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Author Topic: 9 weeks postOp significant discomfort and limited ROM  (Read 514 times)

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bcmaughan

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9 weeks postOp significant discomfort and limited ROM
« on: March 25, 2020, 07:46:19 PM »
Hi All

I had an Adept resurfacing implant put into my right hip on 21/01. I have had significant problems with it and just really wondering where I should be at 9 weeks post Op as am quite depressed with it and in constant discomfort. I had a lot of swelling after the operation which I think is possibly not too unusual and obviously my movement etc was significantly impacted until this went down a bit. The real problems seemed to kick in after 5 or 6 weeks once my movement and activity levels went up. I noticed on standing on my operate leg and doing a slow gentle sort of half squat on one leg that there is a pretty noticeable clunk when I start to put weight on the leg. It sort of feels like if you put fists together with knuckles together and slip one fist acros the other. Like something is shifting in the joint itself. I notice as well that there is some very tight pain in groin. If I lie down on back with legs bent and let my operated leg fall inwards it feels like something is pulling in my groin. When I am walking I can feel quite weird clunking a lot of the time and the whole joint sort of feels like it is inflamed inside and offers very limited range of motion indeed.  Sometimes when I try to stand with wide legs it feels as though there is something sort of catching/clicking and then letting go inside the joint (as if it would have been with the symptoms of a labral tear I think). The discomfort is really quite bad and nothing like what I was expecting at this stage as it seems most people after a couple of months are pain free and happy with it.

I went for a 6 week checkup and the surgeon said that the xray was good that nothing has moved and he is happy with the positioning. He tested my mobility with me lying on my back and there really is very limited movement because of this tight groin situation. He suggested that I get a dynamic ultrasound to identify the source of clunking and to possible get an injection into the psoas tendon sheath. However all this has likely been put on hold at present because of cv. As has my physio stuff. So I feel kind of helpless and unsupported and quite worried by this now. I am a gardener and have started back at work now but working seems to aggravate it somewhat. Am I expecting too much too soon. Grateful for any advice or help please as am finding this really soul destroying after hoping it would be a great thing for my quality of life.

autoazure

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  • Prof Meek, Glasgow, 09/10/19, 58mm 52mm head
Re: 9 weeks postOp significant discomfort and limited ROM
« Reply #1 on: March 25, 2020, 08:37:07 PM »
Please do not worry too much at such an early stage of recovery! Your joint capsule and soft tissues/muscles/tendons/ligaments and nerves are still many months from recovering. I found it best to continue moving using a crutch to walk outside for about a mile) and daily gentle leg exercises. It may seem to you like the whole joint is moving however, that metal head and cup are well fixed in place. I too had the Adept and it is one of the best available with special tools to ensure it is fitted in the exact correct position. I look forward to hearing how you are progressing in the coming weeks and months. Don't worry about lack of support, once the follow up shows that all is well it is time to start the slow road to recovery by gentle movements and walking/slow jogging at walking pace! If it becomes painful STOP and rest!

bcmaughan

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Re: 9 weeks postOp significant discomfort and limited ROM
« Reply #2 on: March 25, 2020, 08:46:30 PM »
Thanks very much for reassuring reply. But constant discomfort and clunking/grinding etc is normal at this stage? Seems not to be from what I've read. I have to work and have been advised gardening OK but no impact stuff. There is no chance I could even gently jog with the discomfort I have anyway. I'm fairly good with pain but can't cope with this it's really debilitating.

catfriend

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Re: 9 weeks postOp significant discomfort and limited ROM
« Reply #3 on: March 25, 2020, 09:46:32 PM »
No, IMO this level of pain isn't normal this far out from the surgery. While everyone is unique in how they heal, at your stage I was walking a few miles at a pop without problem, and swimming multiple times per week. I was still in physical therapy to work on specific issues, but nothing debilitating. You should be healing quite well by now, and able to perform a good number of activities. There are some people on this board who have mentioned being on a slower protocol, but as long as you're not then you should be further along.

Swelling up hugely a few days after surgery is pretty common. Also, everybody overdoes it with activities at some point or another. It may be that your body isn't ready for squats. I am bothered by the fact that you mention constant problems and that it is debilitating. I would definitely have more questions for my surgeon. It is unfortunate that you can't do pt etc because of the coronavirus situation.

bcmaughan

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Re: 9 weeks postOp significant discomfort and limited ROM
« Reply #4 on: March 25, 2020, 09:55:10 PM »
Thanks catfriend. That is my feeling too. I keep trying to look on the bright side but am struggling to. Yes I can go to work and do gardening etc but am in constant (and I mean constant not the odd niggle) debilitating discomfort. It is as bad (but a little different) than I was pre surgery. I thought that the surgeon must have had some concerns to recommend a dynamic ultrasound and psoas injection as a first port of call after only 7 weeks post op (the ROM was terrible when he tested it!) - but it looks like I won't be getting them for some time now with the coronavirus situation!

jimbone

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Re: 9 weeks postOp significant discomfort and limited ROM
« Reply #5 on: March 30, 2020, 04:27:47 PM »
It is difficult for anyone on the forum to provide much more than personal experience.  The most common sentiment being we all heal at our own rate and it is best to be persistently gentle with ourselves as we heal.  You mention you are a gardener which I will assume includes a lot of kneeling and getting up and down from the ground.  Getting up from the ground without the use of hands or support is actually a recognized measure of both health and longevity.  I can assure you at 9 weeks i was only barely able to do so and it took a good month or two before I could do so reliably, regularly and without strain.  I agree your discomfort levels seem higher than usual and concerning but I'm sure you understand it is in your best interest not to over react.  I would suggest getting a second and third opinion.  Can you get your imaging to any other HR surgeons?  The well known ones here will generally examine and offer an opinion.  That consensus would help give you a more informed perspective.  One legged squats, even partial, at 9 weeks??  Nope.  That was a 6 month minimum ability for me.  While we wait out the current virus circulating I would recommend taking a few steps back and focusing on the easiest, gentle, basic stretches and exercises we all start with, don't be afraid to rely on some minimal medicated support, self massage and avoiding anything that over does it.  Might even consider a crutch or cane for a week or so to see if that relieves the discomfort.  While some people's surgeons might not have an established "slow" protocol doesn't mean some of their patients don't need one.  Keep us informed and best wishes.

bcmaughan

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Re: 9 weeks postOp significant discomfort and limited ROM
« Reply #6 on: April 13, 2020, 08:58:26 PM »
Thanks Jimbone for the ides on second opinion. Yes I guess I could try to get my xray images to one of the guys I have seen recommended here who will look at the image and give an opinion on it. But I'm not sure how easy it will be to get hold of my images at the present time with the NHS so overloaded with other stuff! Basically I am back to gardening near enough every day and at similar levels to preOp so yes I agree I am pretty functional to some perhaps at my stage in recovery. But the hip is getting worse every day unfortunately. It is definitely going in the wrong direction and is extremely stiff and uncomfortable. Absolutely no chance of thinking of doing anything remotely sporty even a gentle jog. I'm quite sure there is some impingement going on as I get that familiar click/pop type thing going on that people get with things like a labral tear. Also have the very deep sort of clunk/shift when I put weight onto one leg which I don't like at all. I'll keep you updated here but so far I'm really not too chuffed with it at all with the constant pain.

jimbone

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Re: 9 weeks postOp significant discomfort and limited ROM
« Reply #7 on: April 15, 2020, 12:52:10 AM »
I didn't see who you surgeon was but if it were me I'd be going straight to their office about getting the imaging.  Right now locally they are postponing most elective surgery especially HR so your surgeon may not be that busy.  Sorry to hear you're suffering a setback and wish you the best.

Kevman

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Re: 9 weeks postOp significant discomfort and limited ROM
« Reply #8 on: April 15, 2020, 11:52:06 AM »
Hi bcmaughan,

I just had second adept at southmead (21/02) and my follow up with mr baker - you should be able to contact eastaugh-warings secretary with any problems. It certainly sounds as though you are suffering quite a bit following the surgery. If you have an issue then I would definitely raise it with them.

My left hand resurfacing which took place in sept 19 did stiffen up quite a bit more than normal according to my physio, plus I also and still do get a painless clicking/pop sensation in my glute I also remember trying to jog for the bus after about 10-11 weeks and this was too uncomfortable at the time.  It did come good in the end though after about 5 months.

All the best

bcmaughan

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Re: 9 weeks postOp significant discomfort and limited ROM
« Reply #9 on: April 15, 2020, 09:17:51 PM »
Hi Kevman

thanks for reply. So you had yours exactly a month after mine. How is it now? Did you have your followup recently during the lockdown? I have left a message with Mr Eastaugh Waring's secretary but not heard back yet. Mine is really quite uncomfortably stiff. Even just been out shopping and just walking around (let alone jogging etc!) is not comfy at all when it is really bad.

Kevman

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Re: 9 weeks postOp significant discomfort and limited ROM
« Reply #10 on: April 16, 2020, 08:11:42 AM »
Yeah i was lucky to get it in before all this kicked off.  It has been quite different second time round with certain exercises being easier than last time and others being harder. Mentally it has been alot easier.  The joint still feels stiff and I have a niggling painful/weak  muscle in my glute which means I am still limping around a bit.  But last time it did take a few months to clear the limp - I am just a slower healer whose muscles like to stiffen up. Also the lockdown has slowed progress due to no access to the pool and less access to regular walking.
My follow up was done over the phone!

I would say that I believe both mr baker and eastaugh-waring to be excellent surgeons.  I think that eastaugh-waring was trained by mcminn and both worked under gordon bannister (now retired) in bristol who has v.good reviews/reputation from other resurfacing patients. If you have had two x-rays and both have come back okay there is a v.good chance that all your discomfort is due to tendons/ muscles being upset which seems consistent with your increase in activity after 5-6 weeks. Hopefully the lockdown will ease shortly and you can get to a physio.  I have been having some facetime sessions with mine but it is not the same. 

Take it easy, be kind to your hip and I hope that things start to improve for you soon.

 

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