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What to do about thigh pain after hip replacement, anterior approach?

Posted by dfdelacio @dfdelacio, Apr 22, 2022

I had LTHR in August 2021 with an anterior approach.
I have had pain on the outside of my thigh about 1/2 down. The pain is a 7/10 anytime I am standing and or walking, even for short periods of time.
I am on narcotics for the pain management and yet still I have incredible pain.
I’ve had X-rays and MRI, and none have shown anything wrong with the hip joint.
I have had countless visits with a Physical Therapist at $40 a visit with no improvement.
Has anyone else had this problem?
If so, what helped?

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becky060599 | @becky060599 | Apr 27, 2023
In reply to @gussie "I had right hip replacement 5 years ago. Not a lot of pain after surgery. However,..." + (show)
@gussie

I had right hip replacement 5 years ago. Not a lot of pain after surgery. However, in the last two years pain, not in my groin where is was before surgery, but in my side hip and down my thigh. I have 15 inside stairs in my house and have trouble going up and down now. We thought it was bursitis and I have had a few injections into that site. It helped for awhile but not anymore. I just had an MRI last week and have a zoom with my ortho tomorrow. From what I could figure out in reading the MRI my implant looks fine. It's getting hard for me to stand when sitting also hurts if I lay on my side. I had read that 30% of people having hip replacement do get bursitis. The results didn't say anything about my bursa. I am full of osteoarthritis so maybe it's that. Also grabbing at straws here but my cardio changed my statins a few months ago so also wondering if that could be the cause.

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I was wondering the same thing. I am still having pain after 14 weeks and my doctor thinks it could be bursitis but I have been on statins for many years so I wonder if that has to do with it

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gussie | @gussie | Apr 27, 2023

I had switched from one statin to another around the same time this all happened. I had a zoom app. with my ortho this morning and asked him if this could be caused by taking statins. I kind of thought he would poo poo it and instead he said he was now treating another patient also a doctor that had exactly the same symptoms that I have. I just went off the statin I was taking even though it is not recommended but I was going to have to use a walker if this didn't get any better. It may take weeks or months to completely leave my system but I am desperate about what was happening. The other thing my ortho said was since my MRI didn't show much that it could be from my lower back.

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bbrebozo | @bbrebozo | Apr 29, 2023

I'm now 10 months post THR surgery and still having the thigh pain although sometimes it is much worse than other times for no apparent reason. I'm also able to "walk it off", meaning the pain is worst when I first stand up and lessens as I walk for a couple minutes.

I got a 2nd opinion from a different surgeon who also had no clue and seemed annoyed that I would even feel the need to get a 2nd opinion. Like "Go away, you are throwing a monkey wrench into our assembly line." After doing my own research I found a Mayo article that seems about right but who knows. It can be found by googling "Ipsilateral Inflammatory Neuropathy After Hip Surgery".

It's basically talking about inflamed nerves in the surgical leg occurring about a month post-op and not caused by physical damage to the nerve during surgery and which can be helped by use of immunotherapy drugs. The study is about 10 years old so you'd think there would be more current info but this is the best I can do for now.

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1 reply
bbrebozo | @bbrebozo | Apr 30, 2023
In reply to @bbrebozo "I'm now 10 months post THR surgery and still having the thigh pain although sometimes it..." + (show)
@bbrebozo

I'm now 10 months post THR surgery and still having the thigh pain although sometimes it is much worse than other times for no apparent reason. I'm also able to "walk it off", meaning the pain is worst when I first stand up and lessens as I walk for a couple minutes.

I got a 2nd opinion from a different surgeon who also had no clue and seemed annoyed that I would even feel the need to get a 2nd opinion. Like "Go away, you are throwing a monkey wrench into our assembly line." After doing my own research I found a Mayo article that seems about right but who knows. It can be found by googling "Ipsilateral Inflammatory Neuropathy After Hip Surgery".

It's basically talking about inflamed nerves in the surgical leg occurring about a month post-op and not caused by physical damage to the nerve during surgery and which can be helped by use of immunotherapy drugs. The study is about 10 years old so you'd think there would be more current info but this is the best I can do for now.

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A follow-up to my comment. I found a Youtube video of a Mayo doctor explaining study here: https://www.youtube.com/watch?v=av7oU29mBnM

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srwolfe | @srwolfe | Jun 19, 2023

I had my 6 th and 7 th hip surgeries. My two new ones caused by metallosis. My left side surgery was ok the last three months after the surgery. Until out of the blue i have like a charlie horse in the thigh. Painful and hard to put weight on it without severe limp.

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mvwaterskigirl | @mvwaterskigirl | Sep 10, 2023
In reply to @sueinmn "@bbrebozo Good morning - I'm sorry to hear you are having problems after your hip replacement...." + (show)
@sueinmn

@bbrebozo Good morning - I'm sorry to hear you are having problems after your hip replacement. I'm sure you will find some suggestions from others here on Mayo Connect who have similar experiences.

Let me start by saying I have had 5 hip replacement and revisions. Aside from the fact that my first 2 THR implants eventually caused a big problem for me, my first recoveries were uneventful. The revisions (5 years later) was not so happy. I had tissue in my thigh that was badly damaged by metal poisoning in that leg from the failed first implant, with muscle damage. As I recovered, I had severe pain in that thigh, and had to have a lot of extra PT and gait training. It also took a long time for the muscle to rebuild. Also hip replacement surgery, while seemingly routine, is a big deal - bones are cut & pounded on, muscles & nerves are moved around, and may also be cut or damaged, the change in the hip changes your body mechanics, so your other joints may need to be retrained. Finally every body heals at a different rate, muscles heal faster than nerves; nerves repair and regenerate VERY slowly - and we need to be patient.

If you have not had comprehensive PT since surgery, I suggest you ask your doctor to order it. Ask for a full PT evaluation of your body alignment, posture and gait, not just a routine "after hip" cookie cutter process.
Do you think the doc will do this?
Sue

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Sue do you mind me asking how you found out you had metal poisoning after your THR? Bloodwork? If so- what did they test for? I’m
Just shocked that docs don’t so metal allergy testing pre implantation /THR. !! Thx!!

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1 reply
Mentor
Sue, Volunteer Mentor | @sueinmn | Sep 11, 2023
In reply to @mvwaterskigirl "Sue do you mind me asking how you found out you had metal poisoning after your..." + (show)
@mvwaterskigirl

Sue do you mind me asking how you found out you had metal poisoning after your THR? Bloodwork? If so- what did they test for? I’m
Just shocked that docs don’t so metal allergy testing pre implantation /THR. !! Thx!!

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Hello and welcome to Mayo Connect.
This was not a metal allergy - there was a generation of hip implants, used in the 1990's and early 2000's where the femur head (ball) and the acetabulum (socket) were composed of chromium and cobalt, with no "cushion" of polymer between. The theory was that it would last longer in younger, more active people, so need for a revision would be far into the future (at the time about 15 years was the estimated time to revision.)

Unfortunately, unless perfectly implanted and aligned, the two surfaces wear against one another, releasing excessive quantities of chromium and cobalt ions into the body, which causes a condition known as metalosis or heavy metal poisoning. This can cause a wide variety of health issues - tissue breakdown, and affect heart, brain, thyroid, liver... The cure is to remove the offending implants, clean up the tissue damage, and use traditional implants in their place.

Over the next 6-12 months, the body rids itself of the excess metal ions and life goes on.

May I ask what brought you to Mayo Connect? If you have concerns about hip implants, there are many helpful people here who can share their experiences.
Sue

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