1. < Joint Replacements

End of stem pain after total hip replacement

Posted by amber67 @amber67, Jan 5, 2017

I fell down stairs july 2015, fractured femor. Surgeon did a partial hip replacement. Had end of stem pain so they did total hip revision in may of 2016. It It has been 8 months and still having end of stem pain. Does anyone know of a treatment for this. I am still on a cane and walker. Thank you.

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Moderator
Justin McClanahan, Moderator | @JustinMcClanahan | Feb 4, 2019
In reply to @babarker "I had my right knee replaced 10 years ago which has been fairly good with only..." + (show)
@babarker

I had my right knee replaced 10 years ago which has been fairly good with only minor problems. Seven months ago I had a THA (total hip arthroplasty) to my right hip. Both were resultant from accidents, the knee from a motor cycle accident and the hip from a fall.
I now am experiencing what my surgeon calls stem pain or end of stem pain. I am very tall, 6’7”, with very long slim legs.
After doing some research I have found that my condition is common among individuals with long slender femoral bones where the bone prior to surgery had a greater amount of flexibility than that of someone with shorter femoral bones. Now that I have a more rigid titanium stem inserted inside my somewhat flexible femor, as my bone tries to flex , the stem end pushes on the inside of the bone causing pain.
Under normal easy walking conditions I have very little or no pain but the leg just does not feel like the left leg and I cannot help but limp. It’s when I carry any extra weight that pain is felt. This is more severe if the weight is in my left hand to where when stepping with my right foot the weight is pushing diagonally across from left to right and causing the end of the stem to push on the interior femor. Anything which causes flexation such as stumbling, or a sudden shift of weight to my right side causes severe pain so much that I have to stop and let it subside before continuing on. If I carry weight more centered or in my right hand the pain is less. I have a very difficult time if I have to stoop over while walking such as under a low object. I am not real muscular but am not weak either. Does anyone know if muscle increase in my legs will lessen the stem pain? My doctor suggested a stationary bike since a tread mill causes pain. I am on my feet most of the day, sometimes in strenuous work. It’s not like I sit in an office all day. I do not take any pain pills and do not like to take pills.

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Hello @babarker, welcome to Connect. I moved your discussion and combined it with and existing discussion titled, "End of stem pain after total hip replacement." I did this so the members who are discussing the very topic you wrote about would see your message and have a chance to respond and so that you also have a chance to read through some of the messages already posted and jump in where you feel comfortable. If you are replying by email, you can click on VIEW & REPLY in the notification and it will take you to where you post is now located.

REPLY
babarker | @babarker | Feb 6, 2019
In reply to @babarker "I had my right knee replaced 10 years ago which has been fairly good with only..." + (show)
@babarker

I had my right knee replaced 10 years ago which has been fairly good with only minor problems. Seven months ago I had a THA (total hip arthroplasty) to my right hip. Both were resultant from accidents, the knee from a motor cycle accident and the hip from a fall.
I now am experiencing what my surgeon calls stem pain or end of stem pain. I am very tall, 6’7”, with very long slim legs.
After doing some research I have found that my condition is common among individuals with long slender femoral bones where the bone prior to surgery had a greater amount of flexibility than that of someone with shorter femoral bones. Now that I have a more rigid titanium stem inserted inside my somewhat flexible femor, as my bone tries to flex , the stem end pushes on the inside of the bone causing pain.
Under normal easy walking conditions I have very little or no pain but the leg just does not feel like the left leg and I cannot help but limp. It’s when I carry any extra weight that pain is felt. This is more severe if the weight is in my left hand to where when stepping with my right foot the weight is pushing diagonally across from left to right and causing the end of the stem to push on the interior femor. Anything which causes flexation such as stumbling, or a sudden shift of weight to my right side causes severe pain so much that I have to stop and let it subside before continuing on. If I carry weight more centered or in my right hand the pain is less. I have a very difficult time if I have to stoop over while walking such as under a low object. I am not real muscular but am not weak either. Does anyone know if muscle increase in my legs will lessen the stem pain? My doctor suggested a stationary bike since a tread mill causes pain. I am on my feet most of the day, sometimes in strenuous work. It’s not like I sit in an office all day. I do not take any pain pills and do not like to take pills.

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Is there any bone supplement that will build bone mass

REPLY
owieann | @owieann | Feb 7, 2019

@popolopo @guipacker

I had a complete hip replacement in 2015 due to arthritis. I'm 51 years old.
All was well with my replacement until I started having pain in my mid thigh area for about a year now. It is a deep pain......hard to describe.....and noticeable when I put pressure on my leg, walk up stairs and also if I shift positions quickly. It is not always obvious but there are times when it comes on suddenly and the pain is so great it almost puts me on my knees.
I am an active person and exercise. I bicycle, swim, hike and do yoga. I am finding that exercise does not bring about symptoms and I refrain from exercise when there seems to be a flare up in the pain. I have not discussed the pain with my orthopedic doc. yet. I'm sure he would suggest physical therapy. I know that the left side of my body is weaker than the other and have been doing exercises for strengthing. So I'm not sure how helpful additional therapy would be.
I have been researching end pain. And the information I have found is very medical technical. What I did get out of it was that end pain seems relate to whether or not the replacement was cemented. And the findings showed that there was no difference in the pain experienced whether it was ananterior or posterior surgery. I need to find out if mine was cemented.
For me, right now, I'm am living with and working through the pain. I only take motrin 800 for pain and I try to limit how much I take....I like my kidneys and liver.
I know I'm not being much help here in providing usable info. but I guess it's reassuring to know there are others out there.
One thing I can also say is that after my surgery, my orthopedic doc said I seem to have soft bones which prompted me to get a bone scan. The scan revealed that I was within normal range. So I am not certain this is a contributing factor but I dont know what normal range is.......am I on the very edge of the low range?
I would like to have a better idea of what I dealing with because I maybe looking a a right hip replacement soon and I dont think I could live with this end pain in both legs.
Best wishes to all!

REPLY
1 reply
babarker | @babarker | Feb 7, 2019
In reply to @owieann "@popolopo @guipacker I had a complete hip replacement in 2015 due to arthritis. I'm 51 years..." + (show)
@owieann

@popolopo @guipacker

I had a complete hip replacement in 2015 due to arthritis. I'm 51 years old.
All was well with my replacement until I started having pain in my mid thigh area for about a year now. It is a deep pain......hard to describe.....and noticeable when I put pressure on my leg, walk up stairs and also if I shift positions quickly. It is not always obvious but there are times when it comes on suddenly and the pain is so great it almost puts me on my knees.
I am an active person and exercise. I bicycle, swim, hike and do yoga. I am finding that exercise does not bring about symptoms and I refrain from exercise when there seems to be a flare up in the pain. I have not discussed the pain with my orthopedic doc. yet. I'm sure he would suggest physical therapy. I know that the left side of my body is weaker than the other and have been doing exercises for strengthing. So I'm not sure how helpful additional therapy would be.
I have been researching end pain. And the information I have found is very medical technical. What I did get out of it was that end pain seems relate to whether or not the replacement was cemented. And the findings showed that there was no difference in the pain experienced whether it was ananterior or posterior surgery. I need to find out if mine was cemented.
For me, right now, I'm am living with and working through the pain. I only take motrin 800 for pain and I try to limit how much I take....I like my kidneys and liver.
I know I'm not being much help here in providing usable info. but I guess it's reassuring to know there are others out there.
One thing I can also say is that after my surgery, my orthopedic doc said I seem to have soft bones which prompted me to get a bone scan. The scan revealed that I was within normal range. So I am not certain this is a contributing factor but I dont know what normal range is.......am I on the very edge of the low range?
I would like to have a better idea of what I dealing with because I maybe looking a a right hip replacement soon and I dont think I could live with this end pain in both legs.
Best wishes to all!

Jump to this post

Do you still have the pain after 4 years? I have to work for medical insurance and just to survive. I cannot afford to take more time off for fear of losing my job so I suspect I will have to live with it. I work as a mechanic and due to my condition I am finding it difficult to do many jobs which were a piece of cake before.

REPLY
1 reply
popolopo | @popolopo | Feb 7, 2019

Yes,I am retired so money is not my biggest pain.. Doctors not much help. I need stronger drugs but have to beg for tramadol, medical canibas helps but not strong enough and expensive.

REPLY
owieann | @owieann | Feb 7, 2019
In reply to @babarker "Do you still have the pain after 4 years? I have to work for medical insurance..." + (show)
@babarker

Do you still have the pain after 4 years? I have to work for medical insurance and just to survive. I cannot afford to take more time off for fear of losing my job so I suspect I will have to live with it. I work as a mechanic and due to my condition I am finding it difficult to do many jobs which were a piece of cake before.

Jump to this post

@babarker
The pain I am talking about did not start until about a year and a half ago.
Recoperation from hip replacement was no problem.

REPLY
binblessed | @binblessed | Apr 24, 2019
In reply to @babarker "I had my right knee replaced 10 years ago which has been fairly good with only..." + (show)
@babarker

I had my right knee replaced 10 years ago which has been fairly good with only minor problems. Seven months ago I had a THA (total hip arthroplasty) to my right hip. Both were resultant from accidents, the knee from a motor cycle accident and the hip from a fall.
I now am experiencing what my surgeon calls stem pain or end of stem pain. I am very tall, 6’7”, with very long slim legs.
After doing some research I have found that my condition is common among individuals with long slender femoral bones where the bone prior to surgery had a greater amount of flexibility than that of someone with shorter femoral bones. Now that I have a more rigid titanium stem inserted inside my somewhat flexible femor, as my bone tries to flex , the stem end pushes on the inside of the bone causing pain.
Under normal easy walking conditions I have very little or no pain but the leg just does not feel like the left leg and I cannot help but limp. It’s when I carry any extra weight that pain is felt. This is more severe if the weight is in my left hand to where when stepping with my right foot the weight is pushing diagonally across from left to right and causing the end of the stem to push on the interior femor. Anything which causes flexation such as stumbling, or a sudden shift of weight to my right side causes severe pain so much that I have to stop and let it subside before continuing on. If I carry weight more centered or in my right hand the pain is less. I have a very difficult time if I have to stoop over while walking such as under a low object. I am not real muscular but am not weak either. Does anyone know if muscle increase in my legs will lessen the stem pain? My doctor suggested a stationary bike since a tread mill causes pain. I am on my feet most of the day, sometimes in strenuous work. It’s not like I sit in an office all day. I do not take any pain pills and do not like to take pills.

Jump to this post

I have to ask only, because I am in the middle of testing for this exact problem. I have had the pain since right after surgery. After 2 years of complaining a new doc took my old docs place. He examined my range of motion which elicited pain in my hip. But he was the only one who truly examined me and did not say " your xray doesn't show any change since surgery" instead he wanted to make sure it was not an infection i had bloodwork a little elevated. Had nuclear scan on hip then thigh and pelvis then an aspiration of hip joint fluid. None but a meniscule amt was found (which is good) and no one can locate the results yet. I have had bone scans 2 and xrays to compare with post surgery. Now I am being scheduled for an MRI. I have the same pain description as everyone else on here perhaps described a little better than mine plus, I have groin pain If I turn the wrong way or put too much pressure at the wrong time I get burning pain and spasms. I have heard there is a possibility that it could be a muscle tear? And someone mentioned if the stem was cemented in, it could be the difference. I need to check that out. Please everyone keep sharing and let your docs know this is not 1 incidence(you) there are many complaints out there. Who knows, perhaps one of them will do a study on it and come up with a solid answer.

REPLY
binblessed | @binblessed | Apr 26, 2019

I am not even sure I am on the right track here but after doing some medical research I believe all of us have end of stem pain. This can be caused by the type and/or width of the stem. Also whether or not it is cemented. There have been studies out there since the 90,s??? That begs the question....why dont our orthopedists know that it is stem pain and has been a problem for quite some time. I have also taken a survey HOOS it is a hip outcome document. My results were very sad. I am now in pursuit of my medical records to find out the brand, size, width etc. It appears a revision may be the only hope of being pain free. But how hard will it be to actually find a doc who understands what type and process (non cemented v cemented) needs to replace what I now have. If the end is too thick then what your bone would normally bear as weight isnt going to happen. If the end is not as thick and if it has some flexibility then our bodies continue to build bone around the end stem (normally). I will be finding out if my doc agrees soon.

REPLY
popolopo | @popolopo | Apr 26, 2019

Thanks for the research. The doctors need to get a copy of this,they need to change the way they do these. My experience with doctors is is you tell them something but you can't tell them much.

REPLY
1 reply
binblessed | @binblessed | Apr 27, 2019
In reply to @popolopo "Thanks for the research. The doctors need to get a copy of this,they need to change..." + (show)
@popolopo

Thanks for the research. The doctors need to get a copy of this,they need to change the way they do these. My experience with doctors is is you tell them something but you can't tell them much.

Jump to this post

Well, now the place I was going to worries me considerably they are not providing quality care nothing is there test results etc. Seems like docs ok but staff and process stink. Does anybody know of a really good hip guy in the Phoenix area. We live in the north off w bell rd and 67th ave in Glendale. I feel a little desperate at this point. I have very active grandkids coming to live. I need to keep up with them ya know? Whoever I go to, has to understand what I feel and what I have learned and what the outcome HAS to be. There is an implant that they are advertising as perfect for younger people. I want that one.

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