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Total Hip Replacement and Trendelenburg Gait

Posted , 12 users are following.

gidgygirl
gidgygirl

I had a RTHR Jan. 3 with the posterior approach. Everything went well & I was excited about getting back to normal activities. However, after 4 months I am still limping. It's called a Trendelenburg gait. The glute muscles on the surgical side are weak and cannot support the weight to allow me to walk balanced. I was told that with physical therapy, the muscles will gain strength & the limp will go away. It has been 4 months & I've been going to PT faithfully twice a week & also doing exercises at home, but I still have the limp. With the limp it is difficult to walk far because my body is off balance. My physical therapist is also concerned that I'm not showing any improvement by now. Has anyone else had this condition after hip surgery? 

2 likes, 13 replies

13 Replies

  • 2young
    2young gidgygirl

    Posted

    Yes - I have it 13 mos post surgery!  I cannot regain my glute strength despite exercising like crazy and going through PT for 5 mos then again for another 3 mos. I have targeted exercises for my glutes but I'm not seeing any impreovement

  • AnnieK
    AnnieK gidgygirl

    Posted

    I did. At 6 months post-THR, I was still unable to balance even for a second on my surgical leg alone, and had pain and a terrible Trendelenburg gait. I had a MARS MRI of my hip and was diagnosed with tendon tears of my gluteus medius and minimus muscles. They were bad enough that they could not heal on their own. I had surgery to repair them at 15 months post-THR. 

    I had to go for a second opinion to a new orthopedic surgeon to get this diagnosis. My original surgeon, even after seeing MRI results, saw nothing wrong, except for "weakness" in the gluteus. He kept on recommending more PT and cortisone injections. I had already had 21 sessions of PT and wanted no part of the injections.

    It is possible your "weakness" will get better. It would be best if you could get either MARS MRI or diagnostic musculoskeletal ultrasound (if they haven't already been done) to see what is really going on.

    Good luck on getting a specific, correct diagnosis and effective treatment plan, gidgygirl!

  • mary25429
    mary25429 gidgygirl

    Posted

    Yes, I do! I had surgery January 15 and am limping.i had my right hip done in September and four months later my left hip went. They tell me weak glute muscle and    Quadricep. Still need a cane. Glad to hear I am not the only one! 
  • michelle87539
    michelle87539 gidgygirl

    Posted

    You sound identical to me. Had RHR end September last year. Recovery was going fantastically well and then crutch slipped in bathroom and I stepped backwards. From that day I knew something was wrong.. I continued with recovery, physio but was never able to walk without lurching (tendelburg gait), causing pain to hip, buttocks and lower back... nothing made any difference. I saw consultant and he agreed and I had mri.... end story was I had full tear To gluteus muscle... two weeks ago they went back in and reattached muscle using a graft and drilling trochanter to use anchors to make stable ... 4 weeks crutches ... fingers crossed it’s worked... very distressing to go though operation and still couldn’t walk... so I really do feel for you... keep persevering  with your consultant (I was very lucky he knew straight away something wasn’t right)...it almost felt like I had no control of my right leg.... 
  • m05
    m05 gidgygirl

    Posted

    If you can try walking in a swimming pool regularly concentrating on a correct gait.
  • maggie93798
    maggie93798 gidgygirl

    Posted

    Yes Many have including me. I asked for and had a 6 week hydrotherapy course, Then I was able to go to the open sessions in the hydrotherapy pool which I did for well over a year. Improvement was steady and I will still use a pool to do exercises as well as swimming if I feel I am starting to walk unevenly again. Also I was advised to do an exercise called the clam, I also go to tai chi classes. Others go to Pilates or yoga or do a lot of swimming

    In the scheme of things four months is not a very long time especially if you had been compensating in the way you walked before the op because of the hip. 

    I know several nurses who worked worked with ortho patients, improvements can continue for up to two years

     

    • mary25429
      mary25429 maggie93798

      Posted

      Thanks, Maggie! You give me hope! I am almost five months out now and feel awful limping and gimping along. My right hip did great, the left: not so much. 
  • penny08987
    penny08987 gidgygirl

    Posted

    I'm 12 weeks post op and yes I have the same issue I have a massive limp I can't walk without a crutch. But I also have a leg discrepancy, I feel your frustration 😫 I do the bum crunches to strengthen too but I'm not seeing a difference yet

    • madla39168
      madla39168 penny08987

      Posted

      Dear Penny ,

      I had leg discrepancy when i have done first hip about 1.5 cm . I did hydrotherapy and than my physio told me to put insole in my shoes .

      It help to keep balance and not limp ony when i was tired with walking.

      From beginning it was not comfy but after while i got used too. Now with second hip which was done 5 weeks and few days they fix my discrepancy and now i m learning how to walk properly. No more insole. Tomorrow im starting physio and hydrotherapy . Try pool. Good luck with your improvement . Have a patince. You will get there.

      Big hug Madla.💗

    • penny08987
      penny08987 madla39168

      Posted

      Thank you Madla

      I'm having a down day today feeling low about the way I look and feel with the longer leg 😖 I'm still so sore and bruised and everything is an effort x

    • gidgygirl
      gidgygirl penny08987

      Posted

      Hi Penny,

       I have those days, too - and we deserve to have those days - we've been through a lot of physical trauma to our bodies. I used to walk my dogs 5 miles on the weekends - now I can't even make it around the block! And, to make it worse, my twin sister had an anterior THR on April 5 and is already back to work and walking 4 miles at a time! Try to look for the silver lining - I've been doing PT twice a week & my muscles are getting stronger every day. I can walk - not as much as I want, but I can walk. I also have a leg length discrepancy, so I've been wearing a lift in my shoe. Things could be worse - I'm glad they're not. Let's keep in contact.

  • RichardKen
    RichardKen gidgygirl

    Posted

    Having had a THR twenty one years ago and a revision last year to replace the worn out cup, I would strongly recommend that you concentrate strengthening your muscles and walk using two arm crutches until you are walking really strongly a mile at a time with a good well balanced gait.

    Good luck, Richard

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