When Surgery Is Recommended

There are several reasons why your doctor may recommend hip replacement surgery. People who benefit from hip replacement surgery often have:

• Hip pain that limits everyday activities, such as walking or bending
• Hip pain that continues while resting, either day or night
• Stiffness in a hip that limits the ability to move or lift the leg
• Inadequate pain relief from anti-inflammatory drugs, physical therapy, or walking supports

I Had A Total Hip Replacement And My Hip Hurts

Posted on:Dr. Frank Bohnenkamp

Its not common for me to hear a lot of complaints about pain after hip replacement surgery because a total hip replacement is one of the best surgeries a patient can undergo to get relief from a painful arthritic joint. 95% of the time, patients have wonderful outcomes, but sometimes, problems arise after a total hip replacement, and thats where my joint reconstruction experience can help .

A lot of hip replacements are being done, and they are increasing exponentially as the population ages, especially the baby boomers.

We also have better implants now and are doing them in younger and younger patients because the prostheses are going to last longer. With more hip replacements being done, we are expecting a rise in revision procedures too, it is predicted to go up 137% in the next two decades, which will have a significant impact on healthcare.

Before I delve into hip pain possibilities after total hip replacement, lets look at the causes of hip pain prior to surgery. Possibly, some if not all the pain a patient has before surgery is not a result of arthritis of the hip.

Research: Doctors Are Looking For The Causes Of Pain After Knee Replacement And It Is Hard To Find

The confusion as to what may be the cause of chronic knee pain after knee replacement is a cause of great concern not only among doctors but obviously among patients. We often find patients to be confused between what is normal and what is not normal after knee replacement.

• Is some pain normal?
• Are the clunking sounds normal?
• Is the instability normal?

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Your Hip Disability Makes Completing Routine Tasks Difficult

The most important factor you should keep in mind when youre deciding if you should have hip replacement surgery is how much your injured hip is affecting your life. Even if you can manage the pain, significant disability of the hip joint can make even the most routine tasks difficult or impossible, such as:

• Putting on your shoes or socks
• Walking normal distances

Controlling Hip Pain With Medications

Your doctor will prescribe pain medications for you to use. Keep in mind:

• The surgical anesthesia wears off gradually, and you may experience more pain after you leave the hospital or ambulatory surgical center . Opioids or other prescription pain medications may be necessary during this period.
• Over time, you will find that you need your prescription pain medication less frequently and/or at lower doses.
• Gradually, youll transition to only needing over-the-counter pain relievers. This may happen anywhere from 2 to 8 weeks after surgery. Everyone is different.
• Most people are eventually able to stop taking over-the-counter pain relievers, too. The timeline for this transition varies.
• Do not combine prescription pain medications with other medications, including sleep aids, without permission from your doctor or pharmacist.

If you have a history of addiction and are concerned about taking an opioid, talk to your doctor.

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How To Avoid Butt Pain After Hip Replacement

How can you avoid pain after hip replacement? Many times these tendon issues will be talked about on your MRI report. So look for terms like tendinopathy,tendinosis, or tendon tear in muscles like:

• Gluteus maximus

If you dont have an MRI, take some time to press on these spots:

Matis75/Shutterstock

If theyre tender, get an MRI to check if you have gluteal tendinopathy.

What Are The Risks Of Hip Revision Surgery

Keep in mind that hip revision surgery is a voluntary, but safe procedure. Unforeseen complications may develop that are associated with anesthesia, such as respiratory or cardiac malfunction. In addition, complications may arise with an infection, injury to nerves and blood vessels, fracture, weakness, stiffness or instability of the joint, pain, or the possibility of needing more hip surgeries.

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When Will My Hip Incision Heal

The incisions for a hip replacement surgery nowadays are very small and are closed up with absorbable sutures, explains Thakkar. The incision is covered with a dressing and takes about six weeks to heal. During this time, its OK to shower, but to reduce the risk of infection, bathing and swimming should be put off until the wound fully heals.

Gluteal Nerve Injury During Total Hip Arthroplasty

You may also have treated patients after total hip arthroplasty who present with a substantial Trendelenburg sign early post-operatively, that just doesnt seem to resolve in that first few months of rehabilitation. No matter what you do or how compliant your patient is, you just dont seem to be able to significantly change abductor strength or that gait pattern. That may well be out of your control. If your patient has quite profound abductor weakness and gait disturbance, start suspecting a nerve injury.

Abductor dysfunction following hip arthroplasty is sometimes the result of iatrogenic interruption to the nerve supply to the hip abductor muscles the superior gluteal nerve. Your level of suspicion will vary depending on surgical approach. A posterior approach may result in injury to the superior gluteal nerve or the inferior gluteal nerve that serves the gluteus maximus, but the rates of this type of nerve injury during a posterior approach have been reported to be low.16

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How Frequently Should I Schedule Follow Up Appointments With My Doctor Following Hip Surgery

Post-operative visits help your surgeon know that your hip is healing well. Make sure to schedule your first evaluation within the recommended timeframe indicated by your surgeon. This recommended timeframe is 4 to 6 weeks following your hip replacement surgery. Also request that any X-rays be sent to your orthopaedic surgeons office. Hip x-rays are typically taken the week of surgery, at 12 months and then yearly.

If you have a problem before you schedule your return appointment, make sure to call your doctors physician assistant immediately.

In addition to the first follow up appointment after discharge, this additional schedule is recommended:

• Three to six months following the date of surgery
• One year following the date of surgery
• Annually on the anniversary date of surgery

It is important to comply with this schedule and to see your doctor regularly for routine office visits to ensure safe and effective recovery from hip revision surgery.

Recovery Immediately After Surgery

Patients must spend a few days after surgery in the hospital. During this time, they will adjust to their new hip and learn exercises to help with their recovery.

Some health care providers suggest putting a pillow or other device between the legs of patients to protect the hip on the first day after surgery. They also provide pain relievers, such as opioids and nonsteroidal anti-inflammatory drugs, to relieve immediate pain after surgery.

To prevent pneumonia, doctors may ask patients to use a spirometer, a device that helps you take deep breaths and monitors your breathing. Basic physical therapy, such as walking with a walker, usually begins within one day of surgery. Patients also learn strengthening exercises before theyre discharged from the hospital so they can regain their strength and mobility at a rehabilitation center or at home.

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Metal Allergy Or Reaction

If your initial hip replacement was prior to May 2016, your surgeon may have implanted a metal-on-metal device . As these two pieces rub together during everyday activities, they can release microscopic metal particles into your body. This may lead to sensitivity or an allergic reaction in some patients. There are no FDA-approved metal-on-metal hip replacement components available today, but you may need a revision hip surgery if you had one done prior to 2016 and are experiencing symptoms of a problem.

Even if you did not get a metal-on-metal joint, you may still experience sensitivity to metal components that are used in hip and knee replacement joints. It is difficult to diagnose a metal allergy or reaction. However, talk to your orthopedic surgeon if you experience:

• large area of swelling,

Knee Pain Complaints In Women Over 50 Is It Really Knee Osteoarthritis Or Is It Hip Pain Back Pain Weight

Here is an interesting 2018 study centered on women over the age of 50.

The researchers of this study investigated the factors associated with the level of knee pain in community-dwelling women aged 50 years or older. The radiographic grade of knee osteoarthritis, presence of low back pain, level of hip pain, Body Mass Index and presence of depressive symptoms were significant factors associated with the level of knee pain in the study group. For women without knee osteoarthritis, knee pain was found to increase according to increasing age, BMI, level of hip pain, and presence of low back pain. For women with knee osteoarthritis, knee pain was significantly associated with radiographic grade of knee osteoarthritis, BMI, level of hip pain, presence of low back pain, and presence of depressive symptoms.

The question is. Women with knee pain without MRI evidence of osteoarthritis and women with knee pain with clear evidence of osteoarthritis. In this study the doctors warned to check the back, the hip, depressive episodes, and weight to determine the true cause of pain. This could prevent a recommendation to surgery that was not needed, worse, the wrong joint gets operated on.

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Why Is This Important

People with ongoing pain after knee replacement can become trapped in a futility loop. They do not seek help, despite believing they have a good reason to.

Improving the information given before knee replacement surgery could help. The authors recommend warning patients that they could experience ongoing pain. But patients need to be aware that while some pain in the healing period is normal, they should seek help if their pain persists.

It is also important that clinicians acknowledge and legitimise pain at follow-up appointments. This may encourage patients to return for care if their pain persists. Patients need information about how to access the healthcare services and treatments that could help them to manage their pain.

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What Should I Expect During The First Six Weeks After Discharge

During the first six weeks after discharge, you should be making progress week by week. Most patients are eager to report their progress at follow-up visits and are ready to move to the next level in their recovery. Most patients can accomplish the following during the first six weeks after total joint replacement:

• Walk without help on a level surface with the use of walker, crutches or cane as appropriate.
• Climb stairs as tolerated.
• Get in and out of bed without help.
• Get in and out of a chair or car without help.
• Shower using a tub bench once staples are removed as long as there are no issues with the incision.
• Resume your activities of daily living including cooking, light chores, walking and going outside the home. You should certainly be awake and moving around most of the day.
• Some patients return to work before the first follow-up visit. This is approved on an individual basis and should be discussed with your surgeon.

Icing and elevation

After a joint replacement, swelling is expected. Swelling can cause increased pain and limit your range of motion, so taking steps to reduce the swelling is important. Continue using ice packs or some form of cold therapy to help reduce swelling.

Sexual activity after joint replacement

Many people worry about resuming sexual activity after a joint replacement.

Resuming your diet

If youre not eating well after surgery, contact your healthcare provider about nutritional supplements.

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What Can You Do To Manage Walking Pain After Hip Replacement

Many patients ask for How is the Pain After Hip Replacement: What is Normal.

So, as we all know there is no measurement of pain. Many people experience less pain many have severe pain as compared to others. Although after Hip or any surgery, it is common to have some pain. However, your doctor will monitor your pain level often and help you manage the pain.

Since you are the only one who knows where and how severe your pain is, you have an important part in managing your pain. But here in this blog, we have tried to help you with how to manage your Walking Pain After Hip Replacement.

Problem: Difficulty And Pain In Kneeling

Most people had difficulty kneeling because of pain or discomfort in the replaced knee. Many patients described how this limitation affected their daily lives, including housework, gardening, religious practices, leisure activities, and getting up after a fall. Patients often adapted to these limitations by finding alternatives to kneeling, assistance from others, or home adaptations. Many patients had accepted that they could not kneel, however some still expressed frustration. Few patients had consulted with healthcare professionals about kneeling difficulties, and unmet needs included the provision of information about kneeling and post-operative physiotherapy.

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How Long Does It Take To Recover From A Hip Replacement

Recovery length from a hip replacement surgery depends on various factors and can take anywhere from six months to one year. Some factors that influence how long it takes to recover from hip replacement surgery include:

• Your age, nutrition and physical condition.
• The type of procedure whether it was partial or total hip replacement surgery.
• How closely you adhere to pre- and post-procedural instructions.
• Whether any complications occur during or after surgery.
• The strength of your bones and their ability to adhere to the prosthesis.
• Whether you qualify for minimally invasive hip replacement surgery.

The classic hip replacement recovery timeline is as follows:

How Your New Hip Is Different

You may feel some numbness in the skin around your incision. You also may feel some stiffness, particularly with excessive bending. These differences often diminish with time, and most patients find these are minor compared with the pain and limited function they experienced prior to surgery.

Your new hip may activate metal detectors required for security in airports and some buildings. Tell the security agent about your hip replacement if the alarm is activated.

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Painful Hip After Replacement

Total hip replacement is a highly successful procedure with more than 90% people having good or excellent results. Current evidence shows the hip replacement lasting 15 to 20 years in more than 90% of people. However there can be pain and other problems which may need attention in a small proportion of patients. Soft tissue related pain is the common reason for pain around the hip after total hip replacement. The reason for pain coming from the hip joint replacement itself are loosening, infection, instability, fractures, failure of bearing surfaces etc. Our surgeons are highly trained and are high volume revision surgeons with excellent outcome.

Soft tissue problems: Common reason for pain around the hip is soft tissue related problem. These can be due trochanteric bursitis/ Gluteus medius muscle tendonitis, Iliopsoas muscle tendonitis etc. Doing the hip exercises will usually ease the pain. Physiotherapy is commonly helpful. Rarely steroid injections are considered. If there is persistent pain in spite of adequate exercises then hip replacement will need to assessed with examination and investigations to identify the problem.

Occasionally the pain around the hip could be radiating pain secondary to low back problems.

Where Will I Feel Pain After Hip Replacement Surgery

You can expect to experience some discomfort in the hip region itself, as well as groin pain and thigh pain. This is normal as your body adjusts to changes made to joints in that area.

There can also be pain in the thigh and knee that is typically associated with a change in the length of your leg. This is one of the many reasons why its important to closely follow a physical therapy routine following your surgery. You will be asked to do various exercises during the day. Some patients continue to work with a physical therapist at home to learn how to correctly sit, stand, get out of bed, and walk. This process can be invaluable to get your mobility and strength back.

While it is common to experience some pain at the site of your incisions, new advances in technology have made this aspect of the procedure much easier. Smaller instruments allow for incisions of just three inches, rather than the larger incisions that were necessary in the past. This improved technique allows for less damage to the muscle and soft tissue. This can reduce the level of pain you can expect to experience after surgery.

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Pain A Year After Hip Replacement Surgery

gadget015263961 over a year ago

I had a total hip replacement on October 13, 2011. At first my recovery was going well. I went back to work four months after the surgery. Shortly thereafter I began to have pain in my groin, thigh, and buttocks. It has gotten increasingly worse ever since. The surgeon say that the x-rays look great, and that it healed perfectly, but can’t explain why I still have the pain and it’s getting worse. A bone scan was done and reveled nothing. I have days where the pain goes all the way down my leg and it starts to get numb. I’m worse off now than I was before the surgery. Has anyone had any of these symptoms? If so, can you tell me what was done to help you?

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