissy

So frustrating, our bodies and we are so in the dark about what’s going on  

Will ask my surgeon about the pinched nerve or whether it’s the psoas that’s not repaired. 

I’m going to write to Dr Ross that a few people on here have mentioned. I’m hoping if I send him my medical notes he can give me his expert opinion. I just want to know why the cup was protruding in my case. This was the cause of my problems.  

Unbelievable how much suffering people have to put up with.

I’m annoyed as it was never discussed with me that it was a possibility the cup could protrude, I was told I might get slight numbness, I never had numbness. 

Wishing you all the best. Inhal 

Hi Inhal

im just reading about your psoas release.

i have had 2 done  and am 5 mths post op from my 5th THR i have had intense tendon pain all through my surgeries and just 2 days ago i had ultra sound guided injection into the psoas hoping to relieve the pains haven't been able to lift my leg or walk more than 20min without intense pain .im not sure that this injection is a fix or just a pain relief for awhile. guess i just wait to see what happens but today i still have pain .

is there a difference if you have the tendon cut,??

Far out Donni! 5 THR!! You poor thing. 

In my opinion guided injections don’t do anything but temporarily have an anaesthetic type relief. I believe the intense pain is caused by the cup rubbing on your psoas & irritating the bursa & resulting in bursitis. 

A lot of us in here have had this which is usually caused by the anterior approach to hip replacement & the cup being too large and or not placed correctly. 

I had a full release date of the psoas  & revision surgery. Surgeon cuts the psoas. I’m just clarifying with my surgeon what a full cut actually means. You need a skilled physician & someone who understands what is going on. I’m in Australia & Dr Michael O’Sullivan did my revision & psoas release. 

Might be worth asking on here for recommendations. Dr Ross in US in Florida is mentioned here a lot & has excellent reviews.

I’m 9 months post revision and slowly improving, not sure if I’ll ever be 100% but I’m not in constant pain, I’m not limping. I can walk well whereas prior to that the revision after  the anterior approach. I couldn’t even walk or go up the stairs. It was terrible. 

Hope I’ve answered your questions. Wishing you all the very best. 

Ha Ha theres not many Ozies on here But does seem like Dr Ross is the man over there.ive also had 2 dislocations, and all my surgeries don in RPA.ive had the injection done back in 2010 and it didn't work then but since then im now wth different surgeon and he asked me to give it another try's i am i guess i have nothing to loose.i just want to be pain free every day is a struggle.

Sorry for the late response, it breaks my heart to see how many people are hurting on this forum....There are literally hundreds who have no quality of life after hip replacement and their doctors don't know or won't help them

What i have learned this past week, since i am still having butt pain another ortho specialist who does basicly spine hips and spines said my back has a ton of arthritis in it and most likely several pinched nerves, He referred me to pain management who can put a nerve block in there after the results are in from MRI...

Here's where it gets icky....Dr said alot of times, lower back pain refers to hip pain but its really the back.  I am going to request my xrays before the hip replacement to see if i really needed hip replaced.. Just think if we never had hip replaced where a simply nerve block had fixed it we would have avoided all this..

My advice to everyone now is to get x[ray of your lower back and if warranted an MRI

Stay tuned to more BS....and still i am not back to a normal active life but I am not giving up!

Chrissy

Hello, I am brand new to this forum. I had my iliopsoas released/tenotomy and let me tell you it has ruined my life and left me in chronic pain. Mine was a FULL release, NOT just a partial lengthening. Please do your research before allowing anyone to do this to you are someone you love. Review the anatomy of this tendon and muscle group, as well as the actions it is responsible for. I had the right tendon released and the surgery resulted in adult onset scoliosis. My spine was perfectly straight prior to this surgery, and now I am in constant pain from overcompensated muscles and muscle imbalance. I have permanent weakness on the right side with hip flexion, and the left side is working in overdrive in effort to stabilize my spine. I literally watched my spine turn into an "S" after this procedure and no one I've spoken with is willing or has even heard of doing a reversal. Now, after nearly 3 years of pain and misery I have exhausted all options known to me and my doctors. I am left with the grueling decision of having the opposite side cut, in a desperate attempt to restore some sort of symmetry to my spine. Please, please think not once, twice, but 5 times before ever undergoing this procedure. It has ruined my life, and I am only 25. I was very active and working out was my passion. I can not do the things I used to be able to do. MRI's reveal my spine is twisted all the way up now. After healing from the surgery, when I was able to go back to the gym I immediately noticed that one leg felt longer than the other while doing squats, and that was just the beginning of my spinal rotation from a loss of strength and ability in A MAJOR SPINE STABILIZING TENDON AND MUSCLE GROUP. Realize that the psoas connects to the lumbar spine and though the surgery has potential to alleviate hip pain, ask yourself if the groin pain is something you can live with. If I had one wish in life, I would go back and never allow that to be done to me. I would take hip pain and be grateful, over entire spine pain, all over muscle pain, and the myofascial pain syndrome this has resulted in. Stretch every day, if you have to. Modify your activities. Do WHATEVER you can to avoid this procedure as it is NOT a cure all. It ruined me. If anyone has had a FULL iliopsoas tenotomy in one or both hips, please reach out to me as I would love to know how you are doing. Like I said I am trying to decide whether or not to undergo the same life shattering procedure on the left side in a desperate attempt to stop the constant pulling of my lumbar spine to the left, aka the stronger side! Thank you.

OMG Lexy! That is appalling. My heart goes out to you.  

I had a botched up hip replacement & saw another surgeon & he advised revision surgery to fix the cup that was protruding. Whilst he was doing the revision he also did a “full” tendon release. I asked him at my one month check up if he partially cut the psoas or fully cut it. He said fully cut it. I asked if this would recover and he said it would. I’m 9 months post surgery and I am out of pain and although I don’t have full function ie that leg feels heavy and it’s not easy to say put that leg into shorts. It’s improving slightly & incrementally and my hope is it will continue to improve. I have emailed the surgeon to ask him to explain exactly where the cut was and how it was cut. That was nearly two weeks ago and he hasn’t replied. I will ask again. I think the surgeon who did the revision & psoas release did the best he could under the circumstances and I am a million miles from the agony of not being able to walk. I can train now and I do so gradually trying to build strength.

I’m a personal trainer so it’s my livelihood. 

When you say you had a full cut, can you tell me where the cut was. 

My surgeon said it would repair. So confusing. 

Have you had a second opinion? Where are you located? I’m in Australia. Why did you have psoas release in the first place? 

All the best, you are so young to be in this condition. 

Far out Chrissy! These surgeons have got no idea of the impact they are having on people’s lives. They literally just cut and hope for the best!!! We just blindly trust them!!! This is so bad.

Here in Oz at the moment there is a big awareness campaign regarding knee arthroscopy procedures and how this is a totally unnecessary procedure with no evidence based research backing up this procedure. Literally people being put under the knife for zero benefit. It’s literally a money spinner for surgeons!! I put anterior hip replacements into this category too. Too many risks associated with it. And now you are highlighting hip surgery carried out when you possibly didn’t even have bone on bone at the hip. So alarming.

Keep me posted Chrissy. You have a friend here. I know it’s a bloody lonely path we are on.😘

What is the new surgeon suggesting you have done? Not more injections I hope. What is surgeon saying is the cause of your pain? Is it the cup? Is it bursitis caused by the cup rubbing on the psoas. Get those answers first and ask exactly what the surgeon is going to do and what the success rate is. 

All the very best😘

OH the new surgeon is the one that has done the last 3 THR i had a different surgeon for the first 2 THR.

So this second surgeon has done the 2 tendon releases as well  im not sure what the next plan he has or even if he has one but i won't be doing anymore injections they don't work.

I had a partial release by Dr Ross at Boca Raton Hospital 7 weeks ago. I felt the surgery wasnt bad at all with the biggest issue was not being able to lift my leg at all for a week. Now I can lift it but like others I have difficulty getting dressed like putting socks on and getting leg into pants. You will need to do a lot of PT for a long time to build up muscles that you haven't used in years. Before you do it I highly suggest you work on your core as you will have to use it a lot! Dr Ross told me it will take a year to get full function back and the way it is going I agree(today I walked 3 miles and I am hurting bad!). What I have noticed I no longer have the pain in the groin area of the psoas. I do have lower back pain but I did have that pain prior to surgery and just got another MRI of the lower back and shows herniation L5-S1 which I attribute to my hip out of whack for so long and a screwed up Psoas.

Hope that helps and good luck~1

Hi Inhal,  i think there is a huge problem (as least it is in US) since the advent of of the Hana table this enables hip replacements in under an hour but the insurance companies is still basing their payments on the old surgical hip replacement surgical procedure where it took 2 to 3 hours and now its done within 1 hr. The greed factor has brought all sorts of orthopedic surgeons into the fold who are not properly trained and should not be doing these procedures...in my case my insurance paid $74,000+ and he does 5 to 10 week...For a little doc $75000 additional revenue $$ a WEEK is a big deal.  So of course there are a lot more surgeries....

There is nothing that i can do to the surgeon, with what spine dr found out if i had epidural nerve shot before hand this MIGHT have all been averted..

Back nerve pain very closely mimics hip pain since one of the nerves run through there....Having spinal stenosis or some degeneration of spine is pretty normal for anyone over 50.. I recommend everyone get a spine xray first before even considering hip replacement.

I had the butt pain (caused by nerve) before hip replacement, still after psoas lenghening, so i hope finally I am at the cure....I am so disgusted in behaviors of doctors. I used to be in medical sales before all this started and knowing what i know now, all the payola, greed, etc. I will never go back to it (too honest).....

Next week Im meeting with dr for epidural to fix butt pain...will let you know..

Thank you for sharing this. You have completely nailed what is going on in orthopaedic surgery. 

It’s a money spinner and patients need to ask more questions to make sure they are getting appropriate treatment. 

Take care & wishing you all the very best😘

Sorry for late reply😔 

I’m 52. 9 months post revision & filull psoas release. 

Not 100% recovered . Leg still hard to lift & put into shorts,  can’t jog on spot as can’t lift leg well,  my balance is not great.  I can walk & can do 4-6 km on the flat; uphill easier than downhill.  

I’m much better after revision. Hoping I’ll continue to improve. 

Hi, i had constant hip snapping and pain/ aching around my hip and into my groin, I had a guided steroid injection into the muscle , this eased the pain for up to 6 weeks , this confirmed it was my psoas and my consultant recommended a psoas tenotomy . I am 8 week post op and get a lot of discomfort when bending forward and whilst in the seated position.

I also cannot lift my leg at all when seated or bending forward, this means I have to use my arm to lift the leg into a car etc and really struggle to put my socks and shoes on.

i have attended 5 physio sessions mentioning this weakness each time, I am constantly reassured that this is normal at this stage,  but all I can think about is being told before surgery that I will have a slight permanent weekness, i just hope this isn’t it.

 

I’m 9 months post op of this surgery. The improvements are very slow and gradual. 

Step climbing in moderation helps strengthen this. I’m not sure if I will be 100%  Surgeon said I would be 100% by 12 months, I’m not convinced but am grateful I’m not limping.

Wow LexyDes

That is so sad for you.

I have had 5 THR. 2 psoas t releases  2 dislocations. I’m 6 mths post my last THR and still have intense groin pain. I have intense lower back pain that never seems to fade and butt pain as well which I did have a tear in. But your right I feel like my body is broken I’m on a wait list for Physio so my days are long and painful. I don’t have the strength in my leg any more, getting dressed ,stairs, and getting in and out of a car are all a challenge plus I haven’t driven in 3yrs now just from the loss of strength in my leg and my confidence shattered it’s all so life changing. I’m 56. But you are so young it’s just not fair.hope you find some answers.

Inhal03672,

I have had 3 different opinions, just from hip surgeons, not to mention several other specialists. I am in the United States.

I had the full release performed at the lesser trochanter, so it was completely severed right from the bone. The last hip surgeon I went to told me that only in very rare special circumstances would he ever consider releasing the tendon from that area, and almost couldnt believe that my surgeon had done the release there. He reached out to my surgeon for his op notes just to make sure that what I was telling him was correct, and sure enough I was. My third opinion said he only very rarely performs the release from that area because it results in permanent muscle weakness. What he usually does for "snapping hip" is a release higher up, not from the bone, where more of the muscle group can stay intact which does not result in weakness. Or they do a partial lengthening where they perform vertical cuts in the tendon to help it elongate, bot not severe it completely.

That is very interesting to find out you are a personal trainer as the gym used to be my life. Now whenever I do abdominal cable crunches, the next day it feels as if I was punched over and over in the area of the release, because that tendon is no longer pulling on bone, it is pulling on the underlying fascia and soft tissues where it has scarred down to. I still cant believe someone, "He", ever thought this was a good idea.

What is the most saddening to me, is that I had only torn my labrum from running track, and he said it was likely torn due to CAM impingements, which I have in both hips. Ive also been told I have mild hip dysplasia, so my joint sockets are slightly more shallow than average. Releasing this tendon while having shallow joint sockets makes me more prone to dislocating my hip as I get older, something that terrifies me. I will never forget that appointment. He asked me where my pain was located, and I told him at the front of the hip. Then he asked me if my hip ever snapped or popped, which I said yes (which is fairly normal for everyone). And without any further questions he said he would "repair the labrum, remove the impingments, and release the iliopsoas tendon." After which I  asked him, wont that result in weakness, cutting a tendon? And he said "No no no, there are so many muscles in the hip that they will just hypertrophy and take over that ones job," and foolishly, I believed him. I wish I had done my research before allowing that to happen. I would have told him, just repair the labrum and remove the impingements, and I would still be a very happy person everyday. The research that I found, post release, was that case studies have been done on individuals with the full release at the lesser trochanter, and a year or two later they performed tests to see if there was hypertrophy of the surrounding musculature... there wasn't. Which when you think about it, each muscle connects to a specific point to do a specific job, how would different muscles connecting to different areas "take over" and perform the job of the one that is no longer able. Its called compensation, and my entire body is now miserable from it. I just keep getting worse, feeling pain in more and more places of my body as i continue to live in a twisted state. And furthermore, the research states that only if the snapping and popping is painful, WHICH MINE WASNT, you are to try every conservative measure (PT, stretching, Injections) before performing a release. I had no pain from the popping, he simply asked if I had popping/snapping. I wish he would have asked if that hurt, because maybe I wouldnt be in this position now. He did not bother to recommend conservative measures for the popping/snapping, and instead sent me straight to the operating table.

After the initial surgery, I still had pain in the hip, and was developing pain in other areas of my body. So I went back to him. This time he said "Im 95% sure its just scar tissues built up in the joint, so we'll go in and remove it." After the second arthroscopy, I felt exactly the same. It had done NOTHING. The absurd thing that I did not know at the time, was that performing surgery to remove scar tissue, only creates more scar tissue!!! My 2nd and 3rd opinions thought that it was ridiculous that I had a 2nd operation just for that purpose.

I was actually going to go back to the same surgeon who ruined my life this week, to request that he remove the impingments in the left hip, and perform the exact same release in the exact same spot as he did on the right, in a very desperate attempt to even out my spine... Ive reached out to many to try and find out if this could be the solution Ive been longing for, or if it would truly make me wish my life was over. No one has ever heard of it being done for that reason, and therefore it is considered an experimental surgery, hence why I would have to go back to the same man that performed it in the first place, because no one else wants to "experiment" on me. Which I dont either, but Ive exhausted all of my conservative options. I dont know whats left for me to try, and I cant live like this the rest of my life. But I opted out the last minute, because I am moving several states away in just 13 days to complete an internship I have worked my whole life to get. The healing time would make moving and getting around so much more difficult, especially since I would be on my own. Thus I am forced to live like this and wait another 10 months until the internship is over, and at that point, I feel that I am likely to go through with it. It terrifies me, because there is no way of knowing if it is the right decision, and there will be no going back.

I wish time machines existed. Sorry for such a long post, and thank you for responding to me.

Hi Donni L,

I am very sorry to hear what these procedures have done to you. I agree it is completely life shattering and makes you feel broken from the inside out. I understand the physical and emotional pain you are going through.

If I may ask, how did the dislocations happen? Were you doing anything in particular that caused them? And were your psoas releases a full release? Do you know if they were performed at the lesser trochanter? I am interested to know this because I have been strongly considering having the left released to "match" the right. I feel this is a desperate attempt to get my spine to untwist and my soft tissues to all stop hurting, but thats just what it is, desperate. I will have to wait at least 8-10 months to go through with the surgery regardless, because I will be out of state trying to complete an 8 month long internship. This gives me some more time to gather more opinions and do more research, but I honestly dont know what I have left. Nothing has worked, and Ive tried everything known to me and the ~20 different doctors/surgeons I've seen in the past 3 years.

Do you believe your low back pain is associated with the 2 releases? How long apart did you have each of them performed?

Thank you for your response, it is so greatly appreciated.

Hi LexyDeS,

I am very sorry for what you are going through.  I have been considering for some years whether to get the psoas release and after seeing your story I am glad I have waited.  I had bilat hip joint replacements with the left side being more painful afterwards.   That psoas has been diagnosed as needing the release.  I also have spine pain in the low back since the hip surgery and I have always thought it was from the trauma of the surgery itself.  I have several herniated disks and other things.  The nurses there said they could hear Dr N pounding on the patients bones outside the surgery and down the hall.  I have since had lung surgery and the lasting problems caused by that invasion are also painful (nerves crushed).  I am thinking now that whatever pain I have now could get worse with more interventions by well meaning practitioners and I will try my best to avoid this.  It is tempting to continue nevertheless to look for an out.  Knowing we are not alone does help although you would not wish this on anyone.   

Hi lexyDeS

So both of my dislocations happened while I was sitting.and I was in a hired chair from a medical aid place specifically for hip recovery. I just felt them slide out. And with in 3 mths of each.my tendon releases were not cut, I was told if you cut them you end up with much less strength. 

Clearly it would not have mattered cos I don’t have strength now.

And still have intense groin pain.

I now also have a lump forming near my scar, near my groin like a good hand size lump. I was told today by my Gp it looks like a hernia like mass of tissue pushing through the muscle. It’s so painful and more pain down my thigh.waiting to see what the Physio says. It never ends. 

Hi Lexus and all who reads.

I reckon it would be so nice if the was a weekend put aside somewhere where we could all get together and meet each other from all over the world, we are all battling the same pain, and just doesn’t seem to be to many positives, what an amazing event that would be.

Hi Faith, 

I am glad that my story could help you put that thought to rest. I would hate for you to be in even more pain than it sounds like you are already in. The psoas release is not a cure all, its a ruin all from my experience. Seems we are always being assured by those with a medical degree that a surgery will help, and for those that it does I feel they are very lucky as I feel like I hear more horror stories than positive ones. I understand your temptation, as I think about having the opposite iliopsoas tendon released everyday, thinking it could be an out. But even though my pain seems unbearable already, I know that it could always get worse from another surgery, and its the scary thought not knowing. I feel that in another year I will be so desperate that I will give it a go. My doctor that has cared the most out of everyone said "It could help... but it scares the hell out of me." And that is the position I have been in for 3 years. I keep thinking cutting the opposite side could make things more symmetrical and stop the pulling of my lumbar spine to the left, towards the stronger side. So giving that side permanent weakness as well, might be just what I need.. But it could also result in me losing whatever little spine support I have left, and lose whatever natural curve there is left as well. It could be disastrous, and I still dont know what to do. It does help talking to others that are in pain and have similar experiences. Since I am so young I often feel very alone, as none of my peers have daily pain or the issues I have. It makes me bitter when I hear people my age complaining about petty things in life feeling sorry for themselves, because they dont know how good they've got it in life. But thats a little off subject.. 

Thank you for your response, I pray that God brings a miracle your way. 

Hi Donni, 

Just to make sure I am understanding you correctly, you had both iliopsoas tendons released prior to your hip dislocations? If so, do you know if the release was performed at the lesser trochanter? I am sorry to hear what you are going through. Its miserable to feel trapped inside your own body and that it will never end. I cant go a day without thinking about it and how different my life would be if I just told my surgeon to go ahead, but skip cutting that tendon. Its painful to think about and often brings me to tears. I dont think I will ever accept what has happened to me. I feel as if I have been cheated from a normal 25 year old's life. I feel like the old me died a long time ago. 

As for your suggestion to have a meeting, that sounds so wonderful. It would be an incredible experience. 

Hi LexyDeS

I had the  psoas tendon release done twice on the right side only.After the dislocations happened.

i was also told after these releases the tendon is more prone to being court or trapped or pinched by the prosthesis again,im not sure how true that is.

all my Thr and revisions have all been on my right side,Thus leaving my left side in pain,due to over compensating all my muscles, and im sure it all adds to the lower back pain as well

I went to see my consultant yesterday, apparently the weekness I have is normal, it may never get back to full strength, other muscles will start to compensate but you have to be careful not to over load these muscles,I am a  bit disappointed , to me, this is more than a slight weakness.

Hi Donni,

What was the reason you were told to have the tendon release? So you noticed the low back pain and left side pain starting to come on after the release was performed? If possible, could you explain to me where your pain is located on the left side? Seems like a silly question, I guess I am just trying to compare to see if our left sided pain is in the same location. Mine is a very deep, burning, tightness, that is often very sore in my "quadratus lumborum" muscle and along the crest of my left hip towards the front where the psoas is.

Hi anne,

My question is, how are you supposed to avoid overloading the muscles that will start to compensate? They will become overloaded regardless because of exactly what they are being forced to do anyway, compensate for a loss. What was your consultants advice on this? Avoid activity altogether? I am frustrated for you, as I am struggling with the compensation as well. This may not be what you want to hear, but it has only gotten worse and worse for me over the past 3 years since the release. Month by month more muscles have become affected. I hurt now everyday in places that I didnt hurt just a month ago. Basically was diagnosed with myofascial pain syndrome. I wonder what your consultant expects you to do to prevent muscle pain from compensation.

Hi Lexy 

The release was done because I had chronic groin pain. I could nearly take a step with out pain I couldn’t sneeze or cough without pain.

My left side just feels like a deep burning hip pain and aches all the time, I’m not getting it looked at for now cos I’m not going to go through all this again . So I will just live the best I can on pain pills and Physio . It sucks.

Hi Anne 

I was told the same thing, and I feel the same as you, it’s more than just a little strength gone,it rules your every day living.

Hi Donni,

Yes I understand all of the appointments can really wear ya down, especially when they do no good. Why did you have to have the release performed twice on the same side? How much strength would you say you've lost? Are you able to raise your right leg from a seated position? If so, can you raise it as high as the other leg? The most obvious way I can tell that I have permanent weakness is putting my shoes on. The left (uncut side) I can raise my knee to my chest and put my shoe on from a standing position. However, the right, I must bend over and put my shoe on leaving my foot pretty much on the floor. Also from a seated position I can raise the left knee/leg much higher than the right.

What angers me is that my surgeon told me that cutting the tendon wont result in weakness at all. That the other hip muscles would get bigger and "take over". He was completely wrong.

Hi Lexy

I have massive weekness.

I can walk but not far prob 25mtrs then everything starts tightening my groin doesn’t want to let me keep walking,from pain.

I need to lift my leg in and out of the car, I do stairs with left leg lead,and only now wear slip on shoes. Sitting in one position is painful for to long but so is standing.i had it done twice because the first time made no difference at all, but neither has the second I won’t be doing a third. I know there’s lots of scar tissue that also causes a problem but I don’t want to be in anymore pain than I’m in 24/7. I just know that my left side hurts now.

Lexy

He was very wrong.

LexyDeS:  Thanks for your prayer for a miracle for me and I pray that for you as well.  That is what we need now.  Because of your young age especially, I hope you can find a group locally you can share your story with and who can understand what you are going through.  Maybe not with the exact same stuff, but life changing pain.  Love and compassion for you.   

Strangely enough when I was on scholarly articles/research articles on tenotomy surgury and outcomes, before I found this forum, the outcomes were reported in the papers as almost 100% positive with no more pain reported.  This is what had convinced me to look into more surgery.  I am wondering if the surgeons were honest or if the patients didn't want to complain.  We need to believe our own experience and that of others who have been a patient in this process.  A site like this is so helpful as a warning to the others who are considering trusting a surgeon without knowing what possible consequences there could be.  My hip surgeon did not want to hear anything about pain, swelling etc.  He just had his PA see me when I made a went there and point to the xrays that showed 2 hips joints that look intact and say I was fine.  I had to go to another surgeon who diagnosed the iliopsoas issue.  

My heart goes out to you Lexy. My surgeon is reluctant to put in writing where he actually cut the psoas. 

All it says in my notes is a release of the psoas was carried out. 

Surgeon who did my revision said I would eventually be 100% but I find that hard to believe.  I’m grateful I can walk and do so most days for at least an hour and for that I feel so lucky. 

 I so hope you get the expertise you deserve. 

Full the very best ❤️

This is an obvious older thread but maybe others will see my reply.

After reading what others have gone through to relieve the constant groin/buttocks pain I'm not so sure any surgical treatment is worth it. I've had both hips replaced in 2018 3 months apart.

The left was first and my recovery was fast and pretty easy other than 1 week of groin pain.

The right THR went well but, at about 3 months post the groin pain started and it was relentless.

At about 7 months upper leg pain just about put me back to a cane. That lasted several weeks. Doc said it was the large nerve that goes up the side of the leg. As the numbness subsided over several months new pain issues would come up but, most were worked away with continuous activity.

What I did was work through it all.

I'm now 59 and have been extremely active most of my life. Surfing, hiking 15-20 miles, running, Mt biking etc... All weekly or even daily.

The groin pain mostly messed up me getting back to surfing as it was very difficult to lift my right leg (front leg on my board). Anyone who surfs knows you need to be quick in standing up. Especially where I surf. A shallow reef break.

Long story short, I kept at it 6 long months of struggling until late April of this year the pain eased enough that I was starting to make my critical pop ups and taking off on overhead steep waves.

I would rest it as needed and often used an ice pack after activities and my infrared heating pad. Also, an inversion table for 3-5 minutes at the slightest setting of 15 degrees tilt.

On my 59th B-Day I really pushed myself and hiked 9 miles with a pack and 3 brutal steep climbs. Unfortunately I started with left groin pain from using a new seat on a bike ride so, it was painful during the hike. But, I did it. I could hardly walk the next two days but, I planned on that and was fine.

I walk 2+ miles 2-3 times a week and jog 2 times a month. Jogging actually feels better than walking. Less pain.

I'm just learning to live with the discomfort/pain in my right groin. I don't take any pains med and haven't the entire time after the right THR. I do use Arnica cream on occasion. From what I'm hearing researching this issue is the treatments/surgery are worse.

I'm not so sure I'll ever be able to do my 15-20 mile hikes again but, before the surgeries I could barely get in and out of my jeep let alone hike somewhere so, I'm definitely better off than I was before the hip replacements.

You just can't let it beat you down.

Some of my walks started out in so much pain but, I walked through it after maybe 1/2 mile or so and I could tolerate it or it went away the rest of the way. I'm med build and slim with a semi athletic build.

Soon I'm going to try medical massage therapy and see if that helps. My right buttocks and upper leg often feel like they're cramping so, I'm thinking the massage will help some.

The hardest part was having patience and not overdoing stuff along the way.

Being so active I aggravated other parts of the body. Shoulders surfing, feet hiking/walking.

Good luck to everyone having this horrible groin pain post THR.

Don't be so quick to have another surgery.

I also got myself one of those Total Gyms and that has helped tons.

thanks for being encouraging Bryan. i maybe am in a different situation. i have been in and out of PT over the years, sometimes for long periods of time others short. I've tried just powering through but every step hurts every time since ,5 days after the hip replacement in 2012. The pain sometimes abates if I lay flat for a few hours. i tried to walk around a few furniture stores last August and the level of hobbling threw my back out and into such severe spasms that I literally couldn't move for hours, not even reach my phone. a neighbor finally heard my screaming after 2 hours and then got an ambulance. was in Emergency room overnight and they first thought slipped disc, it was so horrendous. so I'm not powering through these days. That night in hospital costs me 1800 dollars, and I have good insurance. (whatever the hell that means here in the US). i can't go to big grocery stores, too much walking and it's so painful I can't get to work the next day. when you say surfing and walking multiple miles, i think we're dealing with different levels of problems. i literally dread the first step each day to the last and have questioned if I really want to live life in pain and immobility, at what point I'd quit. currently I'm dreading doing laundry because it involves a lot of pain and steps. I've been to some of the most renowned PT folks, even driving an hour each way 3x week, forty dollars a visit after insurance, for 3-4 months. it was expensive and the only way I got time to do it was when I was laid off from my job. Even all that effort didn't work out. I'm very glad you are able to surf and hike and walk. If I could even just walk I'd probably not pursue surgery, but I'm in a different category I think. i uses to be very active too. some level of dumb optimism is why I still own my downhill skiing and cross country skiing equipment, my hiking boots that have been through New Mexico and Colorado, my tennis racquet, paddle racquet, mountain bike etc. I know I should just give it all away but keeping them, I can at least dream about being me again.

Different but, the same in many ways too. I never know how my day is going to be until I take those first steps when getting out of bed. Some days I know right away its a stay home day. My cane is always bedside just in case.

Today was one of those days but, I decided to stay active but, it was futile.

I should have mentioned I have a unusually high tolerance for pain. That's both good and bad. I get those back issues too. My knees too. Everything is trying to adjust.

I'm self employed luckily as trying to hold a normal job would be challenging.

But, being a photographer that specializes in extreme activities I'm a long ways from being where I need to be.

I'm sure you experience the same.

One step forward and 4 back.

A few other people I know locally have had both hips done recently too.

Were all experiencing the same daunting issues.

Hang on to all of your gear. You never know when that turning point day will arrive.

Its always good to hang on to hope.

Best of luck to you on eventually being pain free.