Question
My MIS THR was May 25, 2007.  Pain was intense immediately after surgery.  Got a little better, but any weight bearing was excruciating.  Had 3 weeks in-home physical therapy.  Had 8 weeks water therapy.  Pain level stays at 8-10 on weight bearing.  All summer I complained about the pain.  I was told I went back to work too soon (1/2 time after 3 weeks).  Then I was told I wasn't working hard enough in therapy.  On August 21, through MRI, they determined blood had been leaking into the hip cavity due to the blood thinner I was on, and it has pooled in the hip socket.  I finished the thinner on August 29.  Doctor has said the blood may, or may not, reabsorb into the body.  In the meantime, I am in constant pain on weight bearing.  He said if it does not reabsorb and get better in 6-8 weeks, surgery will be required.  He sent me for a bone scan yesterday to make sure he hasn't missed anything, and I do not have the results yet.  I am 48 years old, runner/walker/biker, and feel like I've made the biggest mistake of my life.  Have you ever heard of this before?  Does it ever get better?  Is it something I did to cause it?  It is wearing on me physically and emotionally.

Answer
Hi Michelle

When a person has a hip replacement it's imperative that they follow the doctor's orders to the letter.  The main problem is that shortly after the initial pain from surgery wears off, we feel that we can do anything.  You have to remember the replacement is NOT your own bone and you will always have restrictions.  But for most people, the idea of being pain free is enough.  As you well know, bone pain is horrible.  Normally the return to work is scheduled for half  days beginning 8 weeks post op, or longer depending on the severity of the surgery and the patient's level of healing.  Three weeks of post op and then returning to work is a very short time, and may not have been enough time for the muscles to heal properly so that return to work, in addition to the other things you had done earlier than recommended by your doctor may have caused some post operative problems, but that is not for me to say,  only your doctor can answer that.

The problem with pushing yourself is that sometimes dislocations can occur (as was the case with me one time, and I had to have a revision after only two years to fix it).  It was my own fault and I paid for it by having an additional surgery that could have been avoided only if I had listened to my doctor.  The problem, was that I felt great and pushed myself.

I would think that the leakage of blood is causing the pain in your hip, but since I am not a doctor that would be the question you need to ask him.  You might also ask, after the tests come back, how long it will take for the blood to be reabsorbed into your body, and if it isn't reabsorbed, what would the surgery he suggested entail?  Is it a new replacement?  Is it just drainage of extra blood?

Being active before the surgery and then going to being non active had to have been hard for you.  You have to remember that a THR is a major surgery and you must give yourself time to heal.  You may never be able to do some of the things you did prior to surgery, but your pain level will be decreased.  You'll need to find activities that you can do to substitute for the contact and pounding activities you did prior to surgery.  You might also want to look into finding a counselor for some emotional therapy.  It does help and I have used it many times when I had THR surgery.  It's not forever, and once you begin to heal and gain more and more of your independence back you'll see less of a need for emotional support.  Just give yourself time, and give your doctor the benefit of the doubt.  

The last thing that bothered me was when you were told that you were not working hard enough in therapy.  If a PT ever says that to you again, and you are in pain and you feel something is not right, trust yourself and how you feel, stop the session (you have the right to do that), and speak with your doctor about it.  

Hope this helps you.

Sharon Davis