Pain post hip replacement

[Cruise1]

My wife had a hip replacement early Sept 2020. Her progress was slower than she’d hoped re walking distances due to bad weather and leaves on the ground. She is now finding that she is getting pain in the hip area and lower back when out walking sometimes and even getting up from a chair. Painkillers prior to walks don’t seem to help. Two weeks ago in all that cold weather she had a whole week pain free and felt great. Now the pain is back and although she goes out walking and doing the hip and back exercises, is obviously not enjoying the walks and has to make a real effort.

Anyone else had this problem?

She had both knees replaced several years ago and it was much easier.

[Leroy_HUL]

I hope that your wife has found relief by now.

As soon as I tried to go back to work, I started to have pain in my hip and mid-thigh. X-rays showed that the prosthesis might be loose. A bone scan showed possible infection. Two hip aspirations and Sinovasure tests confirmed it. Infection is the worst case scenario. As it turned out, the orthopedic found that it wasn't infected during the revision. There was anecdotal evidence that there may have been an impingement.

After the revision, I still had pain. It turned out I had a stress fracture in my femur. It may have been there after the initial replacement. I had a bone graft installed over the stress fracture because it would not heal. During this operation, it was discovered that I had an impingement and metallosis as a result. That caused another revision. I'm told that I likely have a tendon impingement today. The doctor offered to cut it loose.

Any of these can cause a lot of pain. I know that the prosthesis can settle too.

The unfortunate part is that there aren't many ways to diagnose the issue until a year or so after the operation. Bone scans have been the most useful. The prosthesis causes interference with MRIs, so MRIs aren't very useful. It missed the stress fracture. Her doctor could check for infection and heavy metals. If a person is tall, short, or over-weight, there is a greater likelihood of issues developing.

[Cruise1 in reply to Leroy_HUL]

Sorry to hear you had a rough time with your hip. My wife had an X-ray and eventually got a face to face appointment with her consultant (which lasted all of 5 minutes) he said there was no problem with the prosthesis and some of the pain was muscular and some pain from the sacro iliac joint. He will see her again on 12month anniversary of surgery.In desperation she is now seeing an osteopath who has ruled out sacro iliac joint problems. It is early days so will see if this helps. She is not sleeping well though and gets pain when sleeping on operated side and some pain when walking or getting out of a chair.

[Leroy_HUL in reply to Cruise1]

I can relate to how she feels. Pain when first getting up and walking is a classic sign of looseness (not trying to play doctor). The X-ray has to be taken in a specific way to detect it. My first orthopedic missed it.

If I may be so bold to make a suggestion, be persistent and forearmed. The first time I saw the orthopedic, he says to me, "Leroy, you don't have a problem." I had had an MRI already. A Chinese doctor had told me I had avascular necrosis. I looked at the MRI myself and searched the internet. I could see the obvious difference between the two hips. So, I asked the doctor, "What's all that black stuff in the MRI? and why is it different from my right hip?" He thinks a second and says, "Hmm...let me check that again." A few minutes later, he comes back and says, "Leroy, you have a problem."

I slept in a recliner for the first two or three months. It's suggested to put a pillow between your legs when sleeping in bed. It never helped me, but she might want to give it a try. My doctor insisted the pain was in my back, despite the MRI showing otherwise and gave me cortisone injections in my L4 and L5. It wasn't my problem, but that might be worth a try, if she can convince the doctor to have it done. A bone scan--at least for me--was the very best diagnostic tool. It is very sensitive to any problem but is not specific as to what the problem might be. It is only useful after the bone has grown into the prosthesis, about a year after surgery. An EMG is useful for picking up any nerve problem. Can she see a neurologist?

[Cruise1]

Seeing anyone during the pandemic is a problem. I live in the UK. It is difficult enough getting a phone appointment with a GP and their answer is painkillers, even advising taking them before pain kicks in! It took her 6 weeks to convince GP to get a further Xray done, a four week wait for the appointment, 2 more weeks for the results, then a phone appointment with consultant followed by a demand from her for a face to face appointment with another 4 week wait. Painkillers make her like a zombie, so she tries to avoid taking them if at all possible. She has even tried a TENs machine.She does sleep with a pillow between her legs and has done since surgery.