8 months out...disappointed

[enmayer]

      Hey Fellow Hippies,
 
I am a very young guy (early 30s) with a complex history of hip problems over the last 5 years that has resulted in multiples failed hip arthroscopies and hip preservation procedures to both hips. It finally got to the point that I decided to pull the trigger on resurfacing in December 2016 on my right hip. As a long time lurker on the boards here, I anticipated a recovery that would eventually return to me to the activity level I had been missing out on prior to surgery. However, I feel that my hip is perhaps worse off now than it was prior to surgery. I never had a loss of range of motion and my joint space on Xray was pretty good, but I had a constant achy pain that grew worse with activity and MRI evidence of a large focal cartilage defect in the acetabulum that was not improved despite multiple scope procedures. My main goal after surgery was to return to a level of function that would allow me to play some tennis, hike, play beach volleyball, bike, and weight lift. Not a runner, and don’t anticipate becoming one, but I feel that I am now less able to do many of those things that I had hoped for by having the surgery.
 
Now at the 8 month marks I have tightness and soreness, sometimes sharp pain in my groin that worsens with activity. I also feel very restricted in my ROM, barely able to get to 90 degrees of hip flexion and I feel like there is a mechanical block/pinch if I try to bring my knee to my chest. If I slide my knee out and try to bring it to my shoulder while bent then I get pretty good ROM, but the closer I get to having my knee midline (adduction), the worse my hip flexion ROM becomes. I also have a lot of pain in the incision area where my surgeon cut through the muscles. Sometimes a get a lightning bolt-like sharp pain with a catching sensation in that area if I bend or twist. Lastly, my follow up xrays have been anything but normal and it looks like the superior neck of my femur is jamming against the cup edge of the prosthesis cause a large wear defect. Radiologists and my surgeon confirm that there is no fracture or sign of loosening, but this finding doesn’t seem normal to me after talking to a lot of people with resurfaced hips and looking at their imaging.
 
Basically just wanted to get everyone’s opinion on where I should be at this point and if anyone has experienced similar issues/had similar imaging findings.
 
Cheers.
 
E
 

[Paprika]

'Very sorry to hear.  One question:  Have you been working with a physical therapist?  I'm only 3.5 months out but aggressive physical therapy has really aided my flexion and overall ROM.

[blinky]

I'm with paprika. I'd try PT and give it a good six weeks to three months. Supplement with the painful massage therapies if your PT doesn't use them (ART and myofasial massage to break up scar tissue). Ask them about your back flexibility, especially in the SI joint. IMO the people who make the most complete recoveries are the folks who do this.


If you don't feel like you are making progress, bring it up with your surgeon. Ask him specifically about the X-ray spot you think looks abnormal. If the answer doesn't satisfy, get a second opinion from a different resurfacing doc.


And I'd give it some more time. Okay, my hips were a lot more messed up than yours, but I don't think I was able to bring my knee to my chest easily at eight months. Within the first year, I could get in child's pose (lying in a ball with knees touching shoulders) and I could bring my knee up to my shoulder on the same and opposite side while dancing (think  those aerobics moves).


edited to add: I could tie my shoes at six weeks so I guess I could get my shoulder to my knee, but that was in a scrunched over position, not lying on my back and bringing my knee in with my body/opposite leg straight.

[blinky]

Oh! I was going to add about the incision:do other incisions feel this way on your body? From other hip surgeries? Or just this one? Do you think it could be the loss of fat in that spot? Or scar tissue?


I felt like my incision on the right side (I'm bilat) stayed sensitive for quite a while. I wasn't concerned because 1) I think I just heal that way based on other incisions (stitches on my knee at age five that were still pretty sensitive at age eight) and 2) I think I hyper focus mentally on small out of the norm feelings, like an itch or a loose hair. It doesn't bother me now but the loss of fat on both sides does make it more difficult for me to lie on my side on a hard floor. The places where I was sliced are defatted and that fat isn't coming back! It looks fine, but I don't have that padding any more.


Final thought is scar tissue. You are healed enough for someone to try to break that up. (and yes it hurts)

[Quig]

What Blinky said!


I'm a bilat also and overall have been incredibly happy with my result. I'm currently about 15 months out from surgery. However, I too still have flexibility issue with my right hip. It's still improving but I absolutely cannot pull it to my chest/shoulder. I have been slowly increasing the amount of force I put into stretching it and has slowly (very slowly!) continued to improve. Also, like Blinky, my incisions felt quite different. The one on my left side was always more tender and I have some scar tissue in there (I think?) that still gets aggravated from time to time. I've rolled it pretty regularly with a rolling pin or a foam roller and it isn't comfortable but certainly is continuing to improve. I may look into professional massage help with that spot because other than that I'm very nearly 100% pleased.


Time and patience is your friend. It's early still... you'll continue to see improvement for some time to come...

[Joe_CA]

Hi enmayer,

I'm sorry you're going through these issues. I'm responding since I too am roughly 8 months post surgery with Dr. Gross (I viewed your first post to see who your surgeon was). We may have been in the hospital the same week (my bilateral surgeries were Dec 12, 14). I wish I could contribute more to your specific problems, but I'm not experiencing much pain at this point. The only reminder (with the exception of the scars) that I had the surgery is the continued loss of full strength (but improving monthly), and the occasional soreness when I perform leg workouts at the gym.

My goals may be different than yours. I never had much flexibility, and I probably haven't stretched any of the surrounding muscles in two months. I know this is a short-sighted approach, and I could definitely benefit from more stretching. But being an impatient guy, I wanted to simply get back to sports I enjoyed (like you, beach volleyball is one of them). So I focused on strength and breaking up the scar tissue. So initially, I performed all the front and side (weighted) leg lifts recommended by Dr. Gross religiously. The last several months, I've been hitting the weights pretty hard, for example squats (135-150 lbs.). All the exercises hurt a bit when I first started (still do, but much less than previously). I wonder if you can slowly start integrating some more specific strength training into your rehabilitation efforts? Hopefully, nothing that causes you sharp pain.

The concerns about any potential movement of your device are troubling... Did Dr. Gross make any further comments on the chance that something moved (or was not angled optimally during the surgery)? Are you certain the device is "jamming" versus some other form of pain (temporary muscle/tendon issues) that some patients suffer for longer periods of time than others?

Like Quig stated in his reply, it is still relatively early for us in the overall process. I certainly hope your issues are merely related to a little bit slower recovery than perhaps some of us here.

Keep us posted.

Joe

[catfriend]

Granted, some people heal more slowly than others, but there are a couple of things in your story that bother me. You state that your x-rays are not normal. Is this you opinion only, or is it also the opinion of your doctor? If you are concerned that something is wrong here, if any part of the implant was placed incorrectly, for example, then I would seriously look at sending copies of your x-rays to a hip resurfacing specialist familiar with revisions.

Otherwise, work with a qualified physical therapist on your ROM issues. Since I don't know you and can't see or feel your motions I can't tell from your descriptions if you're healing normally, but just not nearly as fast as you'd like, or if something is actually wrong. If pt brings no improvement in 6-8 weeks I would seek a second opinion regardless.

My post surgery incisions - both from this and a prior knee surgery - were sensitive for months. It's a good thing I'm a back sleeper. The sensitivity will eventually fade.