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Author Topic: 15 months post surgery pain on moderate exercise  (Read 19722 times)

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willsand

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15 months post surgery pain on moderate exercise
« on: December 15, 2012, 08:55:31 PM »
15 mos after bilateral resurfacing by Dr Gross, one hip is great (a '10'), the other somewhere between fair and poor (a '5').  Ironically, it is the asymptomatic hip prior to surgery (though the before surgery x-ray was a train-wreck). 
The pain is like having a pebble in your boot.  It goes from an irritant (up to 2 miles hike) to full-on need to stop (by 7 miles).  It affects biking and swimming also, though less so. 
Dr Gross spent 30 minutes with me (at one year), but could offer no solution.  He was puzzled, saying x-rays were perfect (assumably including angle of cup, etc).  He (and I) are hoping for improvement by 2 years (at time of metal ion blood test; apparently too early now).  He also said something about soft tissue MRI at some point.
I have read about metalosis causing tissue reaction.  But why on one hip, and not the other.  At this point, I have little hope that year two will bring a miracle.  This hip has been a problem from the onset, lagging far behind the 'good' hip.
Does anyone have anything to add to this?  I was expecting so much more by this time.
Thanks for any help or suggestions or perspective.
Bill

obxpelican

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Re: 15 months post surgery pain on moderate exercise
« Reply #1 on: December 15, 2012, 09:44:40 PM »
What everyone is finding out about the metal ion issue is that unless the device is not implanted correctly your metal ion test will come out normal.

Did Doctor Gross offer up any ideas such as a problem tendon or anything else?

Chuck
Chuck
RH/Biomet U/C Dr. Gross/Lee Webb
8-6-08

hernanu

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Re: 15 months post surgery pain on moderate exercise
« Reply #2 on: December 16, 2012, 03:17:41 PM »
Hi Bill, sorry you're dealing with this. It is puzzling that you're having issues when the placement is good, any issues with allergy would have shown on the other as well.

Hope you figure it out, the metals test will eliminate one possibility, I'm sure you and Dr. Gross will get it resolved. Wishing good thoughts, keep us informed.
Hernan, LHR 8/24/2010, RHR 11/29/2010 - Cormet, Dr. Snyder

tennisgirl

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Re: 15 months post surgery pain on moderate exercise
« Reply #3 on: December 16, 2012, 04:19:18 PM »
Hi Bill,

I too am having problems at 13 months post op.  I was doing great at 2 months, and then the bottom dropped out.  I saw Dr. Gross twice in six months, and then at my one year check up.  Implant is fine, but I'm not.  I've had a blood work up to rule out infection and metallosis...everything came back normal.   Like you, Dr. Gross is stumped as to why I am having pain.

I consulted with a local hip surgeon who does resurfacing and THRs at 7 months, and his advice was to wait and see, it was too early to make any decisions.  Last week I saw another hip surgeon who has me scheduled for a psoas injection to see if that it where my pain is originating from there (groin, thigh, buttock).  There is a possibility the psoas tendon is rubbing on the cup.  If my pain goes away, the psoas is the culprit, according to this surgeon.  Dr. Gross did mention this could be my problem at my one year check up, but opted not to do anything at that time.  All surgeons agree my implant is perfect.

I also have pain at my incision site, which seems to be puzzling every doctor I have seen.  Nerve damage?

I have been in PT since April, tried accupuncture, and am just started working with a chiropractor who is using ART to try and help me.  I work out, play tennis and just try to stay busy.

I'll keep you posted on my results after the psoas injection.

Mindi
R Biomet Uncemented Dr. Gross 11/9/2011

willsand

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Re: 15 months post surgery pain on moderate exercise
« Reply #4 on: December 16, 2012, 06:32:47 PM »
Thanks all for your input.  I am particularly interested in the outcome of your psoas injection, Mindi.  I don't have any 'snap', which I would associate with a tendon rubbing.  Do you?  Who is doing the injection, someone local (to Columbia)?  What is ART?  Good luck.
Bill

willsand

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Re: 15 months post surgery pain on moderate exercise
« Reply #5 on: December 17, 2012, 10:54:10 AM »
anybody have any other thoughts...?

patrick_d

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Re: 15 months post surgery pain on moderate exercise
« Reply #6 on: December 17, 2012, 04:18:43 PM »
Hi willsand –

I am sorry to hear that you are having this issue.  I have a thought, it might not be simple or inexpensive, but it may help you figure out what is going on….

It seems that you have something that is getting inflamed or aggravated as you exercise, so could you talk a doctor into performing 2 MRI’s on your hip….one pre-exercise and one immediately after a long hike when you are feeling that pain at a high level?  The next step would be to have someone compare those scans for differences.  There are at least a couple of ways to do the comparison.  A radiologist might be able to take a quick look and show you some differences.  Alternatively you could ask/pay someone to build a 3D model from the MRI using some software like Materialise Mimics or you may be able to find someone at the University of Utah’s SCI Institute (http://www.sci.utah.edu/) that would be able to help build the models.  Then you have some nice 3D models that you could send around to a number of doctors/scientists/engineers to see if they can highlight the differences and pinpoint the problem.

-Patrick

Disclaimer: I am not a medical doctor, rather a mechanical engineer that works in the medical technology field.  I use these types of techniques to solve other problems and I thought it might be something that could work here as well.
Dr. Gross 14-Nov-2012
Biomet Recap - Right Hip
41 yrs old at surgery

tennisgirl

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Re: 15 months post surgery pain on moderate exercise
« Reply #7 on: December 17, 2012, 11:39:03 PM »
Hi Will,

ART is Active Release Technique.  It is a type of intense stretching and myofascial release.  I tried it before my surgery (doesn't help with joint pain), and am now trying it again.  I've only had three sessions, but my PT noticed my hip is somewhat looser (she didn't know I was doing something else).

I forgot to mention that in the spring I also had ASTYM deep tissue massage on my adductor, hip incision, and hip flexor...no help there either.

According to the surgeon I am seeing now (metro Atlanta), if my pain goes away with the injection, then I could consider a psoas tenotomy, which as I understand it, is where the surgeon will cut or nick the psoas tendon to release it (which has become too tight).  Not sure I want to go down that path....

I am just tired of the pain, ya know????

Later,

Mindi
R Biomet Uncemented Dr. Gross 11/9/2011

hernanu

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Re: 15 months post surgery pain on moderate exercise
« Reply #8 on: December 18, 2012, 01:14:21 AM »
Hi Will,

ART is Active Release Technique.  It is a type of intense stretching and myofascial release.  I tried it before my surgery (doesn't help with joint pain), and am now trying it again.  I've only had three sessions, but my PT noticed my hip is somewhat looser (she didn't know I was doing something else).

I forgot to mention that in the spring I also had ASTYM deep tissue massage on my adductor, hip incision, and hip flexor...no help there either.

According to the surgeon I am seeing now (metro Atlanta), if my pain goes away with the injection, then I could consider a psoas tenotomy, which as I understand it, is where the surgeon will cut or nick the psoas tendon to release it (which has become too tight).  Not sure I want to go down that path....

I am just tired of the pain, ya know????

Later,

Mindi

Man, Mindi hope the ART helps to release that tendon. Here's a description from someone who had the surgery done to describe it and how it helped him. It'd be great not to do it, but he seems to have gotten relief from it:

http://arthroscopyofhip.wordpress.com/about/apatientsperspective/surgery/iliopsoastenotomy/

Again, hope this works out without having to do the surgery.
« Last Edit: December 18, 2012, 01:16:13 AM by hernanu »
Hernan, LHR 8/24/2010, RHR 11/29/2010 - Cormet, Dr. Snyder

willsand

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Re: 15 months post surgery pain on moderate exercise
« Reply #9 on: December 29, 2012, 08:51:55 PM »
I am wondering if it is possible that my pain is from bursitis, since pain is lateral (not actually groin).  Dr. Gross never seemed to consider bursitis as my continued problem; indeed he dismissed my claim of pre-surgery bursitis as related to hip joint issues.  (Maybe I am just looking for something simpler than other options.)

tennisgirl

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Re: 15 months post surgery pain on moderate exercise
« Reply #10 on: December 29, 2012, 10:08:46 PM »
Hi Guys,

I had the injection last Wednesday...jury is still out if it will help.

I'll keep everyone posted if I have a miraculous improvement.  In the meantime, I'm restricted from exercising for a week (grrr).

Will, I feel your frustration on not getting relief or answers. 

Mindi
R Biomet Uncemented Dr. Gross 11/9/2011

John C

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Re: 15 months post surgery pain on moderate exercise
« Reply #11 on: December 30, 2012, 01:03:48 AM »
Hi willsand,
In respsonse to your question about bursitis. I did have a few bouts of trochanteric bursitis off and on for the first couple of years after Dr Gross did my surgery, though happily I have had no issues with it for the past couple of years. From my experience, there is a very easy test to see if trochanteric bursitis is the issue. Feel for the location of the greater trochanter (if you are not up on your anatomy, look up some pictures to help you find it. It will be the bony protrusion on the side about 4" to 6" below the iliac crest), then use your finger tips to press hard right in that area. If the trochanteric bursa is inflamed, you should feel pain to the touch in that area. Dr Gross diagnosed mine over the phone, largely based on that test. If that is your issue, the good news is that it usually very treatable. Many of us solved the problem by using rollers, stretching, and massage to take the tension off the IT band that runs across that bursa, though Dr Gross did offer a cortisone shot if that did not work.
Best of luck in getting this solved.
John/ Left uncemented Biomet/ Dr Gross/ 6-16-08
Right uncemented Biomet/Dr Gross/ 4/25/18

hernanu

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Re: 15 months post surgery pain on moderate exercise
« Reply #12 on: December 30, 2012, 02:55:26 PM »
Hi Guys,

I had the injection last Wednesday...jury is still out if it will help.

I'll keep everyone posted if I have a miraculous improvement.  In the meantime, I'm restricted from exercising for a week (grrr).

Will, I feel your frustration on not getting relief or answers. 

Mindi

Hope that sorts it out, Mindi.
Hernan, LHR 8/24/2010, RHR 11/29/2010 - Cormet, Dr. Snyder

willsand

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Re: 15 months post surgery pain on moderate exercise
« Reply #13 on: January 04, 2013, 09:22:30 PM »
thanks, john.  my tenderness (to the touch) is a bit below trochanter (on lateral portion of leg).  i'm going back to icing.  i'm taking just as many Advil as i did before surgery.  several times now i have stayed off hip (no hiking) for 2-6 weeks at a time.  pain seems to move; occasionally in groin also.  bah!
and good luck to you, mindi.  i'll be interested in how you do.
bill

Ross

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Re: 15 months post surgery pain on moderate exercise
« Reply #14 on: January 05, 2013, 01:44:18 AM »
Bill

When you had surgery on the hip that has the issues, you had no issues with it?  When did you notice the issues because one obviously got significantly better quicker correct.  What was your cup angles?
Cordially,
Ross

willsand

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Re: 15 months post surgery pain on moderate exercise
« Reply #15 on: January 05, 2013, 09:44:46 PM »
Hi Ross,
The now-troublesome hip was symptom-free prior to surgery (though the x-rays were as bad as the symptom-rich hip).  I had the two hips resurfaced two days apart.  First surgery was smooth.  Right off the bat the second one just didn't feel right--much more pain.  This hip lagged far behind the healing-curve.  It pretty much peaked at four months.  No real improvement since then.  I alerted Gross' office to this at 6 months.  They said one is always worse than the other and I should wait the full year (Oct '12).  When it was still no better (it does fluctuate, good days and bad days, relatively speaking), a 2-year period was mentioned (without much enthusiasm; I can see that will make no difference).  Dr. Gross seemed pleased with x-rays and puzzled by my lack of progress.  It seems pointless to get a second opinion, since Dr. Gross is The Man.  I assume my cup angle is fine since he said x-rays were perfect.  I don't really know my cup angles (nor how to find that out). 
I just looked up some material; I do have paper copies of x-rays, done right after surgeries.  Right hip (okay now) is 31 degrees and left hip (problem) is 32 degrees.  I don't know how definitive that is.
Thanks,
Bill

mountaingoat

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Re: 15 months post surgery pain on moderate exercise
« Reply #16 on: January 19, 2013, 02:14:13 AM »
I'm wondering how you guys are doing - Mindi and Willsand? I am 12 months post-op bilateral with Dr. Gross and was doing perfectly until just a week ago when one of my hips started bothering me with exercise and is pretty darn sore for this far out. It feels like joint pain to me - I guess that's the only way to describe it and actually because this hip never hurt as bad as the other I have to say it feels worse than pre-surgery at the moment. Dr. Gross said the x-ray looked fine.

I really get nervous reading these forums because I see that there are other people out there with top surgeons like Dr. Gross who are having on-going problems that are preventing them from living the active lifestyle they want. In my case, I haven't had any problems with this hip at all during recovery and now it seems to have come out of nowhere over the last few weeks. I would notice it ache a bit from time to time after yoga but nothing that lasted more than a few hours or required advil. I fear so much just having to wait interminably for something to improve when I can honestly say I have no idea where the pain is coming from and no idea how to fix it. It is a deep ache along the upper thigh and a bit of groin and glute pain too.  Sure, it could be the psoas but it feels like joint pain. For me the distinguishing factor is generally that muscle pain hurts during activity while joint pain tends to hurt worse afterwards and that is what I am experiencing. Early on I would get muscle pain when doing single-leg lifts with this hip but it never hurt after exercise until now.

Wow, this is super frustrating. I hope you guys have some answers soon.  :-[


obxpelican

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Re: 15 months post surgery pain on moderate exercise
« Reply #17 on: January 19, 2013, 02:48:29 AM »
Many people have setbacks at around 12 months and even 2 years post op.  Sometimes rest, ice and ibuprophen can help a lot.

If Gross thinks the x-ray is ok it's probably another issue.


Chuck
Chuck
RH/Biomet U/C Dr. Gross/Lee Webb
8-6-08

DGossack

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Re: 15 months post surgery pain on moderate exercise
« Reply #18 on: January 19, 2013, 07:33:42 PM »
I have had pain on and off but I attribute this to muscles that are not recovered.

In my humble opinion we do not consider how much the muscles adapted as we adjusted our movements to avoid the pain.  Our limps are an example of how our bodies adapt.  So after years of relearning our hip pain is gone.  So our bodies start readjusting.  The problem is the big muscles recover pretty quickly.  The small stabilizer muscles do not.

As we continue our activity, whether strenuous physical activity or normal living, we will strain these smaller muscles. 

I am running, swimming, biking, etc again.  I will have pain in the groin, hip flexor, and IT band (knee and glute).  I simply back off, stretch, and ice.  Then I am able to come back stronger than before.  I have not been as diligent in strengthening the smaller muscles as I should be.

I hope this experience helps.  Best wishes.
LBHR, Dr. Pritchett, 8/1/2011
fullmetalhip.wordpress.com

Rolls

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Re: 15 months post surgery pain on moderate exercise
« Reply #19 on: January 21, 2013, 12:49:02 PM »
Hi All,
It has been quite awhile since i have been on this site.  I still have the pain in my right hip, it has been six years now.  Nothing has worked.  All the while my right knee has become very problematic with chronic pain.  I do not want a knee replacement too, so I am fighting it.  I don't think the knee is causing the hip pain, but at this point, who knows.  I also get the pain down to my instep on my right foot in the plantar area.  I can't walk hard or run any longer, so I do the elliptical and bike.  I have a strenuous job as well, so I am in quite a bit of pain most of the time.  Actually, driving a car for longer periods causes the most pain in hip and knee.  My left hip is still...Awesome.  Anyway, keep plugging away.  Rolls
RBHR 2007 Snyder NWH,Boston not considered a success.  Still pain 5 yrs post surgery.  Snyder did Ganz procedure. LBHR 2011 Marchand SCH,RI is doing excellent, Marchand did it like it is supposed to be done.

 

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