Hip Surgery - Sac Tissue Pain

[Dixidude]

I had hip joint replacement from the top orthopaedic surgeon in our city specializing in hip and knee joint surgery.  Post op XRAY ok.  Recovery without complications, except 10 weeks after surgery, I began feeling progressively greater pain -- primarily in the pubic (not genital) area adjacent to the operated hip.  It is a burning pain.  Fortunately it does not occur during sleeping hours, but tends to manifest itself after bending or sitting.  Saw surgeon 2 days ago,
and he rotated my leg (without joint pain) and said "...come back in 30 days if it is still bothering you."  This seems
like it might be post-surgical scar tissue pain.  Does scar tissue pain develop in ____% of these kind of procedures?
Are pain killers like tramadol a practical approach if this condition does not improve significantly in 30 days?  Thanks.  Bill (male 72 in good+ health).  

[Christopher R Newey, DO]

Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with a doctor.

Without the ability to examine and obtain a history, I can not tell you what the exact cause of the symptoms is. However I will try to provide you with some useful information.

If the pain is on the inside of the thigh, it may be a condition where the nerve is entrapped. This nerve is the obturator nerve. This may happen during hip surgeries because of its vulnerable location. If it does become entrapped, it will produce pain from the groin down the inner thigh. There may also be weakness with bringing the thighs together against resistance.

Another condition that can cause pain on the outside of the thigh is from entrapment of a nerve called the lateral femoral cutaneous nerve. It can become entrapped in pregnancy, obesity, or from direct compression, fracture of the front part of your pelvis, or too much rotation of the pelvis anteriorly.

Treatment will depend on the etiology (either nerve or bone). If nerve, neuropathic pain meds such as gabapentin or pregabalin may be useful. If bone pain, NSAIDs are typically the main treatment option. I would suggest you discuss your pain with your surgeon. You may need to have a referral to a neurologist.

Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.

[Dixidude]

Thank you, Dr. Newey