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Chronic bursitis, tight IT band and torn muscle after THR. What now?

Posted by nancyppp @nancyppp, 2 days ago

I had more pain after THR than before. 2 yrs later went in for exploratory surgery. Found out tight IT band was rubbing on bursa, causing chronic bursitis. Removed the bursa and loosened the IT band.

Also found a torn muscle, which surgeon fixed. Also found permanent internal stitches had come apart and surgeon removed a lot of "debris" as he called it.

6 weeks of PT and still painful - no real improvement. Very weak. Can only walk about 2-3 minutes before pain becomes too much and muscle gives out. Feels like muscle is too weak to hold my weight (I am not overweight).

Any ideas? What to do now? Should I go back to the surgeon?

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Mentor
Sue, Volunteer Mentor | @sueinmn | 2 days ago

@nancyppp A trip back to the surgeon for imaging would be a good idea (an x-ray won't show anything - you'll likely need an MRI or CT.) They might tell you they "have done everything we can" in which case you might aske for a referral to someone who specializes in revisions and complex cases.
I'm not familiar with IT band surgery specifically, but soft-tissue surgeries on ligaments and tendons often result in scar tissue formation, which is not very durable. Maybe this is causing the feeling of weakness you are
describing.
I have one question for you, based on your description of "debris" - do you possibly have a metal-on-metal hip implant? These can cause problems over time, and need to be replaced.

REPLY
1 reply
nancyppp | @nancyppp | 2 days ago
In reply to @sueinmn "@nancyppp A trip back to the surgeon for imaging would be a good idea (an x-ray..." + (show)
@sueinmn

@nancyppp A trip back to the surgeon for imaging would be a good idea (an x-ray won't show anything - you'll likely need an MRI or CT.) They might tell you they "have done everything we can" in which case you might aske for a referral to someone who specializes in revisions and complex cases.
I'm not familiar with IT band surgery specifically, but soft-tissue surgeries on ligaments and tendons often result in scar tissue formation, which is not very durable. Maybe this is causing the feeling of weakness you are
describing.
I have one question for you, based on your description of "debris" - do you possibly have a metal-on-metal hip implant? These can cause problems over time, and need to be replaced.

Jump to this post

Thank you for your response. It is not metal-on-metal. Surgeon said temp stitches dissolve prior to the muscles being fully healed so he uses permanent stitches. He did not say why those fell apart. He has only ever seen that once before. He cut a slit in the IT band to loosen it.
I wondered if I should contact him again or someone else. He said the x-ray looked fine but don't know why he didn't do an MRI or CT. How do I know if he specializes in revisions or complex cases as you mentioned?

I'm so frustrated. Everyone says how wonderful their hip replacement was. I am healthy, active (or was), of normal-to-under weight and 70 yr. old. No physical or health issues of any kind. I struggle to accept the fact that I can no longer walk more than a few minutes. With the use of a cane to take some of the weight off my leg, I can walk an additional minute or two, so it does help a little. I walk very slowly with small steps (even though I have long legs).

REPLY
1 reply
Mentor
Sue, Volunteer Mentor | @sueinmn | 1 day ago
In reply to @nancyppp "Thank you for your response. It is not metal-on-metal. Surgeon said temp stitches dissolve prior to..." + (show)
@nancyppp

Thank you for your response. It is not metal-on-metal. Surgeon said temp stitches dissolve prior to the muscles being fully healed so he uses permanent stitches. He did not say why those fell apart. He has only ever seen that once before. He cut a slit in the IT band to loosen it.
I wondered if I should contact him again or someone else. He said the x-ray looked fine but don't know why he didn't do an MRI or CT. How do I know if he specializes in revisions or complex cases as you mentioned?

I'm so frustrated. Everyone says how wonderful their hip replacement was. I am healthy, active (or was), of normal-to-under weight and 70 yr. old. No physical or health issues of any kind. I struggle to accept the fact that I can no longer walk more than a few minutes. With the use of a cane to take some of the weight off my leg, I can walk an additional minute or two, so it does help a little. I walk very slowly with small steps (even though I have long legs).

Jump to this post

In answer to your question about revisions - as a patient, I would ask. Doctors are usually willing to discuss options if approached in an inquisitive manner. The same for requesting an MRI or CT Scan.
My approach might be something like "Dr What's your name, before my hip went bad I was a very busy and active person. Now I feel like I'm ancient. Can you help me figure out why I am having these issues? If not, can you refer me to someone who deals with these kinds of situations? I really want to get my normal life back."

Let their response guide your next actions.
I hope you get a solution.

PS This approach just worked for me to convince an orthopedic surgeon that I was not "too old" for a complex rotator cuff repair surgery.

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