Lots has happened in the past 2 months: PT exercises definitely increased general leg strength but very little improvement in full weight-bearing on right leg. After one phone visit and an in-person visit with my surgeon during that time, I have done much more in-depth research. All along I have known about a small displaced fracture of the the greater trochanter but surgeon always said THAT would not be the reason for weakness and it would pose no problem unless it caused pain. Early on he vaguely mentioned that it COULD be repaired by going back in and inserting a plate but that he didn't recommend that and I basically dismissed that idea and forgot about it. At this last visit, he now says that, because it has taken this long to regain weight-bearing strength, he doubts any further improvement with PT and the only options he sees now are to accept permanent use of a cane or to undertake the surgery (which he describes as complex and resulting in a "big metal plate on the hip which would be felt under the skin" , with unlikely improvement in gait and with the danger of infection due to having to expose the prosthesis to open air, after it all healed safely.) He says he will be bringing the issue to the next joint review with his colleagues He also says he has only performed that (rare !) surgery once!!
But--- surely the surgeon's knowledge of anatomy would mean that all along he was aware of something I only realized after long, involved research into weight-bearing weakness in hip abductors: The muscle responsible for holding the opposite hip up during waking and with one-leg stance is the gluteus medius....whose point of tendon attachment to hip-bones is at the piece of displaced bone fragment, meaning it would currently have no real anchor and is only supported by the other gluteus muscles and tendons. Some of Mayo's own papers describe those various facts.
I am left concluding that my surgeon, all along, has had a very good idea we would arrive at this point but was hoping against hope I could somehow overcome the weakness. He does say there has been a little improvement in tests of my hip abduction but I think I know why he didn't recommend PT all along.
I am next scheduled for a phone visit with the surgeon in 6 more weeks and he will tell me what his colleagues' opinions are at that time. Unless I have managed to make major headway with strengthening in the meantime, I am going to say I want an MRI to determine exactly what is what with the gluteus medius! As far as that surgery -- NO WAY! Too little chance of desired results. I am still trying to remain positive about discarding the cane one day.......