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Severe Muscle Inflammation 7 years after Left Hip replacement
54-year-old male that had anterior left hip replacement back in Nov 2015 due to an accident. After the surgery I have developed pressure in that hip, feels like swelling or the replacement feel like its bulging especially at night and I have developed a limp. Since the surgery I also have what I call flare ups once or twice a month. These flare ups include severe hip and groin pain, stiffness. They happen out of the blue, one moment I could be walking fine and the next I develop pain. They usually last for several hours, and I will be stiff for a few days. My surgeon has downplayed it. About a 3 weeks ago I woke up fine and was just getting in the shower and started developing pain in the hip which increased to the point I could barely walk. I went to the emergency room and had a x-ray and a ct-scan and blood wok attempting to rule out an infection.
The x-ray showed 3mm lucency at the bone metal interface of the proximal lateral aspect pf the left femoral component.
The CT showed asymmetric atrophy of the left psoas muscle and gluteus Medius also asymmetric stranding along the left psoas and the anterior illopsoas muscles.
I was sent to a surgeon who sent me for an MRI and an ultrasound.
The ultrasound found no signs of fluid
The MRI found edema in the illacus and the iliopsoas junction.
At the moment I have severe pressure on sitting or laying down in the hip area, if I move to sharply, I get a sharp pain in the groin that radiates toward the hip. I am walking with a severe limp. I use my cane as needed.
The sports doctor that did my ultrasound. things it could be a few things.
1, Wrong size replacement
2. It was placed wrong
3. It's coming loose.
Just wondering if any has had the same issues and what the outcome was?
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@pyrotaz68 Welcome to Mayo Connect. I am sorry you are suffering so much pain, I went through a similar situation after bilateral hip replacement, and after revisions 11 years ago I am doing fine. Like you, I always had "issues" with the replacements, and a surgeon who dismissed me.
I have a couple questions to help lead us to some answers.
First, do you know what the components are of your implant? Your symptoms sound a little like I had, with a metal-on-metal implant that was causing tissue breakdown due to metal shedding.
Have you consulted a second ortho surgeon, since the first didn't seem concerned? It sounds like infection is ruled out, so you need some more exploration.
Sue
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1 ReactionI had a THR in ‘04…if I had your symptoms, I’d find a different doc. They excuse everything, mine was too long…I saw him for 4? yrs. He told me to get a lift in my shoe! What a crock. 16 yrs later, I had a rev, 2020. Here is a section of the Rev. report
This is an excerpt of the left hip rev.
You need an aspiration of the joint to rule out infection. I too would seek a new DR. Where are you located perhaps members of the group can suggest some DRs.
I am in a somewhat similar situation right now although I've not yet had the revision. I have many pains and disfunction since my THR in 2009. It was recently discovered that that hip implant is failing and is flaking metal off into my blood giving me cobalt poisoning. I would suggest asking any of your doctors to order cobalt and chromium blood tests and at the same time contact your original THR doctor to find out what material was in that hip implant. Heavy metals can damage tissue around the implant and cause many other symptoms including fluid around the implant. Tissue near the implant is often described as looking like gray oatmeal to compare with yours looking like grated cheese. If you have these metals in you it is important to have them removed so you need to rule this out. Know that you must advocate for yourself, I have found this is not an area doctors understand necessarily or want to discuss. Wishing you all the best on this path.
My son needs a left hip replacement and lives in Salt Lake City, UT. Can anyone on Mayo Connect recommend a surgeon there?
I had a total rt. hip 3+ years ago & Have pain and tenderness in the right hip anterior and inter groin areas.I return to the three times now only to be told last time there’s nothing wrong they truly like me there but do not want me to come back and used those exact words! I have had blood test for infections done twice x-rays done twice in MRIs recently that show nothing, I do not know what kind or size hip replacement I had but I will find out. When I get in my truck I have to get up on the running board with my left leg then switch around and assist my right leg up into the truck using my pants in my left hand, when the doctors lift my leg I feel no pain it only happens when I attempt to raise it on my own. Also I have developed a forward slouch in my posture that has gotten worse over time. Would greatly appreciate any input and or advice From anyone thank you in advance
How frustrating to have no answers in all this time! Your doctor's response just confirms what I keep saying about some Ortho surgeons - they feel their job is finished when they confirm that the implant has healed, is not loose, and is not infected. That can leave us hanging - wondering what to do next. I had the same experience after hip replacements 15 years ago, the surgeon had me convinced that what I had was "Normal" so I tolerated the pain for almost 5 years. Then I learned he was wrong...
The pain and tenderness could have a couple of explanations. If I had this issue today, as a much wiser and more assertive patient, I would do the following -
First, find out exactly what hip implant I have - Manufacturer, Model, and materials. There is a registry, so the surgeon can provide this info. It is your right to insist on it.
Second, if ANY of the contact surfaces of the implant are chromium or cobalt I would ask for metals testing to see if it is shedding into my body. Either your surgeon or primary can order this.
Third, I would research the implant on-line to see if it has been a problem for others. Ignore all the law firm ads and look for other entries about it.
Fourth, I would see a neurologist to see if there is a nerve impingement causing your pain. Also have your spine checked carefully, as back issues can manifest in the hip, and vise versa.
Finally, if all of these are "negative", meaning the implant is safe and sound, and there are no discernable nerve issues, get a referral for a evaluation and PT with a rehabilitation clinic - think, a place that handles complex rehab, not just post-surgery stretches and exercises. After 3 years, you seem to have a great deal of deconditioning (eg can't raise leg, slouch) that needs to be addressed.
Please don't give up and "just live with it" without exhausting every avenue. Do you have a sympathetic primary you can connect with?
Sue
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2 ReactionsGet a Koran method x-ray done.That uses computer graphics to check if cup is in alignment.
I want to thank you for your information and the tips you have given me. I have sent in a request to the hospital for the operative report along with the physicians notes, hopefully this will let me know what hip replacement I have.I did call the facility where the surgeon works to get medical records there and was told I needed to go directly to the doctor which is the one that told me the third time there they didn’t want to see me there anymore because there was nothing wrong. I do notice there is some atrophy in my right thigh In comparison to my left thigh.