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Mamie
@mamie

Posts: 29
Joined: Aug 14, 2017

end-stage hip arthrosis with NO pain?

Posted by @mamie, Aug 14, 2017

Hi. My problem has taken years to develop. After having pains down side of left leg and knee pain, I was sent to PT. Got worse, started “lurching” (Trendelenburg gait) when walking as left leg seemed shorter and I then started using a cane. X-rays taken 21/2 years later said I had end-stage arthrosis of hip. Since I did not have any pain in hip but just down outside of hip to knee, was told to try chiropractors and neurosurgeon for possible stenosis. Did that. No real permanent progress.

Was sent to PT for a year by doc who never looked at previous X-rays or ordered any. Started having pain in left knee and left lower back. This spring, PT said I might have glute medius tear on left side. I saw a different ortho doc and told that IF I had tear it would be fixed when I got my hip replaced posteriorly since I had a collapsed joint with AVN. I said but I don’t have pain but he said to get it done anyway.

I went to different doc who I later learned does anterolateral THR. She said that since pain relief was the MAIN benefit of THR, I would not get that benefit. However, she thought back and knee pain would get better if leg length was evened up. She could not promise if I could get off cane/improve gait because not sure how atrophied my muscles were and not sure how much ROM would improve.

Has anyone else has had anything similar or have any words of advice?

REPLY

Hello @mamie, welcome to Connect!

We have many members on Connect who have discussed having total hip replacements, but I was wondering if you would be comfortable sharing a bit more about arthrosis of the hip? You mentioned that you don’t have any hip pain, but do have pain on the outer part of your leg and to your knee.

@mamie, is your back pain from the change in gait and one leg being slightly shorter than the other? If the main benefit of a THR is pain relief, but you don’t have pain, what did your surgeon reccomend you do? Is it possible to strengthen your muscles as much as possible prior to the surgery?

Hi, @JustinMcClanahan. Thanks for the welcome. Yes, I did have pain on the outside of my left from hip point to outside of knee for years. That finally was fixed with 5 treatments of Class IV laser therapy. The pain I have now is lower left back pain and left knee pain from compensating because the hip joint is “stiff.” Apparently being fixed or immovable in the socket, it forces my pelvis/back to move as one unit when I walk. I’m told that I also am getting all bent around as I compensate for the shorter leg. The surgeon (and other docs I have seen) just look at the X-ray and say to get total hip replacement since it should provide better ROM than the little I have and correct leg length differences. However, the surgeon also says that she can’t promise I won’t walk without a cane or lurching stride after surgery since she doesn’t know if my muscles have atrophied too much. She has not scheduled me for any PT afterwards however.

So, I wonder if I should instead cancel surgery and ask for a PT person trained in “gait” correction or would that only work after the new joint can freely move? I hate to take on major surgery if the results are so “iffy.” Am I overthinking this or needlessly worrying?

I really know nothing about total hip replacements, but my husband had a difference in the length of his legs which was causing him back pain and problems walking. The doctor and chiropractor actually gave him lifts to put in his shoes that equaled out his leg lengths. Has anyone ever suggested something like that for you? They are very simple little wedges that can be one or multiples inside a shoe. Just a thought. I hope you find out the best solution. Jennifer

@mamie, I would like to invite @mnpat, @sma1952, @hosta, and @popolopo to this conversation to share their experiences with hip replacement. Mamie has concerns about getting a hip replacement to help fix her gait as a result of arthrosis. She currently does not have hip pain, but her surgeon says it may help with her gait. @mnpat, @sma1952, @hosta, and @popolop, what experiences did you have with PT and your walking gait after you had hip replacements?

@JustinMcClanahan

@mamie, I would like to invite @mnpat, @sma1952, @hosta, and @popolopo to this conversation to share their experiences with hip replacement. Mamie has concerns about getting a hip replacement to help fix her gait as a result of arthrosis. She currently does not have hip pain, but her surgeon says it may help with her gait. @mnpat, @sma1952, @hosta, and @popolop, what experiences did you have with PT and your walking gait after you had hip replacements?

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If you have no pain do not do it. I have had pain every day for two years now since the operation. I may be in the minority but you really are taking a chance.

Thanks, @popolopo and @jenapower The doc delayed surgery until after I see a specialist. She is confused about why there is no pain and worried that I have atrophied muscles that won’t improve the situation. Can anyone point to good exercises to restore atrophied gait muscles if one leg is shorter than the other? @popolopo, have you tried finding someone who does neural manipulation or has a Class IV laser? I have had pains in other areas reduced or eliminated with those two. @jenapower, thanks, I do have an extra pad in the shoe of short leg. Anything higher causes back and leg pain.

@mamie

Thanks, @popolopo and @jenapower The doc delayed surgery until after I see a specialist. She is confused about why there is no pain and worried that I have atrophied muscles that won’t improve the situation. Can anyone point to good exercises to restore atrophied gait muscles if one leg is shorter than the other? @popolopo, have you tried finding someone who does neural manipulation or has a Class IV laser? I have had pains in other areas reduced or eliminated with those two. @jenapower, thanks, I do have an extra pad in the shoe of short leg. Anything higher causes back and leg pain.

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Well, I can’t see a specialist for awhile so don’t know what to do. I understand that “in the old days,” they used to fuse hip joints to stop pain. If mine seems to be naturally fusing, I wonder if that is why there is no pain? I’m so confused. I was told by an ortho doc almost three years ago that with the joint broken down, nothing more would happen. But now I am told that my muscles are atrophying because of disuse since the wrecked joint doesn’t let them move so a hip replacement might make things worse. Why didn’t the ortho doc see that coming three years ago? With my lower back and knee on same side in pain and the right ankle of other leg hurting from the odd movement, I feel stuck between a rock and a hard place. Very disappointed with the medical profession.

@mamie

Thanks, @popolopo and @jenapower The doc delayed surgery until after I see a specialist. She is confused about why there is no pain and worried that I have atrophied muscles that won’t improve the situation. Can anyone point to good exercises to restore atrophied gait muscles if one leg is shorter than the other? @popolopo, have you tried finding someone who does neural manipulation or has a Class IV laser? I have had pains in other areas reduced or eliminated with those two. @jenapower, thanks, I do have an extra pad in the shoe of short leg. Anything higher causes back and leg pain.

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@mamie, that sounds very frustrating. I know first hand at what compensating for a bad joint can do to your healthy joints. I had arthritis in my right knee as a child and used me left leg for everything, which resulted in left ankle arthritis and eventually right ankle arthritis. So, I can understand your concerns about your other joints. Have you discussed this with your provider? While there may not be many options for your hip, have they talked with you about ways to preserve your other joints?

No provider to talk with. I was referred to a specialist and basically cut loose. I had asked if the specialist would then discuss the situation with the doc. The doc said no, the specialist would talk to me and I could go with the information wherever I wanted. The first ortho doc I saw before this second/last one said that his approach to hip replacement — anterior — would not work for me because my hip is so stiff and he would have to do a lot of tissue/muscle cutting which would negate the point of his approach. So he told me to look elsewhere as well. I feel very much as if I have been set adrift to find my own solution … or not.

@mamie

No provider to talk with. I was referred to a specialist and basically cut loose. I had asked if the specialist would then discuss the situation with the doc. The doc said no, the specialist would talk to me and I could go with the information wherever I wanted. The first ortho doc I saw before this second/last one said that his approach to hip replacement — anterior — would not work for me because my hip is so stiff and he would have to do a lot of tissue/muscle cutting which would negate the point of his approach. So he told me to look elsewhere as well. I feel very much as if I have been set adrift to find my own solution … or not.

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@mamie, I apologize that you are facing this situation. Unfortunately, we cannot promise or provide appointments at Mayo Clinic here on Connect, but if you are considering a second or third opinion and would like to contact Mayo Clinic, use this link, http://mayocl.in/1mtmR63. One thing I have learned as a moderator here on Connect from the members is that you have to continue to be your own best self-advocate and keep pushing until you find a provider who can help address your concerns.

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