Sqeaks, thumps and groin pain

[kriyamon]

I'd like this to be a bright cheery note about my 1 year surgical anniversary for a BHR from Dr. Ure.

But...I have never fully recovered from groin pain, and my hip flexors thump and my joint squeaks when I overdo it (and I'm not talking marathon running).  Dr. Ure says the xrays are fine and doesn't know why I'm having these symptoms.  He claims I am the first patient of his to report this.  OK, so I'm a statistical outlier.  My PTs, not PTs, my family doctor...so on and so forth really have no agreed upon diagnosis.  Rest helps but then it comes back.  I've had about 10 periods of squeaks in the past 6 months...

How do I get a real diagnosis???  It seems a real diagnosis would be fitting for a treatment plan.  I'm tired of being a guinea pig.

Kevin

[kb134]

Hello Kevin!!
Happy One Year man!!!  I've read your post, and I'm puzzled too.  I was going to leave it and wait and see any other replies to your post, but my "gears" are going now.  First and foremost - your X-rays are fine, so that is a good thing.  I'm not sure what you mean by your "hip flexor's thump[ing]."  Could you go into this a bit??   
My first thoughts and questions are -
Is your groin pain constant?  How painful on a 1-10 scale?
The hip is a synovial joint, and now that you have a resurfaced hip, some of the properties of a functioning synovial joint have changed. 
I post this just to ask questions - I'm not an expert.
Do you suffer from an arthritic condition?
Have you ever seen a rheumatologist?
What is your diet like?
Are you drinking enough water?
I ask only because we know why any metal on metal surface would squeek - lack of lubrication.  And if this is true in you, the question could be, why isn't your hip joint being lubricated properly?
Another question - though it is extremely rare, could your prosthesis be incorrectly matched?  If I remember right, the BHR had a recall some time ago, not because of a design flaw, but because of incorrect numbering that helped correspond the Femoral Component to the Acetabular Cup.
Another thought - How is your body weight??

Have you had a second opinion??  Have you considered sending your X-Rays to another doctor??  I'm in the process (I live in Western Canada) of getting a second opinion from Dr De Smet in Belgium.

We'll get this figured out man!  Happy BHR Day!!
Klint

[kb134]

I just read a post by Vicky and she was talking about a "psoas release," because surgery can really make the muscles and tendons tighten up.  Maybe look into that with your PT, if you haven't already.

[Kevin H]

Kevin

I will have my 2 year anniversary (BHR) in december and still have groin pain.  I sent my xrays to Dr Smet (surgery donr by Dr Su) and he recommends having blood work done to test for metal sensitivity which i am going to do at Dr Su's office in New York.  Dr Smet has been very responsive to my emails......wish I could be one of the success stories on here but the doctors are telling me that revision surgery is the option if I feel the condition is severe enough.

another Kevin

[obxpelican]

Kevin,

I am sorry to hear you are still fighting that battle with groin pain.

Have you ever gotten a straight answer from Dr Su as to why you need a revision?  Ask him to be very specific.  Early on I was hoping that it might have been a slipped cup that would allow him to just fix that.  I've heard about difficult dealings with Dr Su's staff, but usually not him.

There has to be some reason why you need a revision.... ask lots of questions and be the very best patient advocate that you can be for yourself.

Wishing you well.


Chuck

Kevin

I will have my 2 year anniversary (BHR) in december and still have groin pain.  I sent my xrays to Dr Smet (surgery donr by Dr Su) and he recommends having blood work done to test for metal sensitivity which i am going to do at Dr Su's office in New York.  Dr Smet has been very responsive to my emails......wish I could be one of the success stories on here but the doctors are telling me that revision surgery is the option if I feel the condition is severe enough.

another Kevin

[obxpelican]

Kevin,

This is not the time to be down about your problem, now is the time to fight!!!

I would get a 2nd opinion as it sounds as if Dr Ure is kind of stumped.  Just because he has never had to deal with a case like yours does not mean that other doctors have not dealt with that problem.  Sometimes it's good to get another set of eyes, brains and ears on a case for new ideas.

Please keep us informed.


Chuck

I'd like this to be a bright cheery note about my 1 year surgical anniversary for a BHR from Dr. Ure.

But...I have never fully recovered from groin pain, and my hip flexors thump and my joint squeaks when I overdo it (and I'm not talking marathon running).  Dr. Ure says the xrays are fine and doesn't know why I'm having these symptoms.  He claims I am the first patient of his to report this.  OK, so I'm a statistical outlier.  My PTs, not PTs, my family doctor...so on and so forth really have no agreed upon diagnosis.  Rest helps but then it comes back.  I've had about 10 periods of squeaks in the past 6 months...

How do I get a real diagnosis???  It seems a real diagnosis would be fitting for a treatment plan.  I'm tired of being a guinea pig.

Kevin

[kriyamon]

Hello Kevin!!
Happy One Year man!!!  I've read your post, and I'm puzzled too.  I was going to leave it and wait and see any other replies to your post, but my "gears" are going now.  First and foremost - your X-rays are fine, so that is a good thing.  I'm not sure what you mean by your "hip flexor's thump[ing]."  Could you go into this a bit?? It feels like very tight mucsle or tendons rolling over a bone...I can feel and hear a dull thump  
My first thoughts and questions are -
Is your groin pain constant? No, it is gone at rest, and worsens after "too much" activity How painful on a 1-10 scale?1-5,
The hip is a synovial joint, and now that you have a resurfaced hip, some of the properties of a functioning synovial joint have changed. 
I post this just to ask questions - I'm not an expert.
Do you suffer from an arthritic condition?Osteoarthritis, so they say
Have you ever seen a rheumatologist? Not since surgery
What is your diet like?I am diet concious
Are you drinking enough water?I think yes
I ask only because we know why any metal on metal surface would squeek - lack of lubrication.  And if this is true in you, the question could be, why isn't your hip joint being lubricated properly?
Another question - though it is extremely rare, could your prosthesis be incorrectly matched?  If I remember right, the BHR had a recall some time ago, not because of a design flaw, but because of incorrect numbering that helped correspond the Femoral Component to the Acetabular Cup.
Another thought - How is your body weight??Excellent...Dr. Ure screens carefully

Have you had a second opinion?? I had one BHR newbie surgeon tell me he didn't want to get involved Have you considered sending your X-Rays to another doctor?? Yes, but how?? I'm in the process (I live in Western Canada) of getting a second opinion from Dr De Smet in Belgium.Please tell me how to start

We'll get this figured out man!  Happy BHR Day!!THANKS!!
Klint

[kriyamon]

Kevin, how is it going with Dr. Su?

Kevin

I will have my 2 year anniversary (BHR) in december and still have groin pain.  I sent my xrays to Dr Smet (surgery donr by Dr Su) and he recommends having blood work done to test for metal sensitivity which i am going to do at Dr Su's office in New York.  Dr Smet has been very responsive to my emails......wish I could be one of the success stories on here but the doctors are telling me that revision surgery is the option if I feel the condition is severe enough.

another Kevin

[kb134]

Kevin - aka Kriyamon,
hey man, one step at a time, and the answers will come.  It can be a little difficult to isolate the actual problem, but it can be done, so don't be discouraged!!! 
From what I gleaned from your posts, we can estabish
1) your BHR makes "thumping" or "clunking" noises.
2) your BHR squeeks from time to time, depending on activity.
3) the local and surrounding area - muscles, tendons, etc.- can get quite painful.
4) You aren't getting the answers you need/want.
I'm wondering if the pain would exist apart from the "thumping" you experience in your hip.  As I've mentioned, I'm at just over 5 months post-op and I still get the "thump/clunk" thing, but minus the pain.
Are you able to separate the pain sensations from the noise?  Or maybe they are related.  I'm no Doctor, but you have to be able to articulate your symptoms very accurately to a Doctor, especially if he is far away. 
Has your Doctor discussed with you the possibiliy of your muscles/tendons rubbing against the acetabular cup's edge?  Apparently it doesn't take much for irritation and discomfort to happen.  Keep pressing.  Someone will have the answers.  I am really surprized that your Doctor - the Doc who performed the surgery - isn't investigating (his work) further.  Have you gone back to him again?

[kriyamon]

Yes talked to Dr. Ure on the phone several times, emailed him and saw him for a complete check in June.  I believe he understands symptoms completely but has no solution other than to wait until the two year mark and hope they go away.  He suggests possible bursitis or tendonitis about the pain, and said the squeaks happen sometimes as the join is "breaking in", but that it should go away.

I do not feel the joint thumping....the joint is squeaking sometimes. The thumping feels like muscles or tendons across bone or each other.  The pain is not specific to the squeaks and thumps, although I have significant;y more pain during the days surrounding times at which I get squeaks and thumps.

Good news is Dr. De Smet said to send him xrays after I sent him a simple email.

[obxpelican]

Hey Kevin,

Glad to hear you're getting a 2nd opinion, Dr DeSmet is another great doctor and it will be good that you get his eyes on your problem, sometimes that's all it takes to figure out what is wrong another set of eyes.



Chuck

[rob webb]

So what did Dr. DeSmet have to say?  I am 14 months out from left bhr with Dr. Ure and have the exact same symptoms.

R. Webb

[Pat Walter]

Hi R Webb

Interesting that you are having the same problem as Kevin.

Does Dr. Ure have any suggestions about what the problem could be?  Have you talked to him about it?  Just curious.

Pat

[rob webb]

Hey Pat,

I have not talked to Dr. Ure.  I also don't have any squeaks. 

R Webb

[Pat Walter]

Hi Rob

Sorry, I got my post mixed up.  I thought you said

"I am 14 months out from left bhr with Dr. Ure and have the exact same symptoms."  meaning you had the squeaking and thumps and bumps of Kevin.  Perhaps I misunderstood what you were saying.

Good Luck.

Pat

[John C]

Hi Rob,
It sounds like groin pain is the main issue? Has this changed with time; getting better or worse? Any correlation with different activities; skiing, martial arts, motocross, etc?  (For those who do not know Rob's background, he is a talented and intense athlete in many different sports, so you can bet that his new hip has been put through some intense paces.)

John

[rob webb]

Hey Pat,

You are right on.  I just meant to say that I have all of those symptoms except squeaks.  I cannot do a leg lift while lying on my back and it is hard for me to bring my knee to my chest while standing do to groin pain.

R Webb

[rob webb]

Hey John,

It seems to be getting worse.  Martial arts and nordic skating might agitate it?

R Webb

[John C]

Hi Rob,
Have you talked to John Koth (for everyone else, John Koth is an excellent local PT that works with a lot of top athletes) about this. I would bet that he would have some ideas about this that might be useful. If leg lifts are that painful, I would want to get going on a plan to deal with it ASAP. My only thought is that nordic skating must be stretching your psoas way beyond what it has done in many years, and it does sound like a psoas related issue. At the serious risk of sticking my non-medical foot in my mouth; if you do not find answers, it might be worth the costs of an MRI to see what is going on with the soft tissue in that area, to rule out bursitis or rubbing across the edge of the prosthesis. In most of my major issues (including my hip), x-rays proved to be pretty poor at diagnosing what was going on, and MRIs and C.A.T. scans have given immediate answers leading to solutions.
Good luck with getting this figured out quickly,

John