Atrophy of left obturator and piriformis musculature after THR

@bellatheball That's a disconcerting outcome to a surgery that was supposed to make you feel better.

Sometimes our bodies need complete retraining after surgery alters our gait, stance and balance. This needs to be done by a rehabilitation specialist in physical therapy.

Now that the surgeon diagnosed the issue, what was their suggestion for remedying the situation? Did they suggest a complete PT evaluation and a new course of treatment?

@sueinmn Thanks for the input.
The surgeon didn't diagnosis the issue, He dismissed me claiming everything looked ok on the x-ray.
A physiatrist ordered an MRI, which revealed the obturator and periformis musculator atrophy,
The physiatrist didn't make any recommendation telling me the problem probably preceded the surgery, which it didn't, since a prior MRI didn't reveal this problem. Her suggestion was to consult a hip replacement surgeon for treatment , Her specialty was tendons not muscles . She suggested a hip replacement surgeon in her ortho practice but I doubt any THR in the Philly area would give me a true diagnosis,Looking for a surgeon out of the area. Need recommendations. Thanks for any recommendations or suggestions,
I am in constant pain with difficulty walking.

@bellatheball Since the hip has already been replaced, if the implant is not failing, a hip surgeon may not be the best person to help you. I am surprised by the response of the physiatrist, I would have thought this clearly in their purview.
My best outcomes well for issues that lingered after surgery have come from physical therapy, but not of the common post-surgical "cookie cutter" type. My ortho surgeon was more proactive than yours, he referred my to a rehabilitation physical therapist. These highly trained PTs did a full assessment, then designed a personal program to train my gait, improve my flexibility, and strengthen my muscles.
If possible get a referral from your surgeon or physiatrist. If this is not an option, ask your primary. They will need the images and diagnosis from the physiatrist.

I am contemplating consulting an orthopedic. My research has lead me to believe this is a serious problem and PT may not be the best cource of action. I have a script for PT but some research indicates PT may not be the best course of action. Since my pain is significant, it may require surgery because of the muscle atrophy and pain.
I was fortunate to find this psyhiatrist , since doctors are reluctant to critique the work of another doctor and even see you as a patient.
I was , at least, able to get an MRI which revealed the muscle atrophy caused by the THR.
Thank You for your help and care.

@bellatheball
I have had a similar journey with THR July 2025. After some pain relief from shockwave therapy the difficulty walking continues along with glute atrophy. New imagining shows progressing nerve issues in my lumbar spine. Could yours be too?

i have an appointment with a neurologist next week, so it may be possible.
but I think the muscle atrophy is connected to the hip replacement. Research indicates the atrophy of the left obturator and piriformis muscles presents as sciatic but it is not sciatic. I believe the THR caused the problem.

@bellatheball
So sorry to hear of your hip replacement complications.
I have had hip surgery three times . 2 on left hip and one on right hip. It takes a lot of courage to get thru these surgeries and rehab. Sending healing blessings your way.