Problem following left total hip replacement - advice please

Lanny

Hi, I had a left total hip replacement at the beginning of March. After approximately 7 weeks I noticed that my leg doesn’t straighten and my knee turns in. X-ray has shown an unstable knee with moderate OA. I wondered if anyone else experienced anything like this and what the outcome was? Thank you in advance. 😊

Ellen

Good Morning @Lanny

I do remember an ancient thread which may or may not be relevant:

https://community.versusarthritis.org/discussion/42112/11-week-update

Hopefully you can read it although I'm not sure you can post on it it's a really old thread.

It may not be the same thing at all if your consultant thinks it's the Osteoarthritis in your knee.

I will add some info on that too just in case it helps:

https://www.versusarthritis.org/about-arthritis/conditions/osteoarthritis-of-the-knee/

Do let us know how you get on.

Best wishes

Ellen.

frogmorton

Hi @Lanny

That's so upsetting after you've been through your surgery now your knee isn't right.

The old thread is about others who have had a THR having soft tissue knee injuries. I wonder if it's because you try to protect the sore hip and walk 'wrong' so unwittingly damage the knee in the process.

What tests did they do? an x-ray was it? X-rays don't show soft tissue injuries do they? I think we need MRIs for that or is it ultrasounds?

I don't remember anything recent along these lines, but know people with OA in their knees do sometimes have. their knees 'give way' that comes up a lot on here.

What are 'they' planning to do to help you?

Toni x

Lanny

Thank you for your interest,

I have now been referred to a surgeon regarding left knee replacement for OA. He repeated plain x-ray imaging of the pelvis and both knees and has advised that this will only be corrected by having a left femoral osteotomy. I am feeling very uncertain and anxious about my surgical options at this point in time. 🥺

stickywicket

I'm not surprised you're feeling anxious and uncertain. I would be too and I'm a veteran of several very successful replacements. Before volunteering for any more surgery I'd want to know:

Why is the knee turning inwards?

Wasn't it before the THR?

Is it caused by the THR and, if so, why and how?

If it was fine before the THR then, surely, the problem is with the hip not the knee.

The thing is, if we have OA in one joint then replacing that joint should fix the problem. But, if we also have OA elsewhere (and it's possible that you had it in your knee before the THR) then replacing one joint will cure the pain from that joint but won't fix the overall problem.

I'm no medic but I'd have thought that, if you have OA in your knee then an osteotomy will only defer the problem. If you don't have OA in your knee then what - clearly resulting from the THR - has caused whatever problem it is.

Get lots of answers first before taking action.

Lanny

Hello Stickywicket (💖the name)

Thank you for your lovely reply

I did have OA of the left knee before my THR, but it did not turn inward and nor was the leg bent, I was able to straighten it fully.

My thoughts are also that because the problem of internal rotation and being unable to straighten my leg properly only followed the THR that this is likely to be the cause of the problem and not my OA of the knee This , however, is contrary to what the surgeon said.

I’m in such a quandary!

stickywicket

Oh *&*%*!

I'm still feeling, instinctively, that, if there is OA in the knee, an osteotomy might straighten it out but might also cause further problems and might also make a future TKR more difficult.

Here's where I'm coming from - way back in the early years of TKRs I had mine done. The left one, in particular, turned inwards and I had hoped the op might correct this. It didn't. The surgeon said that it couldn't because it was caused by the ligaments being knackered. 27 years later I had that knee replaced again. Things had moved on and, this time, the surgeon was able to do some embroidery with the ligaments and tendons and my knee was straight.

But here's the odd thing. 27 years ago, I first saw the ankle surgeon as all my pain was in the ankle below that knee. He did x-rays of both and found that my ankle had fused itself perfectly. All the problems (and my ankle was horrifically painful) stemmed from the TKR above it which had slid from its moorings and gone walkabout. It's a perfect example of referred pain.

I know referred pain isn't your problem but I use this to illustrate how complex and interactive these things are. I do understand your wish for the knee to be resolved but, honestly, if there is some arthritis there anyway, I'm not convinced it will be for long.

My go-to choice in such dilemmas is my GP. They don't know half as much as orthopaedic surgeons but they can sometimes shed a bit of kindly light on things.

Lanny

Stickywicket, thanks so much for sharing your journey with me, I really do appreciate it. It may well be time to return to my GP.

Thanks again. 🙂