Trendelenburg Gait after hip replacement

The posting jumped before I meant to send.  Surgeon will replace weak bone  with metal; he will cut the muscles that manage the hip. Because muscles won't attach to metal, he said I'd have TG.  Since  that visit with the surgeon, I have done a lot of research. I learned that surgeons avoid TG by attaching half of the GM to either the trocanther or TFL.  But that appears to be a relatively new surgical technique.  I have faxed questions about it to my surgeon.  He may just fire me!  But avoiding what seems like it would be a permanent TG and require that I use assistance (walker, cane) for the rest of my life sounds good to me.  Going in, I have a torqued pelvis that creates a functional short leg on the side that will be operated.  I have walked with a cane for 18 months.  My right gluteal muscles have deteriorated over the past few years.  I am trying to rebuild them before May 28 primarily by walking for 40 minutes daily in water but also doing occasional clams and leg raises and bouncing on a rebounder.  Any help anyone can suggest, I'd be grateful.  If anyone reading this has information on splicing half of the GM and tying it to another muscle, thereby avoiding any TG or limp, I want to hear it.

Hi,

i had my left hip replaced last September. I am a very active 64 year old. The first 2 weeks after the op I made excellent progress but knew very early on that my left leg was a cm or 2 longer than the right leg and this affected my gait. Like you I moved to walk with a cane a bit too soon and after 3 weeks I was walking half a mile to the pool with a cane, doing my excercises in the pool then walking back home. I went to the pool at least 4 times that week and also did the exercises at home 2 or three times a day as well. The following week I walked to my daughters house, up hill about a mile! I was very proud of myself but that evening I experienced severe pain in my left groin and blacked out for a few minutes. I was taken to hospital but nothing was found wrong. The probable cause was that the pain was my thigh muscle going into severe spasm due to me overdoing it. I went back to using 2 crouches, even indoors and accepted my husband's offer of a lift to the pool for a few weeks. I still walked home!

do not get despondent. Exercise little and often, work hard to lift the hip with your buttock as you walk but don't give up the crutches too soon. It is not a race and it is the quality of the exercise that matters and will get results. I hardly notice the difference in leg length now and my walking pattern is much smoother. I recommended my Morris Dancing after 4 months and am now back to walking my dogs regularly. The swimming is still very important.

good luck and best wishes, Betty

Thank you so much for sharing your story and encouraging words. Your early progress and then sudden backsliding sounds so much like mine. I wish my doctor and therapist would have set stronger expectations and limits on my activity. I thought I was doing a good thing by working so hard. We have a pool and I find that I don't limp when walking or doing my exercises in the pool. One thing I noticed after researching on the internet today, the form for doing exercises is extremely important. My therapist is relatively young and she hasn't stressed my form. Now that I'm more aware, I'll either be able to correct myself or ask her to be more diligent. 

So glad to have been of some comfort. I'd love to hear more about your progress so do get in touch on Facebook if you like.

Betty Hales

Hi Elizabeth, and others! I am now 14weeks post-op. I'm getting better (about 90%) and back to work. I'm going to physio once a week now and have good days and bad still. I have to watch my walking so I don't limp or use a cane when weak or tired. 

I found one of my main problems was resolved by stretching. I had severe pain above and below my knee on operated leg when I walked. I thought my knee was going bad, but it was only thigh muscle tightening and shrinking. The physio said the bands of the muscle wrap around my knee, which was causing the pain. One stretch that has helped the most is lying on my belly and attaching a strap to my foot on operated side. Pull the strap so it brings my foot near my bum. Gently stretch, hold and release. As that gets easier, put a pillow or rolled towel under your knee to increase the angle. Now, after weeks of stretching and exercise, I can walk nearly pain-free most days. 

Thanks to to all for your posts and encouragement. I think I'll be among the ones of you with a long recovery. But, I'd do the surgery again in a heartbeat. I'm confident that I can get my mobility and life back. 

I agree with using a cane when needed. I am 6-months post-op and still struggling and in pain. I tried to do too much too soon and, per my Doc, reinjured myself, resulting in the T-gait. He said 6-weeks minimum with a walker, which I didn't do. Now, I'm regretting it.

I have a desk job and sit way too much during the day. After 4 months of physical therapy and constant exercise, I finally decided I didn't want to do it any more. I was still in pain and still struggling for normalcy. My activity decreased and I'm still dealing with the consequences. I recently started doing my exercises again and am hoping to get better.

Anyone else have a similar experience? I'm frustrated that 6-months out and I'm still in almost constant pain. Sometimes I wonder if something went wrong with the surgery or if I'm just a slow healer. The doctor says the xrays look fine.

I did not look back through your previous messages I believe you had a lateral procedure done. Is that correct?I had an anterior lateral procedure my scar is huge compared to the anterior approach. My Maryland doctor admits that the downside to an anterior lateral procedure is sometimes people have a permanent limp. This was never mentioned to me before surgery.

The lateral procedure seems to mandate a longer recovery as certain muscles were cut. My therapist said I would know if a muscle became detached. It would seem a MRI would be necessary to see muscle tissue issue, not an x-ray. However, I'm not a doctor.

This is all very confusing comparing recovery times to different procedures. My doctor is an advocate of movement and says sedentary lifestyle can create more problems than an active one. I'm really sorry you're having pain issues which remain unexplained, must be very frustrating. I'm glad you're back at therapy.

I found the below site when associating T gait issues with running and the need to avoid additional injuries. My therapist has me doing a couple of these moves which expand on the standing on one leg, which is a great exercise especially if one maintains the correct position.

http://www.epainassist.com/sports-injuries/hip-injuries/trendelenburg-gait-or-hip-drop

This is a good one:

Single Leg Squat Exercise For Trendelenburg Gait or Hip Drop.

The regular squat is very good, but be CAREFUL with the

single leg squat, especially if you have 2 hip ops, or one leg

helping the operated leg, i.e. you are planning a 2nd hip op.

Cathie