Re: ortho expert leg length

[Guest guest]

Here are my thoughts on leg lengths.

The condition of unequal leg lengths is called 'leg length

discrepancy' or LLD.

LLD can be hard to measure - both in the clinic with a physical exam

and during the surgery. The only true way to measure it is by taking

a full length standing x-ray called a scanogram which can show LLD of

2-3mm (1/10th of an inch). When surgeons, therapists, chiropracters,

etc measure someone during a physical exam - it's always a guestimate

(even if blocks are used). It's more important what the patient feels

when they walk (even or uneven) than what someone tells them from a

guestimate. A 'true LLD' is one that is measurable. An 'apparent

LLD' is one that the patient feels or has 'guestimated'- but is not

always due to a shorter leg. Sometimes the patient's pelvis is tilted

making one side feel longer.

In general, a LLD of 1cm or less is usually not noticed by the patient.

1~3cm is noticed and can be treated with a shoe lift.

Anything >5cm is difficult to tolerate and can lead to back and knee pain.

Equalizing leg lengths during a THA is always a challenging issue.

There are many techniques used by different surgeons to do this. The

longer you make the hip (and leg), the more stable the joint. Since

THA dislocations are feared by both patient and surgeon, there is

always a temptation to put in a longer(not larger) ball and make the

hip 'tighter' or more stable. This may create a LLD. It's always a

balancing act to get a stable hip with equal leg lengths.

When someone has hip arthritis with worn out cartilage and bone, that

leg usually becomes shorter because the ball moves up in the socket.

People with DDH or dysplastic hips, may have a LLD since childhood.

The hardest situation comes when someone comes in with two bad hips

that are both short. THA's are usually done staged - or 1 at a time

with a 3-9 month recovery period inbetween. So if the surgeon does

the first THA and restores the original hip length (and improves

stability), then the patient has an LLD until their next surgery. Not

everyone undergoes that second surgery because their health fails or

they don't want to go through it again. So now that person is

condemned to a LLD for life (and one bad hip). If both THAs are done

and the hips are left 'short' with no intervening LLD time period,

then there is a higher chance to have at least one hip which is

unstable.

To get to your specific question, since you feel like you leg is

shorter (not just because someone guestimated) it may be worth looking

in to. The main reason for a true change in leg length within a few

months of surgery would be what's called 'subsidence'. This means

that the femoral stem may have 'settled' or sunk into the femur. It

was a common problem with certain older hip designs. To avoid this

problem, surgeons used to make all patients with uncemented hip stems

be non-weight bearing for many weeks to allow the bone to grow into

the stem porous surface and hold it in place. It was also thought

that too much 'micro-motion' because of weight bearing would lead

failure of the bone to grow into the stem. Over the past 5 years,

many surgeons have begun to let patients walk with full weight bearing

immediately after surgery because 'subsidence' and 'micro-motion' seem

to be less feared. A hip with mild subsidence which is still stable

is usually treated with observation or a shoelift. Those that subside

to the point of instability or intolerable LLD can get revised to

another implant.

It is possible that your stem subsided. You can't tell subsidence or

leg lengths by looking at an AP & lateral view x-ray of one hip(the

usual clinic visit follow-up x-rays obtained). The best way to to

tell is to compare x-rays from right after surgery to current ones.

The surgeon can measure from a fixed point on the stem to a fixed

point on the femur(usually greater troch or lesser troch) and compare

the two measurements (with correction for magnification difference).

A good way to check for a LLD without a full scanogram is to take an

x-ray of the whole pelvis and compare the heights of the lesser

trochanters. With the new world of digital x-rays, it can be harder

(or easier for some) to figure this out.

Other reasons to get a shorter leg after a THA are:

- polyethylene wear (doubtful after only a few months)

- ceramic fracture

- socket component migration

- dislocation

(all unlikely for what you describe)

The final thing may be that this is only an apparent LLD that you

feel, and a scanogram x-ray would show no true LLD. If this is true,

then you may benefit from a small shoelift to adjust to your comfort

level - check with your surgeon first.

Hope this answers your question.

BTW, I would personally stay away from any chiropractic treatments

until I'm fully recovered from an major surgery I undergo (3-6 months

usually for a TJA).

On 6/2/05, goldspitzer <goldspitzer@...> wrote:

> Ortho Expert

>

> I really appreciate the contribution you are making to this board.

>

> I have a ? for you. I am a 57 year old male. I have had a RTHR on Feb

> 16, 2005. Everything seemed to progress well. Before the operation it

> seemed my leg would sink into my hip as i walked. My chiropractor

> always found my right leg short. After the operation I felt like I was

> riding high on the right side and no sinking feeling and my walk was

> getting better considering the normal post op pain . I had great weight

> bearing on the right side even the first time up I could feel real

> solidness in my hip. At 7 weeks I had a chiropractic adjustment and my

> chiropractor was impressed. My right leg length was even with the left

> side. At 12 weeks post op I had another chiropractic adjustment and by

> then I had a short right leg and that high riding feeling was gone. I

> am now about 15 weeks post op and it seems my right leg is shorter and I

> have that sinking feeling into the hip while walking. My walk is not

> improving. x rays show that the implant is OK. and there is no

> additional pain from the hip implant area. I have had no impacts or

> accidents. I have an Oxinium implant with a 32 mm head.

>

> What happened to my leg length?

>

> goldspitzer

>

>

>

>

[Guest guest]

Orthodoc,

Thanks for your valuable information on LLD. My question is: when attempting to match leg lengths when the second hip is replaced, how much of a concern is there for "foot drop" to occur as a result?

My OS feels it isn't much of a concern because my LLD is not over the mm. length of discrepancy that would lead to foot drop. (I can't remember what number he gave me for that mm. length).

What are your thoughts about this? Thanks for any information.

Re: ortho expert leg length

Here are my thoughts on leg lengths. The condition of unequal leg lengths is called 'leg lengthdiscrepancy' or LLD.LLD can be hard to measure - both in the clinic with a physical examand during the surgery. The only true way to measure it is by takinga full length standing x-ray called a scanogram which can show LLD of2-3mm (1/10th of an inch). When surgeons, therapists, chiropracters,etc measure someone during a physical exam - it's always a guestimate(even if blocks are used). It's more important what the patient feelswhen they walk (even or uneven) than what someone tells them from aguestimate. A 'true LLD' is one that is measurable. An 'apparentLLD' is one that the patient feels or has 'guestimated'- but is notalways due to a shorter leg. Sometimes the patient's pelvis is tiltedmaking one side feel longer.In general, a LLD of 1cm or less is usually not noticed by the patient.1~3cm is noticed and can be treated with a shoe lift. Anything >5cm is difficult to tolerate and can lead to back and knee pain. Equalizing leg lengths during a THA is always a challenging issue. There are many techniques used by different surgeons to do this. Thelonger you make the hip (and leg), the more stable the joint. SinceTHA dislocations are feared by both patient and surgeon, there isalways a temptation to put in a longer(not larger) ball and make thehip 'tighter' or more stable. This may create a LLD. It's always abalancing act to get a stable hip with equal leg lengths.When someone has hip arthritis with worn out cartilage and bone, thatleg usually becomes shorter because the ball moves up in the socket. People with DDH or dysplastic hips, may have a LLD since childhood. The hardest situation comes when someone comes in with two bad hipsthat are both short. THA's are usually done staged - or 1 at a timewith a 3-9 month recovery period inbetween. So if the surgeon doesthe first THA and restores the original hip length (and improvesstability), then the patient has an LLD until their next surgery. Noteveryone undergoes that second surgery because their health fails orthey don't want to go through it again. So now that person iscondemned to a LLD for life (and one bad hip). If both THAs are doneand the hips are left 'short' with no intervening LLD time period,then there is a higher chance to have at least one hip which isunstable.To get to your specific question, since you feel like you leg isshorter (not just because someone guestimated) it may be worth lookingin to. The main reason for a true change in leg length within a fewmonths of surgery would be what's called 'subsidence'. This meansthat the femoral stem may have 'settled' or sunk into the femur. Itwas a common problem with certain older hip designs. To avoid thisproblem, surgeons used to make all patients with uncemented hip stemsbe non-weight bearing for many weeks to allow the bone to grow intothe stem porous surface and hold it in place. It was also thoughtthat too much 'micro-motion' because of weight bearing would leadfailure of the bone to grow into the stem. Over the past 5 years,many surgeons have begun to let patients walk with full weight bearingimmediately after surgery because 'subsidence' and 'micro-motion' seemto be less feared. A hip with mild subsidence which is still stableis usually treated with observation or a shoelift. Those that subsideto the point of instability or intolerable LLD can get revised toanother implant.It is possible that your stem subsided. You can't tell subsidence orleg lengths by looking at an AP & lateral view x-ray of one hip(theusual clinic visit follow-up x-rays obtained). The best way to totell is to compare x-rays from right after surgery to current ones. The surgeon can measure from a fixed point on the stem to a fixedpoint on the femur(usually greater troch or lesser troch) and comparethe two measurements (with correction for magnification difference). A good way to check for a LLD without a full scanogram is to take anx-ray of the whole pelvis and compare the heights of the lessertrochanters. With the new world of digital x-rays, it can be harder(or easier for some) to figure this out.Other reasons to get a shorter leg after a THA are:- polyethylene wear (doubtful after only a few months)- ceramic fracture- socket component migration- dislocation(all unlikely for what you describe)The final thing may be that this is only an apparent LLD that youfeel, and a scanogram x-ray would show no true LLD. If this is true,then you may benefit from a small shoelift to adjust to your comfortlevel - check with your surgeon first.Hope this answers your question.BTW, I would personally stay away from any chiropractic treatmentsuntil I'm fully recovered from an major surgery I undergo (3-6 monthsusually for a TJA).On 6/2/05, goldspitzer <goldspitzer@...> wrote:> Ortho Expert> > I really appreciate the contribution you are making to this board.> > I have a ? for you. I am a 57 year old male. I have had a RTHR on Feb > 16, 2005. Everything seemed to progress well. Before the operation it > seemed my leg would sink into my hip as i walked. My chiropractor > always found my right leg short. After the operation I felt like I was > riding high on the right side and no sinking feeling and my walk was > getting better considering the normal post op pain . I had great weight > bearing on the right side even the first time up I could feel real > solidness in my hip. At 7 weeks I had a chiropractic adjustment and my > chiropractor was impressed. My right leg length was even with the left > side. At 12 weeks post op I had another chiropractic adjustment and by > then I had a short right leg and that high riding feeling was gone. I > am now about 15 weeks post op and it seems my right leg is shorter and I > have that sinking feeling into the hip while walking. My walk is not > improving. x rays show that the implant is OK. and there is no > additional pain from the hip implant area. I have had no impacts or > accidents. I have an Oxinium implant with a 32 mm head. > > What happened to my leg length?> > goldspitzer> > > >

[Guest guest]

A foot drop is rare when a hip is lengthened only slightly (1-2cm).

The exact cause of foot drops (sciatic nerve or peroneal nerve palsy)

is usually never found. There are tens of thousands of THAs done per

year where a hip that started off short because of arthritis is made

longer to recreate the original biomechanics and equalize the leg

lengths where a foot drop doesn't occur.

The highest risk for a foot drop secondary to lengthening the leg

occurs with female patients with a large LLD secondary to a high

riding dysplastic hip which has been up and out of the socket for many

years. I did a case once on a patient with DDH where I initially

lengthened her by more than 4cm (almost 2 inches) to bring the hip

back down to its normal position. Then I put my finger in the back of

the wound to feel for the sciatic nerve. It was as taught as a

bowstring - so I shortened the hip by about 1 cm to relieve some

tension on the nerve. Thankfully, she woke up with normal foot

function. It's definately a scary condition for the surgeon to face

too.

On 6/5/05, renazee@... <renazee@...> wrote:

> Orthodoc,

> Thanks for your valuable information on LLD. My question is: when

> attempting to match leg lengths when the second hip is replaced, how much of

> a concern is there for " foot drop " to occur as a result?

> My OS feels it isn't much of a concern because my LLD is not over the

> mm. length of discrepancy that would lead to foot drop. (I can't remember

> what number he gave me for that mm. length).

> What are your thoughts about this? Thanks for any information.

>

> Re: ortho expert leg length

>

> Here are my thoughts on leg lengths.

>

> The condition of unequal leg lengths is called 'leg length

> discrepancy' or LLD.

>

> LLD can be hard to measure - both in the clinic with a physical exam

> and during the surgery. The only true way to measure it is by taking

> a full length standing x-ray called a scanogram which can show LLD of

> 2-3mm (1/10th of an inch). When surgeons, therapists, chiropracters,

> etc measure someone during a physical exam - it's always a guestimate

> (even if blocks are used). It's more important what the patient feels

> when they walk (even or uneven) than what someone tells them from a

> guestimate. A 'true LLD' is one that is measurable. An 'apparent

> LLD' is one that the patient feels or has 'guestimated'- but is not

> always due to a shorter leg. Sometimes the patient's pelvis is tilted

> making one side feel longer.

>

> In general, a LLD of 1cm or less is usually not noticed by the patient.

> 1~3cm is noticed and can be treated with a shoe lift.

> Anything >5cm is difficult to tolerate and can lead to back and knee pain.

>

> Equalizing leg lengths during a THA is always a challenging issue.

> There are many techniques used by different surgeons to do this. The

> longer you make the hip (and leg), the more stable the joint. Since

> THA dislocations are feared by both patient and surgeon, there is

> always a temptation to put in a longer(not larger) ball and make the

> hip 'tighter' or more stable. This may create a LLD. It's always a

> balancing act to get a stable hip with equal leg lengths.

>

> When someone has hip arthritis with worn out cartilage and bone, that

> leg usually becomes shorter because the ball moves up in the socket.

> People with DDH or dysplastic hips, may have a LLD since childhood.

> The hardest situation comes when someone comes in with two bad hips

> that are both short. THA's are usually done staged - or 1 at a time

> with a 3-9 month recovery period inbetween. So if the surgeon does

> the first THA and restores the original hip length (and improves

> stability), then the patient has an LLD until their next surgery. Not

> everyone undergoes that second surgery because their health fails or

> they don't want to go through it again. So now that person is

> condemned to a LLD for life (and one bad hip). If both THAs are done

> and the hips are left 'short' with no intervening LLD time period,

> then there is a higher chance to have at least one hip which is

> unstable.

>

> To get to your specific question, since you feel like you leg is

> shorter (not just because someone guestimated) it may be worth looking

> in to. The main reason for a true change in leg length within a few

> months of surgery would be what's called 'subsidence'. This means

> that the femoral stem may have 'settled' or sunk into the femur. It

> was a common problem with certain older hip designs. To avoid this

> problem, surgeons used to make all patients with uncemented hip stems

> be non-weight bearing for many weeks to allow the bone to grow into

> the stem porous surface and hold it in place. It was also thought

> that too much 'micro-motion' because of weight bearing would lead

> failure of the bone to grow into the stem. Over the past 5 years,

> many surgeons have begun to let patients walk with full weight bearing

> immediately after surgery because 'subsidence' and 'micro-motion' seem

> to be less feared. A hip with mild subsidence which is still stable

> is usually treated with observation or a shoelift. Those that subside

> to the point of instability or intolerable LLD can get revised to

> another implant.

>

> It is possible that your stem subsided. You can't tell subsidence or

> leg lengths by looking at an AP & lateral view x-ray of one hip(the

> usual clinic visit follow-up x-rays obtained). The best way to to

> tell is to compare x-rays from right after surgery to current ones.

> The surgeon can measure from a fixed point on the stem to a fixed

> point on the femur(usually greater troch or lesser troch) and compare

> the two measurements (with correction for magnification difference).

> A good way to check for a LLD without a full scanogram is to take an

> x-ray of the whole pelvis and compare the heights of the lesser

> trochanters. With the new world of digital x-rays, it can be harder

> (or easier for some) to figure this out.

>

> Other reasons to get a shorter leg after a THA are:

> - polyethylene wear (doubtful after only a few months)

> - ceramic fracture

> - socket component migration

> - dislocation

> (all unlikely for what you describe)

>

> The final thing may be that this is only an apparent LLD that you

> feel, and a scanogram x-ray would show no true LLD. If this is true,

> then you may benefit from a small shoelift to adjust to your comfort

> level - check with your surgeon first.

>

> Hope this answers your question.

>

> BTW, I would personally stay away from any chiropractic treatments

> until I'm fully recovered from an major surgery I undergo (3-6 months

> usually for a TJA).

>

>

> On 6/2/05, goldspitzer <goldspitzer@...> wrote:

> > Ortho Expert

> >

> > I really appreciate the contribution you are making to this board.

> >

> > I have a ? for you. I am a 57 year old male. I have had a RTHR on Feb

> > 16, 2005. Everything seemed to progress well. Before the operation it

> > seemed my leg would sink into my hip as i walked. My chiropractor

> > always found my right leg short. After the operation I felt like I was

> > riding high on the right side and no sinking feeling and my walk was

> > getting better considering the normal post op pain . I had great weight

> > bearing on the right side even the first time up I could feel real

> > solidness in my hip. At 7 weeks I had a chiropractic adjustment and my

> > chiropractor was impressed. My right leg length was even with the left

> > side. At 12 weeks post op I had another chiropractic adjustment and by

> > then I had a short right leg and that high riding feeling was gone. I

> > am now about 15 weeks post op and it seems my right leg is shorter and I

> > have that sinking feeling into the hip while walking. My walk is not

> > improving. x rays show that the implant is OK. and there is no

> > additional pain from the hip implant area. I have had no impacts or

> > accidents. I have an Oxinium implant with a 32 mm head.

> >

> > What happened to my leg length?

> >

> > goldspitzer

> >

> >

> >

> >

[Guest guest]

Thanks orthodoc! My LLD was less than the 2 cm you mentioned as being a concern, and all went well with my surgery on the 8th. No foot drop! I now have even leg length, although I haven't been able to appreciate it yet. The second surgery went very well, as did the first (10 weeks ago).

For this current surgery they had given me antivan for anxiety right before the operation (I freak out for IVs), and my OS came in to see me the morning after surgery to tell me a funny story ... that when they wheeled me into the operating room, I was slurring my words, acting drunk, not making sense, yet insisting that the antivan did nothing to calm me, and that I wanted nitrous oxide. My OS said that they all had a good laugh and that they did as I asked and gave me the nitrous ... but I don't remember a thing. He said he didn't think I would and hoped I wasn't embarrassed by hearing that I had made everyone's day. I was the last surgery of the day, so I guess the operating team should be allowed to go home on a humorous note

Other than a lot of nausea in the hospital and that awful nausea medication which knocks you out, I did pretty well. I came home on post-op day 3 which was yesterday.

I take my pain meds on a regular basis. Last time I waited till I was in a lot of pain before I took something, but I realize now that no one expects me to be a martyr. It's easier to do the things you need to do to speed your recovery,(ie, exercises, walk with my walker), and also not to mention that being comfortable during recovery is not too shabby either.

For anyone reading this who is anticipating THRs in the future, I will say that I am glad I had this done. The post op pain I have now is nothing compared to the pain before surgery. And with having dysplastic hips, things kept getting worse and worse real quickly, so waiting until I was OLDER was no longer an option.

I look forward to taking a short walk in the near future. It's been a LONG time coming!!!!!!!!!!

Re: ortho expert leg length> > Here are my thoughts on leg lengths. > > The condition of unequal leg lengths is called 'leg length> discrepancy' or LLD.> > LLD can be hard to measure - both in the clinic with a physical exam> and during the surgery. The only true way to measure it is by taking> a full length standing x-ray called a scanogram which can show LLD of> 2-3mm (1/10th of an inch). When surgeons, therapists, chiropracters,> etc measure someone during a physical exam - it's always a guestimate> (even if blocks are used). It's more important what the patient feels> when they walk (even or uneven) than what someone tells them from a> guestimate. A 'true LLD' is one that is measurable. An 'apparent> LLD' is one that the patient feels or has 'guestimated'- but is not> always due to a shorter leg. Sometimes the patient's pelvis is tilted> making one side feel longer.> > In general, a LLD of 1cm or less is usually not noticed by the patient.> 1~3cm is noticed and can be treated with a shoe lift. > Anything >5cm is difficult to tolerate and can lead to back and knee pain. > > Equalizing leg lengths during a THA is always a challenging issue. > There are many techniques used by different surgeons to do this. The> longer you make the hip (and leg), the more stable the joint. Since> THA dislocations are feared by both patient and surgeon, there is> always a temptation to put in a longer(not larger) ball and make the> hip 'tighter' or more stable. This may create a LLD. It's always a> balancing act to get a stable hip with equal leg lengths.> > When someone has hip arthritis with worn out cartilage and bone, that> leg usually becomes shorter because the ball moves up in the socket. > People with DDH or dysplastic hips, may have a LLD since childhood. > The hardest situation comes when someone comes in with two bad hips> that are both short. THA's are usually done staged - or 1 at a time> with a 3-9 month recovery period inbetween. So if the surgeon does> the first THA and restores the original hip length (and improves> stability), then the patient has an LLD until their next surgery. Not> everyone undergoes that second surgery because their health fails or> they don't want to go through it again. So now that person is> condemned to a LLD for life (and one bad hip). If both THAs are done> and the hips are left 'short' with no intervening LLD time period,> then there is a higher chance to have at least one hip which is> unstable.> > To get to your specific question, since you feel like you leg is> shorter (not just because someone guestimated) it may be worth looking> in to. The main reason for a true change in leg length within a few> months of surgery would be what's called 'subsidence'. This means> that the femoral stem may have 'settled' or sunk into the femur. It> was a common problem with certain older hip designs. To avoid this> problem, surgeons used to make all patients with uncemented hip stems> be non-weight bearing for many weeks to allow the bone to grow into> the stem porous surface and hold it in place. It was also thought> that too much 'micro-motion' because of weight bearing would lead> failure of the bone to grow into the stem. Over the past 5 years,> many surgeons have begun to let patients walk with full weight bearing> immediately after surgery because 'subsidence' and 'micro-motion' seem> to be less feared. A hip with mild subsidence which is still stable> is usually treated with observation or a shoelift. Those that subside> to the point of instability or intolerable LLD can get revised to> another implant.> > It is possible that your stem subsided. You can't tell subsidence or> leg lengths by looking at an AP & lateral view x-ray of one hip(the> usual clinic visit follow-up x-rays obtained). The best way to to> tell is to compare x-rays from right after surgery to current ones. > The surgeon can measure from a fixed point on the stem to a fixed> point on the femur(usually greater troch or lesser troch) and compare> the two measurements (with correction for magnification difference). > A good way to check for a LLD without a full scanogram is to take an> x-ray of the whole pelvis and compare the heights of the lesser> trochanters. With the new world of digital x-rays, it can be harder> (or easier for some) to figure this out.> > Other reasons to get a shorter leg after a THA are:> - polyethylene wear (doubtful after only a few months)> - ceramic fracture> - socket component migration> - dislocation> (all unlikely for what you describe)> > The final thing may be that this is only an apparent LLD that you> feel, and a scanogram x-ray would show no true LLD. If this is true,> then you may benefit from a small shoelift to adjust to your comfort> level - check with your surgeon first.> > Hope this answers your question.> > BTW, I would personally stay away from any chiropractic treatments> until I'm fully recovered from an major surgery I undergo (3-6 months> usually for a TJA).> > > On 6/2/05, goldspitzer <goldspitzer@...> wrote:> > Ortho Expert> > > > I really appreciate the contribution you are making to this board.> > > > I have a ? for you. I am a 57 year old male. I have had a RTHR on Feb > > 16, 2005. Everything seemed to progress well. Before the operation it > > seemed my leg would sink into my hip as i walked. My chiropractor > > always found my right leg short. After the operation I felt like I was > > riding high on the right side and no sinking feeling and my walk was > > getting better considering the normal post op pain . I had great weight > > bearing on the right side even the first time up I could feel real > > solidness in my hip. At 7 weeks I had a chiropractic adjustment and my > > chiropractor was impressed. My right leg length was even with the left > > side. At 12 weeks post op I had another chiropractic adjustment and by > > then I had a short right leg and that high riding feeling was gone. I > > am now about 15 weeks post op and it seems my right leg is shorter and I > > have that sinking feeling into the hip while walking. My walk is not > > improving. x rays show that the implant is OK. and there is no > > additional pain from the hip implant area. I have had no impacts or > > accidents. I have an Oxinium implant with a 32 mm head. > > > > What happened to my leg length?> > > > goldspitzer> > > > > > > >

[Guest guest]

To Ortho Doc or others:

I'm 10 months post THA. I had CDH with an approximately 3 cm LLD due to a "high riding dysplastic hip". My LLD was corrected to what's now about 1 cm; I received a ceramic/ceramic with titanium stem device. My rehab has gone extremely well - my gait is nearly corrected and ROM and strength continue to improve - it's been a long, slow process. I'm doing a rehab based Pilates program to continue to improve ROM and gain strength. My ortho has told me that I still have some pelvic dysplasia. However, I now have a new onset of middle back pain/spasm - particularly on my right side (my THA was on the left hip). I suspect this is due to my body's adjustment to my new hip and posture. I had a significant left trunk lean pre surgery. I do have a referral to return for more outpt PT, but can't get in for a couple of weeks. I know everyone's different, but has anyone experienced this type of problem this far out from

surgery? Any advice for alleviating the symptoms? I notice that the tightness and spasm intensify with computer work, but also with usual activities of walking, standing, etc. Stretching and exercising does help, as does heat and massage, but I'd prefer to prevent the spasm if I can rather than react to it. Any suggestions would be very much appreciated!

Marty__________________________________________________

[Guest guest]

lengthened her by more than 4cm (almost 2 inches) to bring the hip back down to its normal position....... It was as taught as a bowstring - so I shortened the hip by about 1 cm to relieve some tension on the nerve. >>> U mean was as TIGHT as a.... ? Never heard it called the bowstring procedure ? I'm confused~ Anyways... my length was mm shy of 3 full inches and "tight" don't even being 2 describe it.... not just the nerve either~ it's the ENTIRE leg muscle, tendons & all that push 2 extreme. I left the decision with my doc as to what was or wasn't best but the majority don't push the limitations due 2 the difficulties it can create and in most cases the lack of patient stablity for the recovery. Which is more corrective FD prior 2 surgery or afterward and why ? And I'm just curious as 2 what extent in terms of other body systems are actually effected as a result ?

[Guest guest]

middle back pain/spasm - particularly on my right side (my THA was on the left hip). I suspect this is due to my body's adjustment to my new hip and posture......has anyone experienced this type of problem this far out from surgery? Any advice for alleviating the symptoms >>> Same with me.... my lower back muscle LITERALLY stands out & hardens up the longer my day. Good luck finding the fix and if U happen 2 find something simple that works well... let me know would ya ? So far I've tried electronic & lumbar steriod injections, have a tens unit and started resently with Lidoderm patches. None of which have been a "great fix" that has worked well for it 2 GO AWAY & stay away! I've done PT separate for back strengthening exercises 2 C if it would make a difference & it didn't. Might help U out though least worth a try if you've not yet ventured that route. For me the longer & harder the day of activities.... the worse it will be by night fall too.

[Guest guest]

they wheeled me into the operating room, I was slurring my words, acting drunk, not making sense, yet insisting that the antivan did nothing to calm me, and that I wanted nitrous oxide >>>2 funny! Well walking 2 ya sweetie and may your recovery B a quick one

[Guest guest]

HEY Marty

See if you can get a TENS unit. It stops my spasms right now!

Marge

To Ortho Doc or others:

I'm 10 months post THA. I had CDH with an approximately 3 cm LLD due to a "high riding dysplastic hip". My LLD was corrected to what's now about 1 cm; I received a ceramic/ceramic with titanium stem device. My rehab has gone extremely well - my gait is nearly corrected and ROM and strength continue to improve - it's been a long, slow process. I'm doing a rehab based Pilates program to continue to improve ROM and gain strength. My ortho has told me that I still have some pelvic dysplasia. However, I now have a new onset of middle back pain/spasm - particularly on my right side (my THA was on the left hip). I suspect this is due to my body's adjustment to my new hip and posture. I had a significant left trunk lean pre surgery. I do have a referral to return for more outpt PT, but can't get in for a couple of weeks. I know everyone's different, but has anyone experienced this type of problem this far out from surgery? Any advice for alleviating the symptoms? I notice that the tightness and spasm intensify with computer work, but also with usual activities of walking, standing, etc. Stretching and exercising does help, as does heat and massage, but I'd prefer to prevent the spasm if I can rather than react to it. Any suggestions would be very much appreciated!

Marty

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