Clunks/thunks revisited...

[Guest guest]

Having looked through the archives it seems that clicks/clunks/thunks

(nothing seems to adequately describe the sensation) you get when

making certain movements are quite common in the first year after

resurfacing. However, I am still quite puzzled about it. Perhaps

someone can answer some of my questions?

What actually causes the sensation? When I asked the surgeon shortly

after the op (convinced that part of the prosthesis had come adrift!)

I was told it was fluid swooshing between the bearing surfaces whilst

the surrounding capsule was still loose. Whilst this reassured me, the

sensations I felt, although completely pain free, did not feel like

this. In fact, the closest description I read in the archives was as

if shifting gears in a stationary car.

So, are the clunks the result of muscle tissue/scar tissue moving over

the prosthesis? Or is it muscle moving over muscle? And is this

something to be avoided, or is it fine to just ignore the sensation

and carry on regardless? And how come it eventually stops? And does

everybody experience this? Is it perhaps a sign of overdoing things?

Also, does the ball or socket ever come adrift, or develop play in the

short term? (I realise no-one knows the long-term answer). And if this

happened, would we definitely know about it pain wise?

Sorry for so many questions. I know it is quite possibly neurotic, but

no matter how much I try I cannot feel totally happy when I get these

sensations!

[Guest guest]

I had a lot of these feelings/sensations the first 6 -8 weeks after

surgery, and felt nervous about them, but was always reassured by Dr. Gross

and others that these would go away. They have done just that - and being

an engineer, I'm imagining that with all the disturbance during surgery,

muscles & tendons & other " stuff " has to grow back to a smooth working

arrangement with all the items around the joint, plus the fact that there

may be some " empty " space around the femur ball if the resurfaced ball is

slightly less small in diameter than the original femur ball. If there IS

some extra space, the femur or muscles/tendons may be shifting as we walk,

giving rise to the clicking-popping-clunking sensations - ie., things ARE

moving a bit, but with time everything nestles down and finds a home, some

tissue may fill in voids/empty space and keep things from moving around.

All I really know is - 6 months later I have absolutely normal movement -

no oddball sensations, and I can actually run across the street to our

other office, which I certainly couldn't do before the operation!.

Ken - Dr. Gross 9-18-03 rhr

" sundog72001 " jtinsley@...> on 03/31/2004 10:02:28 AM

Please respond to surfacehippy

To: surfacehippy

cc:

Subject: Clunks/thunks revisited...

Having looked through the archives it seems that clicks/clunks/thunks

(nothing seems to adequately describe the sensation) you get when

making certain movements are quite common in the first year after

resurfacing. However, I am still quite puzzled about it. Perhaps

someone can answer some of my questions?

What actually causes the sensation? When I asked the surgeon shortly

after the op (convinced that part of the prosthesis had come adrift!)

I was told it was fluid swooshing between the bearing surfaces whilst

the surrounding capsule was still loose. Whilst this reassured me, the

sensations I felt, although completely pain free, did not feel like

this. In fact, the closest description I read in the archives was as

if shifting gears in a stationary car.

So, are the clunks the result of muscle tissue/scar tissue moving over

the prosthesis? Or is it muscle moving over muscle? And is this

something to be avoided, or is it fine to just ignore the sensation

and carry on regardless? And how come it eventually stops? And does

everybody experience this? Is it perhaps a sign of overdoing things?

Also, does the ball or socket ever come adrift, or develop play in the

short term? (I realise no-one knows the long-term answer). And if this

happened, would we definitely know about it pain wise?

Sorry for so many questions. I know it is quite possibly neurotic, but

no matter how much I try I cannot feel totally happy when I get these

sensations!

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[Guest guest]

Hi,

Well I took advantage of the clunks/thunks to help teach my brain that it

finally had a hip joint to deal with again after 35 years........... smile.

Actually I noticed a few things about it all............. the tighter the

muscles etc around the hip get the less thunking there is.......... So I had

some pretty heavy degree thunking at the start with few muscles to support

anything........ that's about when I decided that instead of being freaked

out I could perhaps use this to my advantage brain teaching

wise..............

Gradually I noted that the only time I had thunking was when I pushed the

hip a little further bend wise.......... and/or if I tired the muscles

around it out - which was pretty easy early on............ So again

suggesting that how firmly it was held together plays the biggest role in

how much thunking goes on........... and I have no doubt that the actual

noise has something to do with gaps and spaces and how the prothesis sits

together at that given time............ However just what occupies possible

spaces? Well if it was tissue I think one would feel some pain as it

pinched............. so that leaves air or fluid......... how either get

there in the sudden quantities doesn't quite figure unless there is a

constant supply of fluid sitting around the joint area just waiting for the

event........ perhaps there is early on............. and remember people

crack their fingers and other joints and something goes into that

space.............

Don't forget too that a hip joint doesn't sit straight into a socket either

but has that funny side on attachment to the body............ that may also

leave room for more need for strengthening etc to keep it all together in a

perfectly working fit.............. and a need to settle down positioning.

And we are dealing with metal and metal clunks when it hits together in the

best of circumstances............ The trick maybe getting it to the point

that it is like a well oiled door hinge......... which again is the need for

good strong muscles around the whole thing.

As for knowing it is coming adrift........... I think and one other did

describe as best they could some of the pain associated with that. From how

the BHR is positioned with that pin I would doubt it would just happen over

night or be indicated by a thunk..........i.e.an amount of bone has to die

to allow the mechanism to start moving......... even then I suspect it would

only be by fractions in a rotation movement for a bit - for again the

muscles etc will hold the whole thing there to a degree........... Some

people get around fairly okay with nothing but a lump of hardened jelly

substance for a joint which suggest to me that in the end it is basically

the muscles that do much of the work of the joint.

Hope that helps a little,

Edith LBHR Dr. L Walter Syd Aust 8/02

> Having looked through the archives it seems that clicks/clunks/thunks

> (nothing seems to adequately describe the sensation) you get when

> making certain movements are quite common in the first year after

> resurfacing. However, I am still quite puzzled about it. Perhaps

> someone can answer some of my questions?

>

> What actually causes the sensation? When I asked the surgeon shortly

> after the op (convinced that part of the prosthesis had come adrift!)

> I was told it was fluid swooshing between the bearing surfaces whilst

> the surrounding capsule was still loose. Whilst this reassured me, the

> sensations I felt, although completely pain free, did not feel like

> this. In fact, the closest description I read in the archives was as

> if shifting gears in a stationary car.

>

> So, are the clunks the result of muscle tissue/scar tissue moving over

> the prosthesis? Or is it muscle moving over muscle? And is this

> something to be avoided, or is it fine to just ignore the sensation

> and carry on regardless? And how come it eventually stops? And does

> everybody experience this? Is it perhaps a sign of overdoing things?

>

> Also, does the ball or socket ever come adrift, or develop play in the

> short term? (I realise no-one knows the long-term answer). And if this

> happened, would we definitely know about it pain wise?

>

> Sorry for so many questions. I know it is quite possibly neurotic, but

> no matter how much I try I cannot feel totally happy when I get these

> sensations!

>

>

>