Trendelenburg Gait.

hi jacqie,

I am so sorry to hear this. ...that is a whole year, 12 months post-op from your thr surgery. .

I read in one of your previous posts that the muscle problem already showed on the xray taken at your 3 months post-op appointment. .

did you see your surgeon since then?

You also mentioned that one of your neighbors was going to have a similar operation in February. ..

I know how difficult it is to make a decision and not knowing the outcome. ..

could you get a 2nd opinion?

I wish I could

give you a better answer. ..you will make the decision when you are ready. .

Please let us know how you're getting on, okay?

Big warm hug

Renee

Jacque, I am 13 weeks with the lateral approach. My hip feels great but I had a terrible limp with knee pain. At about 6 weeks I saw my PA and was okay to drive and give up my walker for a cane even with some mild knee swelling. She then gave me a cortizone injection which was to help with a previous knee injury thought to be causing the swelling after surgery. (Injury happened a year before when I fell on both knees because my bad hip side dragged a little and I landed knees down on the cement.) Two weeks later my knee was causing me horrible pain and swelling and causing me not to be able to walk much at all. Bad limping. Back to PA I went, they determined my operated leg was not strong enough to support me yet and wanted me to go  back to my walker for a few more weeks. I had started back to work 5 hrs per day also, so they took me off work again. Ice, rest, elevation and pt exercises was the course of action. Well I had returned the walker I was using so that was out. After PT evaluated me they gave me the same strength exercises with bands as most of us have had and I had little success doing due to lack of strength and pain. I decided to start water walking at the pool. I was struggling to walk any distance on land without my cane. I am amazed at how much leg and hip strength the water walking has given me. I made up my own 1 hour program which consists of front, side, backwards abductions. Front and backwards, high as I can, water marching. Squats holding onto the side of the pool. I feel so much better when I go for that hour. What a difference! For the last couple of weeks I have added water weights aka. Floats that you strap to your ankles and they create resistance in the water. I complained before that I walked like "Shrek", now I can go without my cane most of the day until I tire out then I use it for awhile. You might want to give it a try before considering another surgery. My gait is still not perfect but it is getting better each week that I pool walk.

I think that's good advice you have got here. Maybe try a bit of strengthening before going for more surgery.  I would definitely get back to physio or get to a pool and really try to strengthen those lateral muscles.  I think that very often in the UK at least the physio support is not great and you either need to pay extra for it or make a scene at your follow up appointments with your surgeon.   I am sure that you will be able to get this sorted as it is not right that you are still in pain.  Have strong words with your surgeon and make him explain the possible surgery to you.  I hope this helps and I wish you all the best.

Alison x 

Jacqui, I can give you hope! I am 68 and had THR in July 2015, so my situation is similar to yours. I have also had a terrible limp and hip/thigh pain ever since then. MARS MRI scans have shown a torn gluteus medius muscle/tendon, damaged badly enough that exercise only causes more pain and damage, and that I need surgery to repair. My original surgeon couldn't even begin to diagnose my condition, and so I went for a second opinion. I am waiting for a surgery date, and hope that this will take care of my problem. I always use a crutch or rollator walker, since it hurts too much to walk without them.

Two of the main muscles involved in holding the hip steady while walking are the gluteus medius and gluteus minimus. Trendelenberg gait is caused by an inability to hold the hip steady while ambulating because the hip cannot be held steady while balancing on the affected side. If the injury is mild enough, it can heal on its own over time. In my (non-medical!) opinion, if your significant pain and disability have existed this long, you have a tear that will probably not be able heal on its own. Certainly you can try exercise, but I wouldn't be surprised if it didn't help.

It was mentioned above that a tear was seen on some kind of scan previously. Perhaps you could get that followed up on with a MARS MRI so that an accurate diagnosis can be given and a treatment plan can be made.

Everyone heels at different paces. Physio therapy and strengthening core muscles helps me the most.

takes time to get those muscles backe. Sometimes a little patience can help as this is major surgery. 

Been thru 3 THR each one was different. My best friend was to stay with exercises, build core muscle and eat good foods. eating well and 3200 calories a day and drink boost, protien shake shakes, helps build muscle and to support the new implant and food for heeling is very important. 

Takeing one day at a time. 

Jacqui - I am so sorry to read your message - and can imagine your anguish with having this problem for so long. 

I had the most horrendous gait, it was terrible - and so noticeable. I got a very good and senior physio therpaist on board and religiously did the exercises she gave me, and little by little we corrected it. My physio works on people just like you, where it has been some great success stories.

Before more surgery maybe give yourself the chance to get better through exercise. It takes time and dedication but you can possibly fix it.

Did you see a physio after your op? Did your consultant say anything about this?

You have come to the right place, to this forum, you will get lots of support and information here - take care and big hugs to you.

Hi Jacquai, So sorry to hear of all your poblems. Its very difficult when your told tht this is such straight forward surgery. My problems are different to yours, but the one thing that I've learnt is to do research and go to the best centre of excellence near you. I'm under the Royal Othopeadic Hospital and although its a long way from where we live, has been so much better than my local hospital. Good luck with everything.