Thigh pain

[icehaid]

I had a total right hip done (due to avascular necrosis) in 1998. The surgery went well, as did my recovery. I am now 40 years old, 5' 9", 165.  I  maintain a relatively active lifestyle and ride a stationary bike regularly for exercise. As is common, I also avoid any high-impact activities. For the last several months, however, I have experienced daily pain mainly in the upper front thigh area. It is not the groin pain I had prior to learning I would need surgery. Also, the pain is not constant - it only arrives when I move certain ways or, get this, sneeze. Believe or not, a sneeze produces a ridiculous amount of pain for a couple of seconds. Also, I can no longer do an extended leg lift exercise from a sitting position and it is also very difficult to do while laying down. Also, this thigh looks noticeably smaller and weaker than the left one.

My yearly x-ray last July showed nothing out of the ordinary, just some wear particles from the plastic lining. It was a particularly nasty winter where I live and I have had a few slips on ice over the last few months, resulting in my tensing up and straining my right side more than usual. That leads me to believe that the pain I'm having is muscular. Any comments/advice will be appreciated. Thanks!

[icehaid]

Thank you for your comments and suggestions. I don't think the prosthesis is loose, as I've been told that loosening would cause a different and much more severe pain than I am experiencing. The weakness in the upper leg and the smallness of the thigh (as compared to my other one) suggest to me that the problem is muscular. Would a worn-out plastic socket liner account for my current issues? It doesn't seem so to me, but I'm only the patient! ;)

So, what can I do to build back my thigh muscle? And, should I continue to ride the stationary bike? I have absolutely no pain *during* exercise but it can be a bit stiff a few hours after the workout.

[DrNavneetMD]

Hi,

Loosening of the prosthesis from the bone is the most important long-term problem of the hip replacement surgery. Excessive force on the implant can cause the bond to loosen
Therefore, try to minimise stress as much as you can.

The duration for which the hip replacement is purposeful depends on a number of factors.
The quality of your bones. - The harder your bones are, the better the bond will be, and the longer the replacement will last. Osteoporosis is a factor of age, as well as the type of arthritis you have.
Small abrasion particles from the implant may play a role in implant loosening. Plastic surfaces shed more particles than metal or ceramic ones.
Wear of the Plastic Polyethylene Socket starts from the day of surgery. The plastic socket is the weakest link in the implant. The rate of plastic wear against a metal ball is about 0.1 millimeters per year, but is more rapid in very active patients.
Please use support and proper footwear with spikes while walking especially on the friction less surface like ice, to minimize fall, so as to prevent damage to the joint.
The repeated history of falls in the recent past might be respnsible for the pain and the muscular trauma.

You can take take acetaminophen or NSAID like volatren if the pain is severe.

Bye
Take care.