Hi, just wondering if anyone has been able to resolve stem tip pain su

I was told by new orthopedic doctor about a year ago that he thought it was stem tip pain. So that was about 19 months post surgery. He suggested a bone growth stimulator as a possible help. I used it faithfully for about 6 months (3 hours per day) and thought I was feeling improvement but that was short-lived and I stopped.
What's funny is that I have multiple friends who all said it was the best decision they ever made and I regret having it done or at least having the older style implant which has a longer stem. But at the time I didn't know there were different types of replacements.

Hi, so I had a fairly easy initial recovery from my surgery on Halloween 2022. About 6 months later I began experiencing sudden weakness sometimes several times a day where the leg would just buckle with pain above my knee. Fortunately I never fell but came close on multiple occasions. The surgeon was no help. He xrayed my hip and said it looked perfect and showed no interest in figuring out what was going on.
I went four months dealing with this sudden buckling of my leg and finally contacted the physical therapist I had used post surgery. I went in to see her and after doing a few physical tests said she thought my back might be the problem. I have seen a chiropractor for 40 years and he adjusts me at L4/L5. She suggested an adjustment at L3/L4. I had one adjustment there and now nearly two years later have not had another episode of my leg buckling.
I do have pain in my mid thigh if I move fast laterally or walk briskly. Jogging is impossible which is frustrating because it was the main reason I had the hip done. The surgeon had assured me that I would be able to run.
A second orthopedic guy that I see now refers to my problem as stem tip pain. I'm able to do everything I need to do, just can't do what I want to do.
I'm self employed working 7 days most weeks so another hip replacement and the much longer recovery time as well as the fear I could end up worse makes it a very undesirable and unlikely
choice.

@leghurts54
Im curious if you have had any success with easing the stem tip pain? I was doing great with recovery from anterior THR, but around week 10 started to get severe pain mid thigh front. It seems to be area where stem ends. I've doing PT religiously since day 2. This is new pain that aches most of the day. I was assured this new hip would be a game changer, so Im pretty frustrated to be now getting this at 3 mos. I don't want the pain and certainly don't want a revision : (

@leghurts54
Im curious if you have had any success with easing the stem tip pain? I was doing great with recovery from anterior THR, but around week 10 started to get severe pain mid thigh front. It seems to be area where stem ends. I've doing PT religiously since day 2. This is new pain that aches most of the day. I was assured this new hip would be a game changer, so Im pretty frustrated to be now getting this at 3 mos. I don't want the pain and certainly don't want a revision : (

@emaries Hi, so my problem is intermittent. My surgery was in Oct of 2022, posterior approach, apparently with the older style, longer stem prosthesis. Pain when I experience it is mid thigh sometimes radiating up towards my groin. I do not have pain in my hip. Although hard to describe I sometimes have a feeling of weakness in the leg when I'm turning while bent over working and a weird inability to pick up my leg while bent over to pick something up. My concern is that I have more discomfort now than a year ago. But the pain up to now has never been bad enough to stop me from my normal daily routine. I'm self employed with two businesses working 6 or 7 days a week at 71. I joke with people that I can do everything I have to do but nothing that I want to do. Until I had the hip replaced I was a runner for 50 years. If I attempt to jog even 10 steps that's when I get sharp, deep pain in my thigh.
I'm actually going back (next week) to the person I saw post surgery for PT. Curious to get her opinion on what might be going on. I resumed working a month after surgery and because I'm so active stopped doing PT exercises. I have wondered if I simply didn't do the necessary work to build up my leg post surgery.
I certainly don't want another replacement when it seems the recovery time is quite a bit longer. But I also don't want to wait until I'm older and complications could be much worse.
It's frustrating because I have four friends who raved about their hip replacements and said I'd be so happy I did it and I've been less than thrilled.

@emaries Not @leghurts54, but the long-time owner of double hip implants, plus 3 revisions (not for stem pain.)
My first question is always - Have you discussed the issue with your surgeon? If not, I suggest you do so at once, so they can evaluate the implant and whether is is still healing properly.

Here is something they fail to stress enough when you are considering surgery - this is a "big deal" surgery, where they cut bone, disturb (even if the don't cut) tendons, muscles and nerves, hammer an alien material into your body and sew you together. That means healing takes time - sometimes as long as a year - before everything fits and feels normal. So even if you are up and walking, doing PT and going about daily life, your body is working hard to heal.

Some things to consider -
First, sometimes the process (cemented vs no cement), stem shape and length, and stem placement can cause the pain. That is why careful evaluation by the surgeon is needed.

Being very active after surgery has been cited as one possible cause for the pain. Try treating yourself as someone "in recovery" and rest your (elevated) leg whenever the opportunity presents, icing a couple times a day to reduce any inflammation that is present. Also, at 3 months post-op, ask your doctor if it is OK to use ibuprofen to relieve the pain, and try to stay ahead of it.

Finally, nerves may have been damaged or irritated during surgery. These take a LONG time to heal, and patience is the only treatment.

Have you tried rest, ice and less activity to ease the ache? In early days after my 2 hip replacements six weeks apart, I was determined to "get going" as quickly as possible - after all, I was a healthy 54 year old who had things to do! I really believe I hampered my own recovery with that approach. Twenty years and many other surgeries later, I know better, and I give myself time to heal.

@sueinmn Thank you for all the good info & encouragement. What were the 3 revisions for? I've heard it takes much longer to recover from those surgeries... is that true? Im really hoping I won't need that🙏
I have spoke with my surgeon who is a nice guy, but holds up xrays of his great work (I hope it's great anyway!). At what point does one request an mri or another scan to look at the bigger picture? Mine wants me to try a 6 day regime of Methylprednisolone. I'm hesitant as I've heard it only relieves inflammation temporarily, plus I don't like any of the side affects (higher BP, lack of sleep and higher risk of infection). I think I'm considering doing the ibuprofen a few days, along with your suggestion of icing & elevating like I did in the early stages. I'm also trying to do more massaging the area. I'll also shorten the amount of walking I try to do daily. I keep up with my pt as that doesn't seem to aggravate me too much. Plus it helps with the ongoing stiffness. Sitting and standing do seem to intensify the pain. I just want the mid thigh jabbing ache to end! You're right it is a big deal surgery, but to see others do so well makes me really wonder why Im having issues😩. I also have an extremely high pain tolerance, so if this hurts I know it's for real. Thank you again.

@emaries I had some thoughts after I replied this morning - for most of the first year after my first round of surgeries, most days I would get an ache that I described as "a toothache from my thigh to my toes." I finally figured out I felt better on "lazy" days, cut back on hurrying and pushing myself, and I felt better. At some point I realized the ache was gone and I could do pretty much whatever I wanted.

My original hip implants were of a sort called metal-on-metal (MoM), very rarely used now, and there was excessive wear on the components which caused high levels of chromium and cobalt to accumulate in my blood and tissues. Fifteen years ago the originals were replaced with titanium and ceramic components and the problem was resolved. Recovery was difficult, but mostly because my body had to heal from toxic levels of the heavy metals. The surgical healing was similar to the first round.

When it comes to recovery, three months is early days yet, so trying conservative measures for a few weeks is very reasonable unless the pain gets worse. Like you, I would probably resist steroid therapy at this time. My second orthopedic surgeon, the revisionist, was very good at explaining and convinced me that everyone heals at a different pace. He also said very active people tend to have more pain because they try to do too much, too soon.

I would also seek out a rehab PT who could analyze my gait, posture and foot position to see if there is something there that could be aggravating your leg. When I did that after my fifth surgery, the first thing I was instructed to do was replace my everyday shoes and NEVER wear flip-flops, slides or crocs. I was amazed at the difference that one change made.

When would I request imaging? Maybe at 6 months, or if things get worse.

Do you have access to a good PT, PhD who can do more than just give you a list of exercises and guide you through them?

My pain is mid thigh basically where the implant ends. I have no pain walking normally or going up stairs most of the time. Walking briskly 3+ physical or moving quickly ie: shooting baskets with my grandkids is a sharper pain that is usually more on the side of my thigh.
After a bone scan the orthopedic guy said the bone never grew properly around the tip of my implant. He says the stresses are not being distributed evenly and I'm feeling everything right at the tip.