Six weeks post op Help !!!

[skysue34]

  Is there anyone out there that can help?  I had the hip resurfacing on Oct 27 2008.  Today is Dec 8th and I am no better than I was before the operation.  The groin Pain is still there and actually it is worse than before the operation.  Has anyone out there had the same problems?  Please let me know.. I am desperate..  Thanks Sue

[Pat Walter]

Hi Sue

A few questions:

Who was your surgeon

What special problems did you have post op

Where your x-rays after surgery OK - was the acetabular cup and femur cap properly placed?

Have you talked with your surgeon about your problem? What has he or she said.

It seems you should be further along in your recovery unless you have really bad conditions pre op your surgery.

Pat

[wayne-0]

Hi Sue,
Because my condition was so bad prior to surgery Nov 7th my aductor muscels were/are super tight( almost like a steel cable). I have groin pain but only when I am strecthing that area. Every day is getting a little better for me but the strecthing in that area is only a little further every time( I'll take whatever I can get out of it  ). I don't know if your pain is constant or certain positions bring it on but I would listen to what Pat says and contact your doctor and let him/her know what is going on. Good luck and hope things turn around for you.
                                                Wayne-0

[dvander]

Hey Sue!

When I read your entry earlier today, my feelings went sad for you.  Pat has given you plenty to check out.  In the meantime, stay encouraged.

I am at the 3 weeks tomorrow, and I am dealing with extreme tightness on the outside of my lower leg and in my ankle.  It is somewhat discouraging, but realize that each one of us heals at different rates and with various problems.

Hope you see brighter days ahead!

Dwight V

[Shawn in Northern Ca.]

Hi Sue,
     I understand how you feel.  I had surgery on Oct. 29th and still feel really sore each day...but I do feel a little better each day.  You are not alone in that I am still not as good as I was prior to surgery but I know that day is coming soon!  Okay, according to my doctor and many other surface hippies it can take up to a full year to fully recuperate from this surgery.  I definitely feel humbled by this experience as well.  At 38 it was hard for me to swallow a walker for the first week.  Wow!  I think our brains feel we should be at one level but our bodies are going...not so fast there partner.  I guess my point is, as I am still using my cane, we too are going to get to that place where we feel better than prior to surgery.  It just may take us a little longer.  I just wanted you too know you were not alone in your feelings.  Shawn

[skysue34]

  I am so  new to this post that I really don't know who I am writing back to.  However Thank you to all of you for answering my post.(maybe I will get the hang of this soon)
Anyway I did have an appointment with the Dr. today and boy do I feel stupid!!  When he said that I was going to have hip resurfacing I just ASSuMEd(lol) that he meant the BHR  Well actually what he did was just cap the femural bone and not the other,  Iam not sure why especially since I still have the groin pain.Sooooo  He gave me a steroid shot and told me to come back in 3 to 4 weeks.  He really is unsure of why i am still having pain.  I would love to know what all of your thoughts are.  To answer a few of Pat's questions, I had a bad fall 3 yrs ago and really hurt my hip.  I went to the DR and was told that nothing was wrong, I continued to work ( I am a flight attendant) for the next 3 yrs untill I could stand it no longer, Finally I found a Dr. that would listen to me and here we are today. no better off than I was, and have been out of work since Sept. 21 ( I had an aurthroscope (sp?) first.  I guess I wil just have to play the wait and see game.  But I am getting very discouraged !!!!   Once again,  Thank you to all that answered my post, and I sure hope that you are all recovering nicely.  Best of luck to all and Happy Holidays to everyone.

Sue

[Bionic]

Hi Sue,

I sure hope the cortisone shot helps.  Was the shot in the hip joint or more superficial (in the groin)?  Did you have other symptoms besides the groin pain before surgery?  Did the surgery help at all?

[skysue34]

Hi Bionic,

 Yes, I had the shot in the grion area.  So far no relief, but I think that I need to be more patient.

 Before my surgery I had the groin pain, and if I sat for say a 20min car ride or around the house I had to be very cautious before I took my first step.  It was like my leg didn't work.And I had a pretty bad  limp untill my leg got use to the weight. But always the groin pain was there and it  would hurt, especially if I twisted or turned a certain way.
Also, if I squatted down, ( as you do alot of as a flight attendant)  I had a very hard time getting up.  It was like I was a 90 yr old woman.  At this point I really don't think that the surgery has helped at all.  However I am willing to give it a few more weeks..maybe I am just a slow healer.   

  Are you, or have you had the surgery?  And if so, how are you doing? 

Take care,

Sue

[stevel]

Hi Sue,

It seems that you received a partial hip resurfacing (femoral cap only), which isn't done much these days.  The existing socket must be OK for this device to work.  Usually if the existing femoral head is bad and cartilage is bad then the socket is bad also.  This necessitates a BHR or THR.  I bumped in a local who had his hip "resurfaced" but further inquiry showed that he had arthroscopy (1 inch incision) and some bone spurs and cartilage was removed.

[sroberts]

Who the heck does hemi resurfacing anymore? It's an antiquated technique with poor outcomes.

Sue-
In my opinion you need to talk to one of the top surgeons listed on this website and get their opinion. You can send xrays via email and get a quick response.

Who did your surgery?

spencer
rbhr 6/26/08

[skysue34]

  Hi Bionic,

  I read your story and it was enjoyable and also I feel bad for you and your pain.

I have come to the conclusion that the more active we were as a young adults, the more problems that we have as we age. It is like a footaball player, by the time he is in his 30's he is done, and when they hit their 40's, they can hardly walk !!!

  I too was active in sports until about the age of 44, that is when I hopped on my son's razor scooter and took off !!!  It was  fun until I came to the curb and did not know what to do. Needless to
 say I flew up into the air and landed on my right leg, I basically just accordianded my leg.  Heard things pop and was in a lot of pain.  Went to the Dr. the next day were he took an x-ray and said everything looked fine. Fast forward 3yrs later I could hardly walk more than 15 steps without having to stop and rest.  Decided to look for a different Dr. who did an MRI and found that my knee was all torn up.  Had surgery and had to be 8 wks non-weight baring.  2nd day home from that surgery, I got the crutch caught on a corner of the wall and fell very hard on my rt hip. Told the Knee Dr and all he said was that I was just fine.  Fast forward another 3 yrs with grion pain, lots of weight gain do to my  inactivity and just miserable at work (12hour days on my feet and also squatting several hunderd times a day!!! Not much fun!!!!   So you can understand that I am a little dishartened that I am not much better. 

 In all fairness to my Dr. He told me that when he looked at my x-rays of my hip, they looked fine.  But he went and ordered an MRI anyway.  That is when he saw a 3 cm tear in the cartiledge. So he thought that an arthroscope of the hip would be just fine.  I had that done on the 22 of Sep.  When I went back for my post-op visit he was not surprised that I was still in pain. He said that when he was scoping me he notice that the femural bone had a lesion on it and it probably needed to be cappped.  So we set up another surgery for a resurfacing (Oct 27th) and as I said earlier I just assumed that is was going to be a brh. But according
 to him today, He thought that the socket was ok,  that is why he just did the femur bone.  So I quess we will just have to wait and see.  Meanwhile I have been out of work since the 22nd of Sept and don't see me getting back to work anytime soon.  That is the scary part !!

Well that is my story and I am sticking to it !!!!   

 It sounds to me Bionic, that you are in good hands and have checked all of this out throughly.  You are much smarter than I.!!  I will look forward to hearing how you are doing in the coming months . 

Thanks again

 Sue

[KarenZ]

I have to say that I am with Spencer on this one, Sue.  If I were you I would send my x-rays and story to one of the experienced resurfacing surgeons on this website.  Based on the research I did for my surgery your predicament seems unusual.
Several of the surgeons will review your x-rays and give you a call free of charge.  I know Dr Gross will and I believe some others will as well.
I wish you all the best.  You are too young to be sidelined this way.  I know I am!
Be well,
Karen

[skysue34]

  Hi Karen,

  Thanks so much for your thoughts.  I really am so impressed with this website!!  Everyone is so helpful and has great ideas.  I will definetly take yours and Spencers advice and look into it.  I just feel bad for my Dr. because I really think that he has done what he thought was appropriate for the information that he had.  I am begining to think that there is something that is not presenting its self in the x-rays and MRI's.  Maybe these other Docs will see something that he has not.

  Again thank you caring.  I would love to hear how you are doing with you BHR and the story behind it.  Take care and Happy Holidays !!!

  Sue

[Pat Walter]

Hi Sue

I am a bit surprised that any doctor would still use a hemi-resurfacing any more according to what I have learned in the last 3 years. They don't normally work well and have failed in most cases.  That is why there is total hip resurfacing.  When you only get a cap on the femur bone - then you have a metal cap rubbing on bone in your acetabulum.  Normally, there is no way that any surgeon can revise a hemi-resurfacing to a full resurfacing since they have not used components that would have matching acetabular components.

The normal revision at this point would be to a THR. It is difficult to revise a hemi to a full resurfacing for most surgeons.  It is too bad that your surgeon did not explain this to you.  There is no reason I know of with total hip resurfacing available and FDA approved for a doctor to not give you a full resurfacing. 

Your surgeon must have had some reason to do the hemi-resurfacing.  Of course you can't sue him because it is a legitimate proceedure - but it is just not used much any more since it normally does not work well.

Lets hope in your case, you will be able to get rid of your pain and get on with your life.  My one suggestion would be that if you don't get rid of your pain - try to find a really expeirneced hip resurfacing surgeon to do a revision to a THR for you.  I would not trust a surgeon that uses old fashioned techniques -  he might try to give you an old fashioned THR.  You need at least a MOM  metal on metal THR, not an old fasioned metal, plastic small ball version.  Be very careful of your next move without getting a few different opinions from some of the top doctors on my list.  Many of them will give you free consultations.

I will keep my fingers crossed for you that you will recover and become pain free.

Pat

[skysue34]

Hi Pat,

 Read your post to me about 2 am this morning because I could'nt sleep.  After I read it I for sure could'nt go back to sleep.  I thank you for all of your knowledge and I am just going to start to put together a plan of action. 

 The pain in my groin is a little better today, but I know that it is due to the shot that I got yesterday.

 I have a call into the Dr., so far it has not been returned. It is still early in the day however.  I was also told that I had conciderable arthritis in the area and what I was going to ask him was could that be why I still have such groin pain?  Also, I was talking to my brother last night and he was under the impression that because I did have all this arthritis that the hip resurfacing really would'nt help that, that what I really would need to get rid of the arthritis would be a THR.  I would appreciate your thoughts on that.

 Well not to much else. I hope this post made sence.  Maybe that is why I have such a hard time communicating with the Doc's (lol)

Take care
 
 Sue

[obxpelican]

Sue,

Pat can correct me, but, arthritis of the hip is the loss of cartilage between your femoral head and your acetabulum.  The bone that is left has nerve endings that make it painful when you move your hip joint.  Cartilage is a smooth material that allows both sides of the joint to move freely, cartilage has no nerve endings that I know of.

A hip resurfacing effectively removes the two points where the nerve endings were rubbing together.  A total hip actually totally removes the neck of your femur and replaces it with a long post that has a ball on it.  

Both surgeries remove the arthritis condition, on the other hand your hemi-surfacing has left one side that is missing some cartilage and thereby is still causing you pain, except for now you have a metal ball contacting an area with nerve endings where the cartilage is not present.

Either operation replace the contact points with metal on metal and thus removes your pain.

A total hip replacement is not the end of the world, the recovery time is about the same as a HRS and the results are close to the same if your surgeon is going to use a large MOM device that has been mentioned on here.  The only big negative is if you're young you will probably need a revision in the future and the revisions are rougher than the original surgery, although in most cases you can have it done successfully.

We're glad to help you and we're happy that you're here.

Chuck

Also, I was talking to my brother last night and he was under the impression that because I did have all this arthritis that the hip resurfacing really would'nt help that, that what I really would need to get rid of the arthritis would be a THR.   
 Sue

[Pat Walter]

Hemi - resurfacings

Please note - they can NOT normally be easily revised to a total hip resurfacing.  The components to a total hip resurfacing must be properly matched together - then when they are installed it is criticial that they are installed at the proper angles for the hip to work proplerly.

There is no doctor I know of that would normally consider revising a hemi-resurfacing into a full hip resurfacing.  They would not normally use a hemi.

The only easy option available is to a THR.

No one should ever consider a hemi-resurfacing according to the experienced hip resurfacing surgeons I know of.  Either you get a full resurfacing or a THR.  You don't want to be opened up twice for major surgery.  Get it done properly the first time.

Also there is no way at this point to revision a poor hip resurfacing by another hip resurfacing.  The only option at this point is a THR.

Please understand this is very difficult stuff and there are not easily interchangable parts.  If you have a full hip resurfacing - then you can get a THR femoral component with a long stem to match your current cup.  The provision is usually made for that. 

Hemis are not easily convertable to full hip resurfacings.  That is very important.  I would never consider letting a doctor give me a metal cap on my femur without a metal bearing component in my hip.  They did not work well.  It was primarily used for AVN since only the damage was to the femur bone.  They did not work well in the majority of cases, that is why full hip resurfacing was developed.

Pat

[obxpelican]

I knew I read it somewhere about arthritis.... I am going to have to correct Dr. Gross   

http://grossortho.com/hipinfo2.htm





"The cartilage has no nerve endings in it and, therefore, any motion between cartilaginous surfaces does not cause pain. In a patient with arthritis, the cartilage wears away, debris is generated producing pain. As the cartilage wears away, bone becomes exposed. The underlying bone does have nerve endings in it and is not a good bearing material. Motion between bones without cartilaginous surfaces usually causes significant pain."

Thanks for the info, I enjoyed reading the information.



Chuck

Chuck,

If Sue still has cartilage in her acetabulum (as is commonly the case with femoral AVN), she should have no more arthritic joint pain.  A post-op x-ray should show whether a ring of cartilage surrounds her implant.  If it does, the pain probably isn't arthritis and is probably coming from somewhere else.

Also, I don't think the nerves in bone are primarily responsible for arthritis pain.  Rather, grinding bones give off chemicals that cause an inflammatory response in the surrounding soft tissues.

[Bionic]

Hey Chuck,

I think Dr. Gross is right.  No need to correct him .  The cause is bone rubbing against bone, but what is the effect?  Is the pain sensed by the bone directly or indirectly, via soft tissue inflammation?

Further research is required ...

[obxpelican]

Hey.... research it I want to read more.

 

Here is my hypothesis:  The bone on bone pain is that shooting pain that made me want to fall to the ground when I would try to walk, the nagging pain and major tightness I had even when sitting was inflammation related?

Ok now young man, you have till March to reasearch this stuff.  LOL

Take care.

Chuck