Hip Replacement Pain
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Introduction

The purpose of this page is to categorize hip replacement pain into one of three broad groupings.

I realize of course, speaking from personal experience, that 'hip pain is hip pain' - whichever way you dress it up!

However, for the purposes of properly understanding hip replacement recall situations, I thought it might be useful to differentiate between the different causes of pain that individuals experience at different stages: starting with pain experienced pre-diagnosis; through pain caused by the (actual) primary hip replacement surgery and during recovery from that surgery; and ultimately unexpected pain arising from damage caused by a faulty hip implant.

Each of these is considered briefly below, drawing on my own experience for the first two categories.

Hip Replacement Pain - Pre Diagnosis

If you've got this far reading the content of this Site you most likely have your own experience of hip or other joint pain. My diagnosis was advanced osteoarthritis of the right hip, which in simple language caused me to suffer severe, debilitating pain whether I was sitting, standing, attempting to walk or lying down.

Mercifully I only had a few short months to wait between diagnosis and my total hip replacement surgery. As the weeks passed running up to my surgery, the pain from the arthritis was so bad that I was actually looking forward to tackling and working through pain and discomfort that I knew would be caused by the trauma of the invasive hip replacement operation.

I knew that, assuming I was able to avoid any complications from surgery such as infection, that with effect from the day of the operation I would be 'over the hump' and the pain caused by the surgery would be transient - almost 'good pain' if that makes sense.

Hip Replacement Pain - Following Hip Replacement Surgery

The promise made by my orthopedic surgeon and others who kindly mentored me prior to my surgery came good. After my surgery, as soon as I had worked off the main effects of the anesthetic, I could tell that the deep, grinding pain of osteoarthritis had disappeared completely and I was left (only!) with the pain caused by the physical trauma of the operation. Hallelujah I thought!

I had a Total Hip Replacement procedure (rather than hip resurfacing) and by any standards that procedure is pretty invasive - it causes quite a bit of physical trauma to the hip area and in my case the right leg.

So, my post operation hip replacement pain was caused by a combination of:

  • the inevitable deep disturbance and cutting of the skin, muscle and cartilage;
  • having the head of my femur completely remodeled to include a cemented metal stem; and
  • having my hip socket remodelled to accommodate a cemented polyethylene (hard plastic) cup
  • the (relatively minor) discomfort of my scar with sutures / stitches rubbing on my clothes

My recovery from the surgery was pretty much exactly as expected:

  • During weeks 1-6: I was tender, sensitive and very bruised - feeling as I imagine I would feel if I had been run over by a bus. Despite this, and with the help of the morphine based painkillers and paracetomol I was prescribed, each day I was working hard on my physio exercises, pushing gradually to increase my walking distance and reduce reliance on my walking sticks
  • During weeks 6-12: the pain became less intense, more predictable, and I was able to quite quickly wean myself off the painkillers. There was some residual itching and discomfort from the scar tissue (which has continued through the 6-9 month period)

Hip Replacement Pain - Caused by a Metal on Metal Hip Implant

A metal on metal hip implant may damage the body and therefore cause pain in various different ways.

There could be problems with the basic mechanics and the physical functioning of the hip implant. For example, the implant components might loosen through time or indeed fail to knit to the healthy bone from day one. This may cause problems with movement and potentially severe pain, sometimes accompanied by noise from the joint - clicking or grinding.

Tissue and / or bone around the hip joint could be weakened and damaged by metal particles released from the friction of metal rubbing on metal.

Furthermore, metal particles, most commonly chromium and cobalt, can circulate in the blood and may cause a range of adverse conditions elsewhere in the body, some of which have painful symptoms.

For a summary of the possible symptoms and adverse affects of metal-on-metal hip implants click here.

Summary

I've often heard it said that at least half the battle with pain, and hip replacement pain is no different, is to understand the root cause(s); from there, we can do whatever is possible to either avoid or reduce it. The underlying causes of hip pain can be complex, so always consult an appropriately qualified and experienced doctor or orthopedic surgeon to get best direction and advise on your particular situation.