Trendelenburg Gait after hip replacement

What a journey my goodness you really must be at your wits end after seven months. It sounds like you have hit on a solution and/or at least a name for your condition which is a good starting point, but it is a shame you are not being properly looked after by a medical professional to diagnose your properly and help you. 

A good physio is absolutely key. Anyway wishing you the very best now on the road to get your hip completely fixed and this post may be very helpful for others that are struggling. 

 

Thank you, Rose0000. I did find (in another post) and realized for myself that sleeping on my back minimizes the clenching of my piriformis muscle. I also read that a botox injection may cause it to relax, offering relief and allowing the patient to rehab. Now that I have a name for my changing, and often difficult to describe symptoms, I'm considering going back to my doc to ask about an injection. I'll try physio for another week and if I don't start to see some relief, off to the doctor I'll go!

I'm now 9 months post op and still struggling to be normal. I can walk much farther and mostly without a limp, but still in almost constant pain. It keeps muted with Tramadol, Celebrex and Tylenol, and is tolerable. I'm still in PT, which is helping. Seeing a pain specialist next week, since other docs seem to have no idea why I'm still in pain. Any thoughts or ideas greatly appreciated. Is anyone else going throughout this after THR?

Patstone, I still have pain 8 months after THR, and it is due to torn gluteal tendons/muscles. Can you be more specific about your pain, i.e., exactly where it is located, and what kind of pain it is. The doctors should be able to tell you which tissues (muscles, tendons, bones?) are involved due to their knowledge of anatomy. Have you had any tests, such as diagnostic ultrasound, MRI or a bone scan? It was physical exam and MARS MRI results that clinched my diagnosis. 

Hello, Jan! I'm so sorry that this happened to you. I can imagine what you have gone through, since I have a similar situation. I had a THR in July, 2015, and have never been without a severe limp and pain in my hip/thigh since then. The surgeon who did my THR is completely baffled by my limp, and keeps saying that there is a weakness (no idea what it is) and that I should do more PT and take steroids. This after seeing MRI results in which he saw nothing wrong. So I went for a second opinion, and new surgeon DID see the torn gluteal tendons in a new MRI. I will be having surgery to attempt to repair the torn tendon/muscles. My surgeon is experienced in this kind of repair and has pioneered techniques for doing it, so I have hope that one day I will be able to walk unaided again. 

My gluteus medius and minimus were cut for the THA and repaired before closing me up, according to the operative report. For some reason, either they never healed or have been retorn by me post-op. I am still flabbergasted that my original surgeon didn't have a clue about what was wrong with me. I have done a lot of research, and discovered that this is known to happen after THR, especially with the lateral approach he used on me. 

Best of luck to you as you search for a remedy!

I think your surgeon is 'baffled' because he/she cut the muscles/nerves and it may be considered outside the standard of care.  More PT won't help if the nerves were severed in the muscles.  Please don't blame yourself ... my surgeon tried to blame me for not working hard enough in order to cover his malpractice.  Best of luck to you ... and DO keep us advised.

Oh, I most definitely don't blame myself! I saw on the surgeon's website that during recovery from the tendon repair I will be wearing a brace to limit movement, and that I will be told not to weight-bear, toe-touch only for the surgical leg, for 6 weeks. Perhaps this limited movement will allow the tissues to heal together strongly enough that I'll get a headstart on a true recovery. I don't think there is nerve damage, since I don't have any of the other symptoms of that, and I truly hope that's not part of my problem. Has it been determined that you had nerves cut?

I did the standard PT starting 7 weeks post-op and continuing for 3 months. It ended 4 months ago and I have done no more of it. It didn't help at all, and may have partly been the cause of the non-healing. I am avoiding PT like the plague. I will definitely keep you advised on this thread! I don't have a date yet, as I am still being assessed, to make sure that they will be addressing all the issues that are going on in my hip/thigh. So, while I am anxious to get going, I am grateful that they are being really serious about getting me all the way back to health!

I wish you the very best!!

When I first posted my questions about having a Trendelenberg gait there was no other discussion available. I'm so glad to see 56 responses now. It has been two years since I had a L THR. I am just now able to walk slowly and for a short distance without an aid and without limping. My cane or walking stick is still a constant companion. I can zip right along if I use my rollator. My surgeon, too, played dumb when I asked 22 months ago "why am I still limping?" I had to search and search for my own answers. After three physical therapists, 3 months of chiropractic because the op leg was 3/4" longer than before and my pelvis was now out of kilter, the opposite shoes rebuilt with 3/4" lifts, pulmonary function test and full cardiac workup to rule out those systems as the reason for my continued shortness of breath (the 3rd PT says it's because I have to exert myself so much when I'm walking) There's more to this story but the point is some surgeons are chicken s_ _ _ about fessin' up to their role in the botched procedure. If I had been told from the get-go that my gluteus medius had been cut and given instructions on how to handle the healing, I would have been happy to comply with instructions. When I asked before the surgery what I would face for recovery afterwards, the flippant and arrogant surgeon said, "some people want to walk back to their room." I am 73 years old and I have so many other wonderful things to do with my life and less energy than when I was younger that I have chosen not to pursue recompense. I am so happy to hear others have elected to go to court. However, when someone asks me who did my surgery, I gleefully tell them so they can avoid him.

So sorry for you, Carol. May I ask how long ago you had your gluteus medius repair? I had my THR in July, 2015 and am scheduled for the GM repair and revision in two weeks. I know it isn't a sure thing to recover from this. I've been limping and in pain for 14 months, and use a rollator walker in the house and one crutch outside. So I have avoided the shoulder pain. I did suffer a vertebral compression fracture in T-11 a couple of months ago, but I have some mild osteoporosis and had another fracture in 2011, so I might have had that with or without the hip problems, I don't know

My only suggestion to you would be to go back to your surgeon and see what he says. Any idea of why your GM repair failed? Does he recommend more surgery? Does he think you might improve without it?

Best wishes to you, and hope you get better.

Hi Annie,

my whole saga started 31/2 yrs ago with a bad fall resulting in a fractured hip. This was repaired with a rod in femur. This seemed at first to be healing well when I developed severe pain, which took many months to diagnose...a vascular necrosis. Then had a hip replacement in2015. Could not walk after THR and was found to have a detached gluteus tendon. Had the tendon repair in Jan.2016. I am struggling to walk after months of PT. Able to walk with cane but without the support, a very bad limp. Would like to know if anyone has had anything like this...I haven't totally given up but it is dis ouraging. I was on crutches for 8 wks.after the repair with toe touch weight bearing and then intense therapy to build up strength and am now doing electric nerve stimulation at home to retrain muscle. 

as far as I know , the tendon is still attached but the muscle is so atrophied that I am not sure it will ever come back. I really think that if I had the tendon repaired sooner it would have been more successful. There was a huge delay getting an MRI and then getting the report and then seeing the surgeon etc, etc. I think that had I been more forceful in my complaint something could have been done sooner.

At any rate good luck to you and hopefully your repair will be successful.

Gosh, Carol, it does sound like the muscle is having a hard time getting itself to work again. That's so awful about the delay. I haven't heard of anyone with this problem who got a quick diagnosis and treatment. It is well-known that with tendon damage, the earlier you get it repaired the better, but that info doesn't seem to have trickled down to treatment for torn gluteus tendons.

Mine will have been out of commission for 15 months, and it looked bad in the MRI at 6 months out. Hopefully the gluteus maximum pull-through will help make up for the atrophy of the glute med.

Thanks for the good wishes. I need them. My back is bad and that will make recovery even harder. I am certainly hoping you can find some way to a better recovery, so you can walk without aids and without a limp. I am looking forward to that, hoping hard.

Thanks for the good wishes and the same to you. The en ouragement is surely appreciated.

As to the decision to have the repair, I knew there was no chance of improvement without the surgery so I was eager to take the chance, even tho one ortho.that I consulted did not recommend it. Now I just want to prove that I made the right choice. 

I guess that the bottom line at this point is to not give up and keep on with the exercises. Sometimes I get a bit over enthusiastic and end up straining my back. However, today I am going out for a short hike, with cane, to have some sort of normal life.

Have a great day Annie.

Here's to your "normal" life today, Carol! May you have some joy! My back feels a bit better, so I am feeling more positive about upcoming surgery.