End of stem pain after total hip replacement

Posted by amber67 @amber67, Jan 5, 2017

I fell down stairs july 2015, fractured femor. Surgeon did a partial hip replacement. Had end of stem pain so they did total hip revision in may of 2016. It It has been 8 months and still having end of stem pain. Does anyone know of a treatment for this. I am still on a cane and walker. Thank you.

@JustinMcClanahan

Hello @amber67, and welcome to Connect.

I would like to introduce @mnpat, @grandmacheryl, @popolopo, and @sma1952, who have all had hip replacements and may be able to talk about their experience with recovery and pain related symptoms.

I am also inviting @success10, @chief917, @Adrainpalmer, @learningtolive2, to return and share their experiences with pain and recovery after a hip revision.

@amber67, would you mind explaining exactly what end of stem pain is? How are you getting around after your hip revision, other than the pain?

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No one has explained what end of stem cell is.

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@popolopo

I had a cortisone shot last week in hip area but did not help. Tramacet is really good for pain but I am worried about addiction. I have asked for cannibus oil but the medical profession is not ready for that yet.

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My situation is much the same,the hip replacement side is about 2cm longer. I am trying to arrange a bone scan. I walk in the morning for about 30 minutes with my walking stick but by afternoon pain has increased. Sitting on a regular chair is my best position . I sleep alright with zopiclone. I take gabapentin,Advil and tylenal. I am on no opiates but have tried cannibus oil but hard to get it. All my X-ray s are normal.

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@popolopo

I had a cortisone shot last week in hip area but did not help. Tramacet is really good for pain but I am worried about addiction. I have asked for cannibus oil but the medical profession is not ready for that yet.

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Just wanted you to know to that I do not take any opioids at all either, they make me sick. The only thing I do take is Tylenol and Celebrex. I tried the gabapentin it did not help at all. i had the bone scan and every x-ray scan test imaginable and I still do not know what is causing the pain. We live in Tennessee so there is no chance of us getting the oul you referred to. Did that help you at all? I'm going to the doctor in two weeks and maybe he will refer me to a pain clinic and we'll see what they say. Keep us all posted on how your bone scan comes out and if they find anything that's causing your pain.

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@popolopo

I had a cortisone shot last week in hip area but did not help. Tramacet is really good for pain but I am worried about addiction. I have asked for cannibus oil but the medical profession is not ready for that yet.

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Hello, I have just joined the group, have bone on bone right Hip, Pain, could not walk without cane, and Did try the cannibus hormone, CBD, very expensive, but had to try, NO HELP

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After a fall in November, 2016 I received a full left hip replacement. I attended physiotherapy which commenced in the January, 2017 at which time I started to experience stem tip pain in my left thigh sometimes to an extreme level. I have since had xrays, blood work and CT scan to ensure hip is secure and everything seems to be in place. This past weekend I have had one of the worst ever with the pain and was wondering if there is anything I can do other than of course the heavy duty medication to relieve such pain.

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Please keep us updated if you find anything. I have had every scan and every x-ray available, they still don't know what's causing the thigh pain. I have posted above so you can read all about my plight. I cannot take pain meds because they make me sick. I stay on a walker when I'm at home by
myself and a cane when I go out with my husband. I even had the revision surgery because the doctor told me that would cure my thigh pain. It did not help at all and I think it even made it worse. All the best, keep us posted

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@amber67

Please keep us updated if you find anything. I have had every scan and every x-ray available, they still don't know what's causing the thigh pain. I have posted above so you can read all about my plight. I cannot take pain meds because they make me sick. I stay on a walker when I'm at home by
myself and a cane when I go out with my husband. I even had the revision surgery because the doctor told me that would cure my thigh pain. It did not help at all and I think it even made it worse. All the best, keep us posted

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I also have pain as a result of left hip replacement in 2015. I take gabapentin but is not very good. Hot and cold packs help. Exercises do not help but I can walk with a walking stick not too bad. X-ray show nothing. Cannibus oil under my tungue helps ,tylenal 3 is also good but also hard to get because of opiod rules.

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@bonniedeely

I had hip replacement on both hips in 2010. I started to have horrible pain in middle of thighs. Doctor dismissed this because xrays, blood tests, etc showed nothing. Finally had bone scan and found that both of the femurs and the rods were not holding together at the tip of the femur, which caused end of stem pain. I have gone to the best hospitals, Hosp for Special Surgery in NY, doctors, etc. and there is nothing you can do about it!. One doctor, before doing another bone scan, said he has never seen this happen in both thighs. I believe it is the actual hip mechanism that was not suited to me. The doctor I went to last year said that this type of problem is not prevalent any more, which leads me to believe the companies who made hips replacements have changed problem. It has been 7 years, and I do get around, but out of nowhere, I pain returns. Because this does not happen that often, I think that hospitals and doctors do not care to find out how to correct this. I was told my one doctor he could replace hip, but would need to break femur.

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I dont know your age but i am 82. I also
have afib and copd. So they said that it would be risky for revision
Surgery,so he refered me to pain clinic,but I am also on blood thinner.I asked my pcp and he said due to the blood thinner it wouldn't do any good because I couldn't get the nerve block. I am at the point when you reach a certain age the drs dont care anymore

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I have had bi-lateral hip replacements. My left hip was replaced in 2015, and my right in 2017. Now I have bursitis in both hips, and the same pain in my thigh bones y'all talk about. I have days when I still need to use my cane because the pain is so bad I can barely stand. I feel very lucky that it's not all the time, yet I'm always afraid of it happening when I'm out somewhere without my cane. It has happened in the grocery store, thank goodness for the grocery cart. My doctor told me it's fairly normal, and can continue for up to 2 years. After reading everyone's comments, I'm not sure it will ever stop.

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@lynnmorgan0916

I have osteoarthritis, degenerative disc disease in my back. I have had bilateral total knee replacements in 2001, L5/S1 anterior lumbar interbody fusion in 2004, C3/C4 anterior interbody fusion in 2009, L1/L5 Posterior lumbar interbody fusion in 2009, Left total shoulder replacement in 2014, right total shoulder replacement in 2016, right total hip replacement in 2017. My recovery from the hip replacement was phenominal and I don't have complaints regarding the hip. I have been having issues with my back, had an MRI of the lumbar done in Dec 2017 which caused my back pain to get progressively worse. I had a caudal injection (Steroids) on 12/20/17, went to the ER had an x-ray and CT of the thoracic spine on 1/5/18, was told I had a compression fracture at T8 and/or an infection. Saw a neurosurgeon on 1/9/18 and was admitted to the hospital with intractable back pain. Had another MRI but of the Thoracic spine, to rule out the infection and possible fracture. Results are no fracture or infection. So went back to pain management, Had a"trigger point" injection at the T8 spot, immediately felt relief. Had Epidural Spinal Injections done on 01/30/18 at the T8 level and the Sacral-iliac joints on both left & right sides. Hoping to relieve pain in back and leg. Back pain is no longer the problem I still have leg pain in the right mid thigh area. Saw pain management PA on 02/14/18, described the pain to him and he diagnosed it as "IT band" pain. I had it injected with steroids that day with absolutely no relief. Prescribed physical therapy and went on 02/ 21/18 with exercises for stretching the back & core. This does seem to help when I stand, if I do these when I first stand up, I have very little pain. If I don't do these, I have pain that knocks me to my knees (almost). I take Tylenol #4- 1-2 tabs po prn every 6-8 hours for the pain, as well as Lyrica 75 mg twice daily, sometimes it is so severe, I have to take morphine 15 mg IR for the pain. I am also a diabetic on metformin 500 mg once daily, synthyroid 100 mcg po daily, diclofenac potassium 50 mg po twice daily, lipitor 20 mg once daily, citalapram 20 mg po once daily. Any idea what could be causing the pain?

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You had quite a bit of back problems.I have a L2facture bulging disc S1L5 fusion I do have thigh pain Dr.told me lts my nerves that go into legs because of fracture are being pinched I found stretching daily works well for me ,Ice when burny pain in groin When I fractured my back I refused surgery .I have bone spurs on hip joints that hurt when I walk but when I get past the pain I can walk with walker and it does,nt hurt that much I do have a high pain tolerance and take Tamadol when needed.

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I was loosing my Health insurance Dec 2013 due to obamacare so I elected to have a total hip replacement in Oct 2013. Three days after surgery, when at home, it felt like my leg was going to explode from the inside out. I was supposed to be at a rehab but the Ortho hospital messed that up but sent out a PT and a prescription for the pain. Finally on the third day I could make it past 5am. The pain didn’t stop as I got stronger. I complained at 6 mo, 1 year and 2 yr visits and he said nothing, and I mean no respose at all. Year 3 comes with exact same complaint “I continue to have severe pain mid thigh and from what I have read it is called end of stem psin.” He immediately said “yes, that is what it is so we need blood work and a nuclear bone scan”, which I did. A MONTH later I had to call him for a diagnosis. He called back in 5 min and said (get ready for this one!!!) … “ YOUR bone is too small for the prosthetic”! I asked what the fix was and he said revision surgery to put in a prosthetic that fits! The first surgery was $28k of which I paid $3600 because I still had good insurance. The fix was also $28k. I know that a surgeon has several sizes to choose from because obviously one size does not fit all but to blame it on my bone being too small is just ludicrous! He never responded to my complaints befor 2 yrs because there is a statute of limitations of 2 years in Indy. The bone scan shows bowing in the mid thigh which is where new bone growth is forming due to the trauma of stem movement of a cementless prosthetic. My guess is they didn’t do cemented prosthetic because I was only 54 and will probably need another surgery. I don’t take maloxicam because I had severe side effect where I thought I was having a heart attack. When I know I will be walking a lot I take a couple of extra strength Tylenol. Staying well hydrated helps the most so I drink a lot of water. I can definitely tell when I am dehydrated. Raw juices are EXCELLENT!! When I do my 10 day raw juice fast I feel no pain because I am drinking a gallon of juice (carrots, celery, spinach, cucumbers, apples, ginger, lemon) a day along with water. Smoothie (spinach, blueberries, almonds, acai, maca, bee pollen, hemp, coconut water or almond milk). I wish there was a better solution but I am going to have to wait for good medical plan or medicare to go through the revision surgery. I am disappointed that so many have had bad success even with revision surgery.

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@guipacker

Hello.
I am Will from Brazil. I am a 6th year medical student in here. My father has had a bilateral total hip replacement 2 years ago due to steroids (kidney transplantation). He is 60 now and experiences the exact same type of pain that you are describing. He is able to walk but experiences a 7/10 pain on a daily basis. He has had a bone scan, multiple MRI’s and blood tests to rule out infection and everything came back normal. As a medical student I feel completely powerless and saddened, as any medical professional can imagine. He has been treated with OxyContin and Lyrica (Pregabalin) with little success. His trauma doctors are unable to determine the cause of his pain but it’s the same type of pain as this other person is reporting in this thread.
Ant insight will be desply appreciated.

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You are describing my end of stem pain. My nuclear bone scan showed slight bowing of the femur, mid thigh, where the end of the prosthetic stem is located. From what he told me, slight movement of the stem against the bone is causing trauma where the bone respones with new bone growth. I am not sure how putting a smaller prosthesis would help and, from the responses here, on revision surgery, it doesn’t help. Staying well hydrated and raw juicing is my only pain medicine since I seem to experience all the rare side effects of prescription drugs.

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