14 months out...still having issues

[enmayer]

      Surface Hippy,
 
I am now almost 14 months out from my right hip resurfacing with Dr. Gross, and I wish I were happier with it. I am very young and a former collegiate athlete, and I got the hip resurfaced rather than waiting or having a THR as I wanted to return to all the activities I love. I have been religious about going to physical therapy (but not overdoing it) for the last 6 months and have definitely seen some improvement in strength but I still have a lot of issues with the hip. I am trying to get back to yoga, weight lifting and beach volleyball, but that has been impossible with the way the hip is now. When I try to flex my leg up I can barely get to 90 degrees and then there is this impingement-type sensation accompanied by pain. If I hold it there for a moment and use my hands to pull my leg up to my chest then the hip sort of locks into place, but then trying to extend my hip out of this causes a VERY visible and unsettling sort of violent catching/locking sensation with pain. My whole pelvis on that side sort of “jumps” as the hip tries to glide from flexion to extension. My PT can’t figure out what is going on. The same thing happens if I try and do lunges, squats, childs pose in yoga or anything that requires significant hip flexion. Even trying to tie my shoes is more difficult than it was before surgery. Sam mechanical impingement type pain, locking and catching as the joint tries to go from flexion-extension. It feels like there is a mechanical stop that I have to overcome every time I flex my hip. If I had to compare the two side, my operated leg also feels shorter and as if my hip is more medialized (center of rotation of the femoral head now more towards the midline of my body). I thought maybe I was just having psoas tendon issues (which I still do), but this locking/catching is pretty severe and different than what other people with psoas issues have experienced. If this right hip had gone well I was planning on getting my left one done as that also has issues, but now I am not so sure. Imaging confirms that the components look stable and in a good position. Anyone else with similar issues in their recovery?
 

[blinky]

No, but I am writing to wish you well. Have you talked to Dr Gross? Is range of motion your sole concern? Have you tried taking time off, like just walking for at least a week?


Good luck.


(I don't have any issues tying my shoes. I am able to do deep squats and get up unaided, but not always. I tried to do what you describe, bring my knee to my chest. I can get decently close without using my hands. The leg lifts higher than 90 degrees. It is hard, though, because I don't have the flexibility in my hamstrings/back to get it that high. I can do pigeon pose, though. I can't straighten the leg once it is that high without it coming lower.


FWIW I feel like this recovery has been two steps forward one step back. I feel good, surge forward, test my limits, over reach, have to back off. For example, run 10k, enjoy success, feel beat up, have to wait a few weeks before doing it again. But progress is made: I can run a 10k distance, not racing, every other day now, but it took more than a year to do that after running that first one. I am not niggle free, especially not when I keep pushing.If I take a week or so off and don't push, just do things I can already do, I do feel normal.)

[surratt]

im curious to know what Dr. Gross thinks about this....Im 8 weeks out and im slowly stretching my joints out and I also feel a very similar pain as i felt before the surgery, an impingement type of pain in the joint, sharp pain when doing certain things.  Butterfly stretching my groin is a sharp joint pain.  It concerns me as well an im so early that my mentality is I will just keep stretching and giving it time but the pain i feel is very similar to pre-surgery, a joint type impingment not so much muscular so it worries me a bit.  Im going to give mine a couple of months before I freak out and call up Dr. Gross. 




At 8 weeks i can bend both my knees past 90 but i feel joint pain.  I feel the joint clicking and shifting but im told that is normal for awhile.  I can squat to about 90 right now and i do so with body weight for my leg workouts.  Internal and external rotation of the hip seems limited and causes joint pain.  What did doctor gross say about the violent shudders you are experiencing, can you reproduce it in his office?

[blinky]

I had another thought.


Is the range of motion you have now within normal limits?


Is the range you seek to achieve exceptional?


My thinking is that the range of motion you had before could have been unusual, perhaps caused by your abnormal hip joints. Pre arthritis, I was freakishly limber. Arthritis and narrowing joint space took that away. I have more flexibility now than I did at the peak of my arthritis, but I am not as limber as I was say in my twenties. My RoM is still improving, fwiw, but I don't think I will ever be as flexible as I was.

[enmayer]

Blinky and Surratt,


Since I am in California, I have only been able to follow up with Dr. Gross over the phone and send him my imaging to look at. I am going out next month to see him in person so that I can get a better assessment of the situation. I talk to another joint surgeon who looked at my xrays and said that because I had mild dysplasia before surgery, it looks like Dr. Gross medialized the resurfacing prosthesis in the socket and that might be what is limiting my range of motion and causing the impingement type pain. Because of this, going into deep flexion can cause the ball to lever out of the cup slightly and then when it pops back in, that is what is causing the violent popping. He said the psoas is likely also rubbing on the joint differently because the ball and socket are in a different position than they were originally and this may be contributing some. Either way, doesn't sound good to me. He suggested that the only option to fix this was conversion to a total hip replacement, which I am not too keen on. Really frustrating regardless. Will have to wait to see what Dr. Gross says in a couple of weeks.

[surratt]

jesus that is scary man.... i cant imagine going through all that recovery and having to do it all over again with a replacement.... please keep us up to date and post here again when you get back from SC and figure out what the game plan is.  Good luck and sorry you have to go through this.

[karlos.bell]

  Hi Mayer. Yep had this.......... it is finally going after 3 years........ left hip. Tight psoas, short IT band. once the posas loosens off the IT band alters then the hip starts to act in rotation correctly.........
Both actions seems to cause an issue. Time and exercise sorted it. Not sure if yours is the same..
Cheers K