Hip Joint Pain After Hip Replacement Surgery

Hip joint pain

Hello, doctor.
My mother is in her fifties and had surgery to replace her left hip joint due to avascular necrosis over a year ago.
She still experiences pain from time to time, sometimes even worse than before the surgery, and often needs to use a walker to get around.
However, she is very afraid of facing another surgery and has been reluctant to make an appointment for a consultation.
What could be the reasons for her ongoing pain? Should she see an orthopedic specialist? Thank you.

Ali, 20~29 year old female. Ask Date: 2018/12/06

Dr. Shi Guozheng reply Orthopedics

Persistent pain after joint replacement surgery may indicate infection, loosening, improper positioning of the artificial joint, or other issues.
It is advisable to return for a follow-up appointment for an examination to identify the cause, which is essential for effective treatment.

Reply Date: 2018/12/06

More Info

Hip joint pain after hip replacement surgery can be a complex issue, especially in patients who have undergone the procedure due to conditions like avascular necrosis, as in your mother's case. While hip replacement surgery is generally successful in alleviating pain and improving function, some patients may experience persistent or new pain post-operatively.
There are several potential reasons for ongoing pain after hip replacement surgery:
1. Surgical Recovery: The body takes time to heal after surgery. In the initial months following hip replacement, it is common for patients to experience discomfort as they recover. This can include pain from the surgical site, inflammation, and the adjustment of surrounding muscles and tissues to the new joint.

2. Soft Tissue Issues: The surgery involves cutting through muscles and tendons, which can lead to soft tissue trauma. If these tissues do not heal properly or if there is scar tissue formation, it can result in pain and discomfort.

3. Implant Issues: Although rare, complications can arise with the artificial joint itself. This includes loosening of the implant, wear and tear of the components, or even infection. If the implant is not functioning as intended, it can lead to pain.

4. Nerve Pain: Sometimes, nerves can be affected during surgery, leading to neuropathic pain. This type of pain can feel different from typical joint pain and may present as sharp, burning, or tingling sensations.

5. Underlying Conditions: If there were pre-existing conditions, such as arthritis or other joint issues, these may still cause pain even after the hip replacement. Additionally, if the pain is radiating from the lower back or other areas, it may not be directly related to the hip joint.

6. Psychological Factors: Fear of pain or re-injury can lead to anxiety, which may exacerbate the perception of pain. This is particularly relevant if a patient has had a traumatic experience with their condition or surgery.

Given your mother's situation, it is crucial that she consults with an orthopedic surgeon or a specialist in joint replacement. A thorough evaluation can help determine the cause of her pain and whether it is related to the surgery or if there are other underlying issues. Diagnostic imaging, such as X-rays or MRIs, may be necessary to assess the condition of the implant and surrounding tissues.

In terms of management, physical therapy can be beneficial in improving strength and mobility, which may help alleviate some of the pain. Pain management strategies, including medications or injections, may also be considered depending on the severity of her symptoms.

It is understandable that your mother may be apprehensive about further medical interventions, especially if she has had a difficult experience with her previous surgery. However, addressing her pain is important for her quality of life and mobility. Encouraging her to seek medical advice can help her understand her options and potentially improve her situation.

In conclusion, persistent pain after hip replacement surgery can arise from various factors, and it is essential to identify the underlying cause through professional medical evaluation. Early intervention can lead to better outcomes and help your mother regain her confidence in mobility.

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The above statement cannot provide a comprehensive diagnosis; please discuss further with your surgeon.