Why continuing pain three years after a successful hip replacement?

I believe you need to look for an appointment in orthopedics. If conservative measures to address psoas (iliopsoas) tendinitis have failed, further imaging and diagnosis may be required. There is a surgical procedure to release an overly tight tendon, but I think other causes must be ruled out first.

I had the exact same pain years following my hip replacement in 2021, I had several steroid injections and another MRI to make sure the components where all in the proper place and they were, it turns out I have iliopsoas bursitis and it’s very tight , I had the release procedure done in December 2024 at Mayo by Dr Mario Hevisi , I think I spelled the last name wrong but so far it feels a little better I am doing PT three times per week to try and strengthen my hip/ legs and stretch the muscles I’m hoping in a few more months I will get more positive results .

Hello make an appointment with Doctor Mario Hevesi he is great and specializes in this procedure

It is rare, but it happens. In fact, it happened to my sister - particle disease. The prosthesis sheds tiny metal particles which the body sees as an attack. This leads to inflammation and degradation of the muscle and bone in the area and is very painful. The fix is a hip revision surgery. My sister went back to her surgeon who claimed everything was fine - 3 years of pain later, during a PT session, her pelvis and tibia both broke! Luckily, the hip revision surgery has worked and she is finally getting around without pain, although she will probably need a walker the rest of her life.

My wife experienced a similar situation! Have a Cobalt / Chromium test preformed; request it. Her orthopedic declined having it done, my wife saw her primary doctor and had her do it; Cobalt was 17.6 ( toxic) and chromium was over 9.0. Also check for a staph infection! My wife has had six hip surgeries now. One thing we have learned! Be a strong advocate for yourself! My wife also had a fractured pelvis from either the original surgery or when she was dropped in rehabilitation center; extreme pain until they finally did a revision; 9 later. I cannot say it enough! Be respectful yet a strong advocate; there is an answer for her issue! Good luck and once you receive the correct answer it would be nice to hear the positive results!

I have had pain since my hip replacement 3 1/2 years ago. I have gluteus medius tendonitis and a tear in my glute minimus which has led to some muscle weakness. I believe the tear was caused by the surgery and the tendonitis was exacerbated. I also have low back issues. L4/L5 or L5/S1 bulging discs or stenosis in particular can cause hip pain. Have you had an MRI of your lumbar spine and your hip/pelvis? Something that helped me for a while is dry needling from a PT . That activates the muscle for you and helped with the pain. Has anyone checked to make sure there was no damage to the superior gluteal nerve wwhich activates the hip abductors.

Hi,

Did you get tested by blood work? I see my PCP next week. I am preparing for a hip replacement and I am very sensitive to many things. I would like to do whatever testing I can upfront.

Yes, request a Cobalt / Chromium blood test; your Cobalt should not be any higher than .03 and I can not remember the Chromium levels but you should be able to check that or your primary should be able to tell you. My wife’s levels were elevated for 11 years and not by choice, a lot of continued complications from her first total bilateral. Just remember, be your best self advocate

I have been reading through your several posts, and see that yours is not a simple situation - between sensitivities, the trauma you suffered, hardware removal and the need for more surgery, it sounds to me like you need an orthopedic surgeons experienced in post trauma and complex cases. Do you have someone who meets that criteria?

I'm not sure why you would need to be tested for chromium and cobalt unless you currently have an implanted joint, but you could ask to be retested for sensitivities to the metals used (typical allergy is to nickel) and if they are going to use it, to surgical glue.

Perhaps I misunderstood, I thought you had an implant currently, if you do not then there is no need for a cobalt test! My wife too has lower back degenerative disk disease and goes to the pain clinic and they burn the nerves in that area, seems annually .