Impingement

[frigator]

Saw Dr Gross few days ago for the butt pain I am having and he decided to go ahead and do my 1yr appointment at the same time even though I am one week short of 11 months.  He moved my bent leg straight towards my chest and was surprised I winced in pain when he moved it up. He said I had an impingement, my cup is high, and the femur is hitting the cup.

Now I knew I had pain when moving  the leg toward the chest but up until now didnt know why.  I think just about everyone has problems doing that move, esp early on. Maybe this explains why I couldn't do some of the PT stretches.  Curious as to whether others may also have this impingement. I guess this is something I will have to learn to live with

Also Dr Gross ordered a special MRI for patients with implants. I can feel fluid in my joint again.  And he had no answer for my butt pain. I still cant sit without bad pain. The PT has made it worse and I don't know where to go from here.

[Saddlepal3]

Frigerator,

Sorry you are dealing with this. When you get the MRI (assume it’s the MARS MRI), i suggest that you get copies made and send to some other top resurfacing doctors for 2nd opinions. In particular, I would send to Dr. Pritchett (Seattle) and Dr. De Smet (Belgium). They both provide free consulting and will be happy to offer their advice.

[frigator]

Thanks for the advice saddlepal....I still havent got the order from Nancy but will try and get copies made when they give me the disc. I really dont know why I have the fluid on my hip...probably from the PT and Dr Gross said 10-20% of his patients do have fluid in the joint. So perhaps its not an indicator of something wrong. Dr Gross said my x-ray was "perfect".

This butt pain has gotten so bad I have taken the predisone dose pack today. The ultimate antiinflamatory. I will have a very hard time sleeping on this medicine but it helps usually. We see if it does this time.

[jimbone]

Frigator

Can you describe the sensation of water in the joint more completely?  Also, do you know it's water/fluid in the joint?  Has your doctor confirmed this?  Will imaging show the water?  Will the water eventually dissipate on it's own?  I ask because I "feel" like my knee is "full"- it resists full flexion as if it were swollen which would indicate fluid build up.  At 2 and 4 months past bilateral resurfacing I cannot get my knee much past 100 degrees of flexion [measure by PT] although when i hit my max it feels like the flexor muscles are just stopping it from going further.  I'll be curious to know what you learn about this.  Best Wishes.

[Saddlepal3]

A MARS MRI will show fluid.

[frigator]

Jimbone....the water will go away on its on, at least it has with me. I have had my knee drained a few times when I was younger and my leg was so stiff I couldn't get past 30deg or so. I could feel the fluid move with flexion from compartment to compartment. I hope you are able to get more ROM with your knee. Ask the doctor cause if you do have fluid in the knee there could be a problem there.

Still waiting on my Mars Mri order which will show whether I have fluid or not. I dont think you can tell by x-ray.

Saw the spine surgeon here in Charlotte who has agreed to help me out and they are ordering an xray guided injection for me to the sit bone bursa. I pray this will help this sitting pain. Anyone else have an injection at this site or similar?

[jimbone]

Frigator-

I'm sorry to hear you're still hurting and hope the injection does the trick for you.  Your explanation about water on the knee made sense and sounds familiar.  Decrease in symptoms over time makes sense as well and the left knee [from first hip] is definitely improved from the 2 month mark until now, the 4th month.  I will mention it to the surgeon when I send in some follow up questions I have- I expect to be told to give it time.  I'm not uncomfortable with that, I am committed to as full a recovery as I can attain and understand I won't bounce back like a youngster any more.  What we lose in youthful recuperation we need to make up with mature perseverance.  I'll just keep working on it.  Do hope you get some relief from the bursar treatment.  Best.  Jimbone.

[frigator]

Received an injection into my ischial tuberosity, or the sit bone bursa, this morning. A bit more painful than those injections I had in the hip few years ago. I really hope this helps, even though I think it may be a nerve rather than the bursa area. We shall see. I always have a hard time sleeping after an injection for a few days but happy to endure that if it removes this sitting pain. I just over 11 moths out and still hurting. Anyone else get an injection in this area?

[frigator]

Still a little worried about me having this impingement. I am thinking this could be one negative of hip resurfacing that the femoral neck will hit the cup if its too high, which evidently mine is. In PT I was mixed in with the THR patients and they could all do the piriformis stretch which I could not do.

Why do I have a high cup? Looking at the videos it looks like if you select one too large you wont be able to get it pounded all the way in.

This small study found 11.5% of patients had the impingement. I was wondering if any patients here on this website think they also have an impingement.

https://online.boneandjoint.org.uk/doi/abs/10.1302/0301-620X.92BSUPP_I.0920144d