Different acetabular Angles

[Ross]

Hello all!  Was curious if anyone knew about having different angles on their devices.  I have one that is 30 degrees and then another at 38.  I ask this as I feel twisted sometimes.   As much as I stretch I feel extremely tight and bound up.  I think that I may be over doing it but have a tough time convincing myself that stretching and walking is not the answer.  My groin feels tight and my back is gradually hurting worse.
Thanks,
Ross

[chuckm]

That is a question for your surgeon. But, my amateur opinion is the articulation of both hip devices will be identical regardless of inclination angle unless there is edge loading on only one, or more edge loading on one than the other.

Chuckm

[hernanu]

Hi Ross, I think you're at four months, right?  You probably should check with the surgeon just to be reassured, but you are still early on.

We all had the impact of years of our body being under the attack of OA, twisting and compensating for the pain and the structural imbalance as our supports gave way. Our bodies did their best to keep things going, but as the toll took, some muscles become overly strained and others, not used, atrophied.

The damage is reversed over time, and helped by exercise, ice, etc. But time is the best for healing. This is the toughest part of the healing process. Once the initial surgical healing is done, we see so much promise that if the pain is done, everything should revert faster.

I've found that it takes more time and that's where patience is ridiculously hard. Especially for high expectation type A's. That seems to describe us here. If you look at other hippies, we all hit this point - a twitching impatience to get things going.

Try some of the things that may ease the way. I found the roller to help the IT band, lower back. Also things like a slide board to simulate skating at home to strengthen the smaller muscles. All of these are good, but the biggest is patience.

I would think the angles are right for your body and you're dealing with muscular healing, but check with the surgeon to ease your mind.

[Ross]

Hi Hern. Four months is right.  I drove over to see Dr Gross I guess about a week ago and told him my concerns.  He was not worried with my progress. The hip giving me more problems was early with regards to arthroplasty.   It had a spot where I had FAI that was bone on bone about 2 cm square.   Apparently, he believed this would lag in the healing progress.   My psoas has been tight since surgery as well as the IT band.   I roll the IT band out daily which helps but when I stretch the psoas area my tendons get overly loose and the joint starts to crack and clunk.   The device is noticeably different to the eye as the cup faces more horizontally.  Guess I feel like I should be back to normal by now but I am not.  I remember when Dr Gross showed me my X-ray I was worried as the two devices look different and they felt very different.

[hernanu]

I had clunking for quite a while.

Fairly often early on (up to about 8 months), much less so later (about 10 months and beyond). To me it meant that your smaller muscles are not quite there yet. At four months, they shouldn't be, I would think. 

My worst clunking was having just gotten up, brushing my teeth or shaving in front of the mirror. I don't know if it was because of the tightness of just getting up, because the bathroom is quieter and you just notice it more, or because shaving causes clunking 

So maybe you need to do some things to help them strengthen.

Leg lifts were a constant part of my therapy to all points of the compass (front, side, back, inside). I used a band around a chair leg, slipped one ankle in and used the band as resistance. Only until moderate resistance. Then I would repeat 15 times, 3 sets.

I also got a slide board, which simulates skating. Scary at first, since you are sliding across about 7 ft, wearing the goofiest booties around your sneakers. It does strengthen the muscles that may not be exercised by the forward motion of walking or even running.

I think juggling also helped me. It's fun to learn and causes that shifting of the body to keep balls in the air. I also later did soccer juggling, but that's a different animal altogether.

Balacing on one leg, first on the floor, then on a throw pillow also gets those muscles involved without too much big muscle intervention.

I don't think you should avoid clunking, it's just a fact of hippy life, just do the things to strengthen those muscles. It will go anyways, but we can help it along.

[Marco Polo]

Ross:  sorry to hear you are still struggling with tightness and back issues.  Dr. Gross obviously is the expert so ultimately I would defer to his judgment.  I am not offering medical advice, but a cup angle of 30 degrees is at the outer limits of his target zone.  Based on a quick review of some of the studies that are available online I know there is a relationship between cup angles and impingement.  It may be worth discussing this with Dr. Gross if you do not get relief with your walking and stretching.

[Ross]

Interestingly the cup set at 30 degrees is not the one giving me the problem.  It is the other one.
Thanks Ross

[obxpelican]

Since you do not have a signature I do not know when you were operated on, but have you had a metal ion test?  A bad cup angle can cause metal to shed and that would show up on a test, if you got the test you would know if the cup is the issue with your pain. If your ion test shows up good then it's something else, obviously.

Some cups like the ASR, because they are shallow tend to be more sensitive installation angles and will edge load and shed ions, thereby causing pseudo tumors and pain.


Chuck

Interestingly the cup set at 30 degrees is not the one giving me the problem.  It is the other one.
Thanks Ross

[hernanu]

Since you do not have a signature I do not know when you were operated on, but have you had a metal ion test?  A bad cup angle can cause metal to shed and that would show up on a test, if you got the test you would know if the cup is the issue with your pain. If your ion test shows up good then it's something else, obviously.

Some cups like the ASR, because they are shallow tend to be more sensitive installation angles and will edge load and shed ions, thereby causing pseudo tumors and pain.


Chuck

Interestingly the cup set at 30 degrees is not the one giving me the problem.  It is the other one.
Thanks Ross

Chuck, it was about four months ago.

[fenceman]

Hi Ross, I will be at 4 months at the end of next week.

I have also been pretty aggressive with stretching, walking, bicycling, and a core workout which includes weights (no leg presses).  Twice during my recovery I have had to take 3 to 4 days off just to let my body catch up.  My back would lock-up, my hip and knee would get sore, and I would feel run down.  After rest I would feel better and continue.

"Patients" and "don't overdue it", are the two words of advice you will hear the most from doctors and the wise people on this site.  It is not a good idea to try to kick-start your son's dirt bike before you are ready (yes, I did this last weekend without thinking and my hip let me know it in a hurry)  and I would also not be running at 19 weeks (wink, wink).   It's a (walking) marathon, not a sprint.  My biggest gains on my other hip done 4-1/2 years ago were at 6 months, 1 yr, and 1-1/2 yrs.  I also notice improvement even at 2 yrs.
Bill