Chronic pain years after hip replacement

@heavyphil I have done MRI and EMG/Nerve conduction studies and they were normal. My quad is really stiff and my abductors are really weak. I'm trying to get botox to see if that will help loosen up my quad, which has been responding to dry needling. I've been to a few pain management doctors but they haven't been able to pinpoint the cause of the pain.

I'm seeing a physiatrist who is supposed to be one of the best around so we'll see what he says.

@loriesco warm thoughts for you as well. Best wishes for a great year ahead. I will try to move forward too. Take care.

@bekifft You have certainly put in all the work to get to the bottom of the problem.
I’ve heard great things about physiatrists so I hope that’s the solution for you.
Phil

Replacemen in 2017, acetabular revised in 2018 and not ok. The Drs say the implant is good but I know the Anterior approach in 2017 did not work correctly- Had fluid early on, could not do PT because of pain which led to revised cup which was impinged in front and surrounded with adhesions in 2018. The 2nd Dr really tried to help but is now on west coast. I have seen other Drs and they will not treat, I need new labs- they fluctuate. I have medication, had many injections. The injections are diagnostic and short lived. Twice worked up for psoas and clearly told it's not the problem. I will not go through a release and loose the functionality that I do have- The pain is relentless, asking for new labs and for the dr(s) to biopsy and/or explore surrounding tissue.
They claim the implant is ok, then it must be me reacting to the implant.

@heavyphil The physiatrist is supposed to be one of the best in town - he used to do the Portland Trailblazers and now he does the US Ski team. He recommended I start with three treatments of their focused Shockwave. It's a $100k machine that goes much deeper than the radial shockwave I tried before. I did my first treatment last week so we'll see how it goes. He also wants to do ultrasound next month to take a look at my stiff quad tendon and weak glute tendons.

@bekifft I also started aqua therapy last week. Mostly walking in the swim lane and doing some gentle strength training.

@heavyphil The physiatrist suggested I try their $100k Shockwave treatment as it is more powerful than the one I tried at my PT. I've done two treatments and will have a 3rd on Friday. It is too early to tell if it's working, especially because I can't take Advil while I'm doing it. I wonder if anyone on here has had success with Shockwave?

Also, the physiatrist is going to do ultrasound to look at my quad and glute tendons to check their health. I like your suggestion about seeing a neurologist, maybe they can help with my pain and recovery.

I had my THA left side two years ago. I’ve been a cripple ever since, EXCEPT for three months when I had total relief from pain and complete restoration of function. Let that sink in… These three months of which I speak were not consecutive, rather they were three separate incidents during which I was being medicated successfully. During the second of these three events, which are documented and in my file, I was able to take a trip to Switzerland, France, Italy and Germany in April 2025 without my cane. During the third event, I presented myself to the surgeon in person and demonstrated that I was pain free with complete restoration of movement. This is repeatable, except it requires a prescription which doctors refuse to provide. My case is ongoing. I had my hip aspiration yesterday. I already had a white cell test and am about to have a second. I am getting a “metal sparing CT”. I am seeing three different orthopaedic surgeons . One in Windsor, one at Henry Ford and soon one in London ON. I do not sport a tinfoil hat. I am a qualified person in the electrical trade with 30 yrs experience in diagnostics on the plant floor for Ford Motor Canada and I have patents, in the US and Canada. I know machines, and this old man’s body is a just a machine.

What is the medication? In the first instance cephalexin. In the second and third amoxicillin. Yes, I was treated for infection, hence the aspiration and the white cell test and the MARs CT.

The tests show no infection, but do not answer the question. I am going to see an infection specialist for the second time. What I am presenting to her is that I have a non standard low grade infection that the tests do not demonstrate. Tests, like the aspiration, are looking for streptococcus. They do not expose for instance low grade tuberculosis in soft tissue. The only way TB gets there is if you had TB and it passed to your hip area, OR… you were exposed during surgery.
Dr. Wayne North at Henry Ford said in effect that he may have to write a paper on this. We will see how that goes,

I do not have all the answers, but I can tell you that if I have cephalexin for 10 days, two capsules daily, I can go dancing at the club and golfing with the buds. And being pain free lasts several weeks before my carriage turns back into a pumpkin.

Alternatively, one amoxicillin daily, after approximately 30 days, same results, no pain and complete restoration of movement. The problem is they won’t give you anymore antibiotics, so you revert. This is not a good scenario.

I don’t know what to do, except PUSH on these doctors, and be very insistent.

I am getting weary of the ‘tinfoil hat’ looks from these people.

@aaronhurts.. My husband is going through much the same thing. He slipped and broke his hip 2 1/2 years ago. He had a hip replacement and developed an infection almost immediately. They had to remove the hip and put in a temporary antibiotic concrete spacer until the infection cleared up. After a couple of months they tried a revision. Infection developed then too. After a few weeks they tried to debride it, but it didn't help so they removed the new hip and put back another concrete spacer. His complication is that after the first surgery they had to leave the catheter in due to an inflamed prostrate. Catheter is still in and he is continuously getting UTIs and even went septic back in September. They discovered then that he had another infection in the hip and debrided again. This is a total of 6 surgeries on the same hip and he has been in constant pain. The incision from the September surgery is still not healed over completely and requires dressing changes every 2nd day as it is still seeping. He still has to use a walker around the house and if we go out to appointments he has to use a wheelchair. He is in constant pain from the hip. The surgeon does not want to do another surgery because he feels the same thing is going to happen again. And we don't want that either! The next step is hopefully to get the prostrate issue fixed and the catheter removed. We will then see what can be done about the hip. Good luck to you!!!

@towser I am so sorry for the both of you. That’s a lot of suffering. We are all in the same boat it seems. 🙁 I was awake most of the night, half worried and half symptomatic. My hip hurts, but the worst part is my aorta now has an aneurism and I am waiting to see how bad it’s getting, the CT scan is still 3 weeks away. I have no family history of it at all. I fear it was caused by the low grade infection in my hip. I already had heart surgery and I feel it’s infection moving to the valves. I think I’m a dead man. I can’t get help.

I was perfectly fine taking amoxicillin daily, and 28 days after I stopped it, I again became a cripple. And now my aorta. And the radiologist report says my pelvis has fractures healing. How the hell is my pelvis fractured! Except the infection is weakening the bone.

I don’t think I survive this, because the doctors and the system are rigid in their approach and my case is non standard. People like me, we just die. And they hand around my autopsy report to satisfy their curiosity.