MRI Findings

[HipToTry]

hi all
So after complaining to my doctor & P/A about the ongoing amount of pain I've been having (7 weeks post op tomorrow), they ordered a blood test and MRI ahead of my follow up appt next week.  I just got the MRI report today.  I'm waiting to hear from the doctor's office as to what they think.  Here's the significant part of the report:

Tendons: The adductor, hamstring and iliopsoas tendons are unremarkable. There is severe attenuation of the distal gluteus minimus tendon with partial width, full-thickness insertional tendon tear. There is high-grade partial tear of the gluteus medius tendon lateral insertion.

I don't know how common these tears are post surgery but I'm wondering if my rehab is making it worse right now.  Any thoughts? 

[Ljpviper]

Who was the surgeon? Both of those glute muscles support your hip and have many functions. Are you walking on your operated leg or on crutches?

That needs to be addressed asap, do not let the surgeon discount the importance of those glute muscles. They have a major impact on your recovery.

Good luck

Larry

[jimbone]

Hiptotry-

Well the good news is you have something solid to examine and question.  That has to be better than worry and wonder.  I would be wanting to know exactly what those tendon tears indicate especially how risky they are, how and why they got there and what the best protocol for recovery would be.  If the PT your doing sees to aggravate the pain I would back it of right away until speaking with your surgeon and I would be somewhat emphatic for clear unambiguous answers.  Wondering why the glute tendons are damage.  Was it a result of surgical approach?  My surgeon uses a Direct Superior and I am told only cuts the periformis- the glutes are not released or need to be re attached- they do need to be retracted and spread as I understand it.  Wondering if handling those during surgery would have had such a detrimental effect.  But also if it is muscle/tissue damage if it won't naturally heal with time and patients even if it means backing off it some.  Best of luck with this, get some answers from the surgeon and keep us posted.

[chuckm]

Stop rehab and rest. Yes, rehab is making it worse. Anything you do that is uncomfortable, other than light stretching, is not helping the wounds heal. Rehab people often do not understand this.

Chuckm

[HipToTry]

Yes I'm rather disappointed with the progress.
Dr Marwin texted me back that all MRI's of hips after surgery show tears but it's just the surgical trauma tainting the images.  Unfortunately I have yet to be able to get him on the phone to discuss.  I have follow up this Thursday.  I feel I know my body pretty well and this isn't my first surgery so I'm upset with the lack of productive feedback.

After reading more about these muscles/tendons and in thinking back, it's very possible that these tears occurred during the summer and much of the pain I've been having pre surgery was due to that.  I just assumed it was more issues with torn labrum since I was bone on bone.  We never thought to get an MRI ahead of the surgery because it's not typical protocol.  I'm guessing the dislocation probably aggravated or worsened these tears if they were pre-existing.

  At this point, I just want to make sure I'm doing the right things for recovery and know if I need to get these tears surgically repaired.  They sound significant to me and I know that my pain and limp are not really improving.   

I'm starting to think I may have to get a second opinion now 7 weeks after surgery 

[Ljpviper]

I don't bye that all tendons have tears after surgery. You need to get him on phone and clarify the matter. As Chuck M stated stop any kind of rehab it will only make it worse.

Its very possible the tears may have occurred in the summer, but I would think the tears would visible during surgery. I am no doctor, so take it with a grain a of salt.

if there full tears they would have to be corrected surgically as both support the hip. Sorry you are going through this.

Good luck

[frigator]

Sorry to hear of your troubles. That would worry me too to see that language about tears in there. I too am awaiting the results of my mars MRI as I continue to have problems with my hip and I am at 1yr post op with Dr Gross. 

Now we know that they do cut some muscles and  then reattach them to the bone. I dont know how they reattach those cut tendons but that could be what the MRI is seeing.  I read about someone else whose glute medius had become unattached. The troubling part is your pain. I hope you can talk to the doctor and he can explain this. Terrible to have to get a 2d opinion so early in your recovery, but you may need to.

[Saddlepal3]

This sounds worrisome. I have had a resurfacing (2006), THR (Feb 2018) and a resurfacing revision (Sept 2018) due to metallosis. I never experienced what you are.

I’d send copies of your MRI images to Dr. Pritchett. He will review them for free and give his opinion on next steps.

Good luck!

[Saf57]

HipToTry--Marwin is a fantastic surgeon.  You have a follow up appointment in two days. I would see what he has to say before hunting around for second opinions.

[HipToTry]

HipToTry--Marwin is a fantastic surgeon.  You have a follow up appointment in two days. I would see what he has to say before hunting around for second opinions.

Yes, I plan to see him first. I'm just a bit irked that I haven't been able to speak with him in over a week despite numerous attempts.