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.

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@bonniedeely

xrays will not help. you need a bone scan

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@bonniedeely
I read your post above and it is just like what I am going through. Do you have any updates from your post in Feb?
I had my THR in 2017, and had the persistent bone pain at the stem. 1.5 years later I was given the bone scan and it confirmed the stem was moving. My doctor said he had never had a patient have this issue. Aug 2018 I had the revision done. The surgeon said I had no bone growth around the implant. He was expecting to have trouble getting the implant out, but it came out with no issue, suggesting that my body did not grow any bone around the implant. He drilled further down the femur and put in a different implant. He told my husband after surgery that he put cement in this time, however in my follow up he said he did not put cement in it. I was non weight bearing for 7 weeks, and now I am in PT. Sunday I woke up feeling the familiar pain down where the new stem would be. I just finished with my PT session, and he spent a great deal of time working on my muscles. He could not find any knots where I am having pain. I had to abruptly stop PT because the pain was too bad. I am calling the doc today to get an appointment. My husband found this thread, and your post stood out to me. Please let me know if you have found a doctor that can help. I am 39 and not ready to give up on my active life style.

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@sunshine1124

@bonniedeely
I read your post above and it is just like what I am going through. Do you have any updates from your post in Feb?
I had my THR in 2017, and had the persistent bone pain at the stem. 1.5 years later I was given the bone scan and it confirmed the stem was moving. My doctor said he had never had a patient have this issue. Aug 2018 I had the revision done. The surgeon said I had no bone growth around the implant. He was expecting to have trouble getting the implant out, but it came out with no issue, suggesting that my body did not grow any bone around the implant. He drilled further down the femur and put in a different implant. He told my husband after surgery that he put cement in this time, however in my follow up he said he did not put cement in it. I was non weight bearing for 7 weeks, and now I am in PT. Sunday I woke up feeling the familiar pain down where the new stem would be. I just finished with my PT session, and he spent a great deal of time working on my muscles. He could not find any knots where I am having pain. I had to abruptly stop PT because the pain was too bad. I am calling the doc today to get an appointment. My husband found this thread, and your post stood out to me. Please let me know if you have found a doctor that can help. I am 39 and not ready to give up on my active life style.

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Hi @sunshine1124 – Welcome to Connect! It must be totally frustrating to still be in pain after your THR in 2017. I'm wishing you the best and hoping some of the members here who have had similar experiences can share some of their own advice. Wishing you the best.

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What can I do about pain from my stem in leg

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@dcurl

What can I do about pain from my stem in leg

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Hi, @dcurl, and welcome to Mayo Clinic Connect. I can imagine the pain is frustrating. Will you share a bit more background about what prompted your surgery, when you had it and how it went?

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@lisalucier

Hi, @dcurl, and welcome to Mayo Clinic Connect. I can imagine the pain is frustrating. Will you share a bit more background about what prompted your surgery, when you had it and how it went?

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Had total right hip replacement in 2011 also had revision on November 5. Put new stem in was doing really well till a few weeks ago now my thigh is very painful dr put in thicker and longer stem so what is going on and what will they do next

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I am soooooo glad I found this post. I had a total hip replacement done 25 years ago and at the 15 year mark I began to have pain I the front upper thigh. The pain is so bad when it happen that the leg will give out and I will fall. My doctor is a very good doctor and he works with me about it but it he cant see what the source of pain is, how do we fix it. The pain will only last for a short time but, when it does hurt, nothing can stop the pain except to stay off the leg. This is so disturbing to be in such pain that I am about to lose my mind. Not sure how much more I can take. It's not about pain meds. I dont want that. I just want the problem fixed. HELP!!!!!!

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@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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Hello everyone. 63yr active female. I too had hip replacement July 3rd 2018. Text book the doc said. Returned to work and within half hour "End stem pain"!!. Has not given in . Cannot work in a fast paced hospital environment if I can't walk. Very dishearting.
Total Rt Hip

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@genmunden

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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My gosh, another one. I'm so sorry to hear. Glad you wrote. I am Canadian female 63 still employed. End stem pain has not let up since December. Trip July 2018. Me too. I would like to know why so many are not cemented , fitted incorrectly, and no answers as to a fix.

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This is an all too common a complaint. The medical community should read this forum and change something about this procedure . I have it also for nearly 4 years. The X-ray often says nothing is wrong,

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I had my right knee replaced 10 years ago which has been fairly good with only minor problems. Seven months ago I had a THA (total hip arthroplasty) to my right hip. Both were resultant from accidents, the knee from a motor cycle accident and the hip from a fall.
I now am experiencing what my surgeon calls stem pain or end of stem pain. I am very tall, 6’7”, with very long slim legs.
After doing some research I have found that my condition is common among individuals with long slender femoral bones where the bone prior to surgery had a greater amount of flexibility than that of someone with shorter femoral bones. Now that I have a more rigid titanium stem inserted inside my somewhat flexible femor, as my bone tries to flex , the stem end pushes on the inside of the bone causing pain.
Under normal easy walking conditions I have very little or no pain but the leg just does not feel like the left leg and I cannot help but limp. It’s when I carry any extra weight that pain is felt. This is more severe if the weight is in my left hand to where when stepping with my right foot the weight is pushing diagonally across from left to right and causing the end of the stem to push on the interior femor. Anything which causes flexation such as stumbling, or a sudden shift of weight to my right side causes severe pain so much that I have to stop and let it subside before continuing on. If I carry weight more centered or in my right hand the pain is less. I have a very difficult time if I have to stoop over while walking such as under a low object. I am not real muscular but am not weak either. Does anyone know if muscle increase in my legs will lessen the stem pain? My doctor suggested a stationary bike since a tread mill causes pain. I am on my feet most of the day, sometimes in strenuous work. It’s not like I sit in an office all day. I do not take any pain pills and do not like to take pills.

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