Ultrasound scan results

Last week I had an ultrasound scan on my right hip/thigh to check out my muscles for anything that could account for the excessive weakness I still have one year on from my resurfacing surgery.

During the scan it was obvious that my abductor muscle was not attached to the bone anymore. Sigh. Knowing full well what this would mean I decided not to speculate and wait on Mr. O's letter hopefully laying out 'what's next'. I got that letter today and it seems that we're just bypassing another consultation and going straight to surgery! As soon as I make the appointment. Big sigh.

In the letter: "The scans show that there is a small but significant detachment of parts of the gluteus medius and minimus [abductors] over the front and outer part of your right hip joint. The best treatment here would be for us to re-open the wound and re-attach these muscles using synthethic ligament material in order to get a really good attachment."

So, here we go again.... Round 4! Hopefully, as this surgery will not be as invasive as the resurfacing, it won't be so bad. Fingers crossed the detached muscles are still in good shape and haven't part-turned to fat (cos that won't help re-attachment!).

Nothing I can do, so, let's do it! Bring it on, I will shift this limp!!

One year

Today, exactly one year ago I had my hip resurfaced!

Today I was back at the Royal Ortho for my first yearly check-up.

Thankfully I can say that it is unremarkable news, the implant is EXACTLY where it was put one year ago. I have no pain or issues in my everyday life....in fact, life is very very good! Which is one of the reasons I haven't blogged in a couple of months.

I do still have unresolved muscle weakness in my abductors. I have been working hard in the gym and in physio to try and get my abductors to kick-in and start working properly. Without them, I'm stuck with this hippy-limp.

Last week at physio was a bit of a turning point in my treatment. My physio, who is a MSK (musculo-skeletal) physio, took me to meet some neuro physios (i.e. those that deal with people who've suffered neurological injuries or diseases that affect their muscles). The idea was to check I haven't suffered some nerve injury during the surgery that might be causing this muscle weakness and to see if they had any other exercise ideas that might trick my muscles into working correctly.

Four physios manipulating your body at once is both confusing and tiring I can tell you! For an hour and a half!!!! The short story is that everything is 'firing' correctly and as it should. But that my body has effectively forgotten how to co-ordinate it all properly. Chances are, I'm probably a long way off getting them to behave, but it should happen in time, with hard work and patience *sigh*. Somehow we're going to try and incorporate the exercises the neuro-physios did with me, which is no small feat considering it involved two other people! My physio said he's going to sort something out but to keep up my other exercises the now for the next couple of weeks. I'm curious as to how I'm going to do this.....

This was discussed today in the orthopod's office. The surgical team would like for me to have an ultrasound scan done on my leg to check that the muscle hasn't actually detached itself from the bone. Recall the nasty staples holding the abductors to the bone in the x-ray?! Yeah, ouch. Wouldn't that hurt though???? I can't say I'm in hideous discomfort any more than the average person after a session in the gym. I would have thought you'd feel something if a muscle had detached itself - that being said, I didn't feel the full whack pain of osteoarthritis at the moment of diagnosis. Mmmmm. Let's just say, I'm hoping it's not detached itself, because that would mean reattaching said muscle.....and as much as I like anaesthesia.....

Anyhoo, it's all good! Life is good! NO pain = good :o))))))

I love my hip. Can't believe that one year has gone by already!

6 mths post-op

Oh my goodness, 6 mths since I had resurfacing surgery! I went to Birmingham last tuesday for a check up with Mr. O'Hara, my implant has not moved one iota and there's nothing on x-ray to cause any concern whatsoever - very happy days!

I've officially been free of osteoarthritis pain for 6mths and that has changed my life beyond words. Osteoarthritis steals people's lives....it won't kill you, but it'll wreak your life and you as a person. I've been given my life back twice now and hopefully this will be the last time before the age of 50 that I'll have to resort to surgical intervention to beat the bugger! No way this is stopping me doing what I want to do.... I might walk a little funky right now, but walk I can..... and I'm not sitting down or staying in anymore!!

The last month hasn't been the greatest psychologically on the recovery front, but I've come to the realisation that there's nothing I can do but keep moving forward with everything. It's done now and I'm pain-free, something that millions are not. I'm in this for the long-haul, so I'd better get comfortable...

Orthopod 3mth check-up

Okay so I have no new x-rays to put up today. Mainly because it was identical to my last x-ray taken 4 days after surgery! Really, mr. orthopod put them up on the screen and I initially said "no that's the one from March", he said "check the date", today! Side-by-side identical. Excellent news!! No movement of implant, just as it's supposed to be. No collapsed femoral head or extra bone growth where it shouldn't - you know, it goes through your head...

Now here's something I suspected, forgot to ask and wasn't told last time. There was bone grafting in the socket. I don't think every resurfaced hip has this and was probably done because of the dysplasia. Mr. O was pointing out how well it's all knitted together, so well in fact that he could barely see the original outline of the socket before it was filled. Apparently the original outline is slightly higher than where the metal cup sits in the socket because it had to be reamed back due to osteophyte formation (knobbly bone spurs) and that the socket was shallow and mis-shapen etc. Bottom line, it was wonky, now its not!

He was also very pleased with my general progress and said I was doing remarkably well considering it was only 3 months post-op. He was pleased I could get my knees to my chest and hold certain leg movements. So it's all good! He did want me pass on a message to my physio - see how far you can push it. Mmmm, scary thought from my point of view! Shall we pass that on....

Orthopod check-up

Another long day!

Up at 5.30am to catch my train to Birmingham as my appointment was for 11am. I actually arrived 1hr early (the trains weren't late for once!) and was taken straight through to the clinic. The nurse on duty was really nice and said that it seemed to be really quiet today so if I popped upstairs for my x-rays I could probably go in early. Excellent I'm thinking! Uh-uh.... there was a reason it 'seemed' quiet. There was a 2hr back-log in x-ray as the computer system had gone down! I've never seen the waiting room so packed, seating was only for patients, rellies had to make do!

After putting in my form and thus effectively joining the queue, I asked if they didn't mind me pottering off for a while - nup! So I walked straight back down to the clinic to let the nurse know as clearly no-one had thought to pass on the message. I also wanted to let them know because if I had waited I might not have gotten to see Mr. O! Previous experience pays off - consultants on the NHS usually only hold morning clinics and if it runs over, you get re-scheduled to another day. As I've always come to the hospital from far away I've always reminded them of this fact so not seeing my orthopod is NOT an option!

So, after letting the nurse know she scuttled off to ask Mr. O; I walked straight in for consultation! As it was 'quiet' we had a good long chat. He said I didn't need a new x-ray that day as he had the set from 5 weeks ago (he thinks the ROHB gives people unnecessary x-rays sometimes and one shot of radiation less is good!). He'll be seeing me in 2 months and I will have x-rays then.

He was pleased with the progress so far and in the ROM that I have regained. He wasn't impressed with my limp! He wants me to have physio and was a bit annoyed that it hadn't been set up already. I explained to him that I'll be moving due to my new job in Nottingham mid-may and as it can take a month to set up the first appointment on the NHS, he said that he has a friend that is an excellent physio down in that neck of the woods so he'll get in touch with him and set it up for me in time for me moving. In the mean-time he's given me a whole bunch of exercises to do, including abduction exercises that he initially told me not to do. I've also to get myself working out in the gym and in the pool. The only downside to this limp is that he doesn't want me to ditch the crutch yet until I get physio!! It is a fairly bad body tilt, swaying thing I have going on - at first he thought perhaps he got my leg length wrong, but its not, its perfect. We think its just my poor muscles got so used to that leg being slightly (0.5cm) shorter for years that now the legs are equal, the muscles are too tight on one side, thus causing me to tilt. It's not a good look so whilst I'm a little disheartened not to lose the crutch any time soon, it is for the best I suppose *sigh*.

I am a considered a complicated resurfacing. So it looks like I'm in it for the rehab long haul! I have done remarkably well recovery-wise so far but its going to be a few months of hard work to sort out all the incorrect muscle usage. Some muscles have been used incorrectly for years, that is one of the consequences of arthritis, chronic pain and previous surgeries. That won't be easy to correct. But I'm going to give it all I have for as long as necessary!

X-ray taken 4 days post-op. Resurfacing with extra fixation screws. Scary!

Close up of my right hip. Red circles highlight the remnants of broken screws left after my osteotomy. Red arrow shows muscle anchors/staples used to reattach one of my muscles back to the bone.

My scar at 5 weeks post-op. Looking much better!

Consultation day

The day I've been waiting for, the results and 'what's next'. I've been having strange dreams recently about my orthopod turning round to me and saying 'there's nothing wrong, what are you complaining about!'. Well, there's most definitely something wrong. There's a serious lack of cartilage over the major load-bearing region. The pelvis shape looks distorted on the right side, that's due to the pelvic osteotomy I had (there are two remnants of titanium pins lodged in the pelvis too).


The lack of cartilage is due to problem number two (or is this a 'which came first, the chicken or the egg?). A proliferation of osteophytes (bone cells/spurs) on the back of the femur head. This has caused the femur head to protrude forward away from the socket and, as the new bone is nobbly, it's worn down the cartilage.

What's next? A hip resurfacing. I have to call to make an appointment but the earliest available time would be easter apparently. I've also been offered a hip block in the mean time - I said I'd think about it. I think it would probably be a good idea though given that treatment could be months away. Scary, giant needles! (have your pelvis realigned no problem, giant needle eeeeeeeeek!). I think I'm just relieved to now know exactly why I'm in so much pain (and what's making that funny crunchy noise....mmmm) and that treatment is on the horizon.