Left hip pain and groin 3 years after posterior total hip replacement

Posted by scottjeffe @scottjeffe, Feb 20, 2020

2016 I had total hip replacement via posterior approach. 2017 I had total hip replacement anterior approach. The posterior approach side constantly hurts, but I get intense pain under load (walking, stair climbing, uneven ground), and the intense pain also makes it impossible to sleep at night. Is anyone else having my symptoms after total hip replacement? I now use a cane for stability, and an electric scooter for long distance travel after my fifth fall. I feel alone with issue, but I can’t imagine others don’t experience my symptoms? Am I all alone? I’m at my wits end, depressed, and now suffer with anxiety as a result of last hip pain. Help.

I had posterior TJR in 2018. I have the same symptoms as you. I just completed a battery of tests to determine the cause of my pain. I no longer really exert myself to avoid the intense pain. But just doing regular housekeeping activities triggers the pain for me. I am still steady on my feet but long walks, periods of standing or sitting trigger the pain. The doctors could find nothing wrong with me. They have sent me to PT for core, hip and glut strengthening. I just am in my second week of that. It is very frustrating. Especially getting people to believe me.

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@nancybb

I had posterior TJR in 2018. I have the same symptoms as you. I just completed a battery of tests to determine the cause of my pain. I no longer really exert myself to avoid the intense pain. But just doing regular housekeeping activities triggers the pain for me. I am still steady on my feet but long walks, periods of standing or sitting trigger the pain. The doctors could find nothing wrong with me. They have sent me to PT for core, hip and glut strengthening. I just am in my second week of that. It is very frustrating. Especially getting people to believe me.

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There’s something about the posterior approach to total hip replacement that that I did not experience with anterior approach. No complications with anterior, but nothing but problems, pain, unsteady on feet, fall due to pain with posterior

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Hoping someone else has some answers for us!!

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@scottjeffe I'm sorry to hear that each of you is experiencing this pain issue – I had 2 total hip & 3 revision surgeries – all posterior, and the nerve pain resolved after about a year, but after the original implants, there was numbness along my femur, clicking in the joint and other issues – all of which the original ortho told me were "Normal". But I wish I had been more assertive when I felt like the hips weren't "right" because it was a sign that they implants were shedding metal into my body, causing tissue breakdown & essentially poisoning me – it took years to recover from that after the implants were replaced.
My friend had pain such as you describe that was dismissed by the surgeon as unavoidable – she finally saw a neurologist who found there was scarring that needed to be corrected – I don't remember the details, only her frustration. She finally got relief after years of suffering.
If I have learned anything over the years as a patient, both for joint surgery & other issues, it is that you must be your own assertive advocate and insist on having your complaints taken seriously, and your situation explored.
What diagnostics has your surgeon done to identify the problem? Or have you been referred to someone else for help? Please don't give up hope for a solution.
Sue

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@scottjeffe

There’s something about the posterior approach to total hip replacement that that I did not experience with anterior approach. No complications with anterior, but nothing but problems, pain, unsteady on feet, fall due to pain with posterior

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Thank you for sharing. Are you still suffering, or did you resolve? If resolved please do tell. Thanks again.

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@sueinmn

@scottjeffe I'm sorry to hear that each of you is experiencing this pain issue – I had 2 total hip & 3 revision surgeries – all posterior, and the nerve pain resolved after about a year, but after the original implants, there was numbness along my femur, clicking in the joint and other issues – all of which the original ortho told me were "Normal". But I wish I had been more assertive when I felt like the hips weren't "right" because it was a sign that they implants were shedding metal into my body, causing tissue breakdown & essentially poisoning me – it took years to recover from that after the implants were replaced.
My friend had pain such as you describe that was dismissed by the surgeon as unavoidable – she finally saw a neurologist who found there was scarring that needed to be corrected – I don't remember the details, only her frustration. She finally got relief after years of suffering.
If I have learned anything over the years as a patient, both for joint surgery & other issues, it is that you must be your own assertive advocate and insist on having your complaints taken seriously, and your situation explored.
What diagnostics has your surgeon done to identify the problem? Or have you been referred to someone else for help? Please don't give up hope for a solution.
Sue

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Every bit of information helps me, and I thank you. It’s actually a very depressing situation.

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@sueinmn

@scottjeffe I'm sorry to hear that each of you is experiencing this pain issue – I had 2 total hip & 3 revision surgeries – all posterior, and the nerve pain resolved after about a year, but after the original implants, there was numbness along my femur, clicking in the joint and other issues – all of which the original ortho told me were "Normal". But I wish I had been more assertive when I felt like the hips weren't "right" because it was a sign that they implants were shedding metal into my body, causing tissue breakdown & essentially poisoning me – it took years to recover from that after the implants were replaced.
My friend had pain such as you describe that was dismissed by the surgeon as unavoidable – she finally saw a neurologist who found there was scarring that needed to be corrected – I don't remember the details, only her frustration. She finally got relief after years of suffering.
If I have learned anything over the years as a patient, both for joint surgery & other issues, it is that you must be your own assertive advocate and insist on having your complaints taken seriously, and your situation explored.
What diagnostics has your surgeon done to identify the problem? Or have you been referred to someone else for help? Please don't give up hope for a solution.
Sue

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Hi Sue and thank you again for your response and sharing your experiences. You’ve suffered quite a bit longer than myself, so I’m glad you finally found relief. May I ask how your medical providers determined you required revision surgery? My medical providers send me for X-ray and simply say everything looks as it should with no signs of loosening of prosthetic and send me on my way with anti inflammatory meds which do absolutely nothing for my pain.

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@scottjeffe

Hi Sue and thank you again for your response and sharing your experiences. You’ve suffered quite a bit longer than myself, so I’m glad you finally found relief. May I ask how your medical providers determined you required revision surgery? My medical providers send me for X-ray and simply say everything looks as it should with no signs of loosening of prosthetic and send me on my way with anti inflammatory meds which do absolutely nothing for my pain.

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@scottjeffe In addition to pain, the xray showed tissue abnormality along the femur, elevated chromium and cobalt levels in my blood, and other indications of metal poisoning,
all pointing to a failing metal-on-metal implant.
This past autumn, 7 years post-revision, I had substantial hip and groin pain again. After confirmation by the ortho that the implant is solid, I was diagnosed with bursitis. For the past 2 months, I have been walking multiple times a day on level ground and doing stretches twice a day. Now the hip aches, but is tolerable. Due to digestive issues from other health issues, I am a no-NSAID person, so I use ice and topical pain rub to ease things. I may eventually have to consider steroid injections, but saving it for now.
Sue

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@sueinmn

@scottjeffe In addition to pain, the xray showed tissue abnormality along the femur, elevated chromium and cobalt levels in my blood, and other indications of metal poisoning,
all pointing to a failing metal-on-metal implant.
This past autumn, 7 years post-revision, I had substantial hip and groin pain again. After confirmation by the ortho that the implant is solid, I was diagnosed with bursitis. For the past 2 months, I have been walking multiple times a day on level ground and doing stretches twice a day. Now the hip aches, but is tolerable. Due to digestive issues from other health issues, I am a no-NSAID person, so I use ice and topical pain rub to ease things. I may eventually have to consider steroid injections, but saving it for now.
Sue

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@sueinmn I have been living with bursitis for 8 – 10 years now, sometimes getting cortisone shots. The shots do not always help. When they don’t it is most often due to it not hitting the spot exactly, it’s sort of a “hit or miss” type of thing. There are doctors who do guided shots and those are generally successful. From what I have found, physiatrists do guided shots, maybe some orthopedists do also. I have not have a guided injection myself, but if I do choose to have one again I will.
https://academic.oup.com/bja/article/94/1/100/379382
The only times I have recovered completely have been when I was inactive due to being ill, or on vacation without access to exercise equipment. I have recently realized that my recumbent bike definitely seems to be a trigger.
JK

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I’ve had 3 surgeries now on my left hip, 1st one was the original thr (anterior) I had a low grade fever start within 6 hours of surgery & I started having extreme ripping sensation in my groin. I went to a new surgeon 8 months later & after numerous tests it was a diagnosis of staph infection & P-acne infection in my hip, I recvd both infections during the original surgery. Had everything taken out, iv therapy, no hip or femur for 19 wks then more tests then a new replacement surgery. I’m still suffering from the ripping sensation in my groin, I now have oozing from the posterior incision (not often now) & excruciating pain down my leg from my pelvis to my knee. I’ve been told by my dr regarding the latest mri that I still have a muscle that’s torn, tendons & ligaments are shredded but no one will repair any of it, dr’s keep blaming on loose hardware which from the latest ct scan there’s no infection or hardware issues! I’m at a lose now as to what any dr will do to help me with the pain!

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@tams84

I’ve had 3 surgeries now on my left hip, 1st one was the original thr (anterior) I had a low grade fever start within 6 hours of surgery & I started having extreme ripping sensation in my groin. I went to a new surgeon 8 months later & after numerous tests it was a diagnosis of staph infection & P-acne infection in my hip, I recvd both infections during the original surgery. Had everything taken out, iv therapy, no hip or femur for 19 wks then more tests then a new replacement surgery. I’m still suffering from the ripping sensation in my groin, I now have oozing from the posterior incision (not often now) & excruciating pain down my leg from my pelvis to my knee. I’ve been told by my dr regarding the latest mri that I still have a muscle that’s torn, tendons & ligaments are shredded but no one will repair any of it, dr’s keep blaming on loose hardware which from the latest ct scan there’s no infection or hardware issues! I’m at a lose now as to what any dr will do to help me with the pain!

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Let's try this again – I just typed a reply and it disappeared.
First, welcome to Mayo Connect – a community of people living with a wide variety of conditions, who share our experiences and try to help one another along the way.

I am sorry to hear that your hip replacement journey has been a difficult one. It is unfortunately not all that rare to suffer one or more complications – my own situation finally involved 5 surgeries for replacements and revisions, but I am happy to tell you that I have now been nearly problem free for going on 10 years.

Two suggestions for dealing with your current situation are
Locate a surgeon who deals with complex revisions. This is best done by contacting a large orthopedic practice or a teaching hospital for recommendations. If it is feasible, you may wish to contact one of the 3 Mayo facilities.
Locate a Physical therapist who has experience with revisions that include torn muscles, ligaments and tendons. These require special care and extra recovery time. My friend had to have a special girdle-like brace made to support her hip and torso during healing, which she was gradually weaned from wearing after many months. She also had over a year of PT with many progressive steps, and still does exercises every day. She is now able to walk long distances using a walker or cane (depending on terrain) with little or no pain.

This is not going to be easy – but you need to be persistent to get the help you need, and then to heal your body.
Good luck, and please let us know how you are doing.
Sue

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@sueinmn

Let's try this again – I just typed a reply and it disappeared.
First, welcome to Mayo Connect – a community of people living with a wide variety of conditions, who share our experiences and try to help one another along the way.

I am sorry to hear that your hip replacement journey has been a difficult one. It is unfortunately not all that rare to suffer one or more complications – my own situation finally involved 5 surgeries for replacements and revisions, but I am happy to tell you that I have now been nearly problem free for going on 10 years.

Two suggestions for dealing with your current situation are
Locate a surgeon who deals with complex revisions. This is best done by contacting a large orthopedic practice or a teaching hospital for recommendations. If it is feasible, you may wish to contact one of the 3 Mayo facilities.
Locate a Physical therapist who has experience with revisions that include torn muscles, ligaments and tendons. These require special care and extra recovery time. My friend had to have a special girdle-like brace made to support her hip and torso during healing, which she was gradually weaned from wearing after many months. She also had over a year of PT with many progressive steps, and still does exercises every day. She is now able to walk long distances using a walker or cane (depending on terrain) with little or no pain.

This is not going to be easy – but you need to be persistent to get the help you need, and then to heal your body.
Good luck, and please let us know how you are doing.
Sue

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Thank You Sue, I’ve reached out to a top orthopedic doc & I just had another round of scans, I’ll follow up with him next Wednesday, so hopefully we can get this resolved once & for all. I did have a very noticeable limp but with my physical therapist assistance over an 7 month time period I can say my limp is gone completely & I only need my cane when I’m walking a lot & my leg gets tired. My bloodwork test levels are hovering around the same #’s as when we found the first of two infections. But I’m trying to stay positive that there’s no infections & that maybe it’s just the muscle, tendons & ligaments causing the pain & nothing more.
Tammy

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