Hip Replacement: Addressing Uneven Angles and Recovery

Artificial joint

Hello, Doctor! My mother had a hip replacement on her right leg six months ago, but now the angles of her legs are different.
The leg with the artificial hip has an external rotation of about 140 to 150 degrees.
A week after the surgery, she experienced significant pain in her leg due to some activities, and we were unsure if it was a dislocation.
When she returned for a follow-up, the doctor mentioned that there was a slight fracture in the bone and advised her to rest more.
Later, we noticed the external rotation of her leg, but it does not hurt.
Is this normal? Can she regain a normal angle through rehabilitation? Thank you, Doctor.

bei mian, 30~39 year old female. Ask Date: 2020/04/07

Dr. Shi Guozheng reply Orthopedics

The primary purpose of joint replacement surgery is to relieve pain.
If there is a slight valgus deformity, it may be related to the angle at which the artificial joint was placed.
Rehabilitation can help improve this condition to some extent.

Reply Date: 2020/04/07

More Info

After a hip replacement surgery, it is not uncommon for patients to experience some discrepancies in leg angles, especially if one leg has undergone a significant surgical procedure while the other has not. In your mother's case, the external rotation (often referred to as "外八" in Chinese) of the leg with the artificial hip joint, resulting in an angle of approximately 140 to 150 degrees, raises some important considerations.

Firstly, it is essential to understand that the primary goal of hip replacement surgery is to alleviate pain and restore function. The artificial hip joint is designed to mimic the natural movement of the hip, but variations in alignment can occur due to several factors, including surgical technique, the positioning of the implant, and individual anatomical differences. If the leg appears to be externally rotated but does not cause pain, it may not be an immediate cause for concern. However, it is crucial to monitor the situation closely.

Regarding the pain your mother experienced shortly after surgery, it is not uncommon for patients to feel discomfort as they begin to mobilize and use their new joint. The mention of a "small crack" in the bone could indicate a minor complication, but if the doctor advised rest and the pain has subsided, it may not be a significant issue. It is essential to follow up with the orthopedic surgeon to ensure that the healing process is on track.

As for the possibility of rehabilitation improving the angle of the leg, physical therapy plays a vital role in recovery after hip replacement surgery. A well-structured rehabilitation program can help strengthen the muscles around the hip joint, improve range of motion, and enhance overall function. Physical therapists often employ various techniques, including stretching, strengthening exercises, and gait training, to help patients regain their mobility and correct any alignment issues.

It is essential to communicate openly with the physical therapist about your mother's specific concerns regarding her leg angle. They can tailor a rehabilitation program to address these issues, focusing on exercises that promote proper alignment and strengthen the hip muscles. Additionally, they may incorporate functional activities that mimic daily tasks to ensure that your mother can perform her routine without discomfort.

In some cases, if the angle discrepancy is significant or if it leads to functional limitations, further evaluation by the orthopedic surgeon may be warranted. They may consider imaging studies, such as X-rays, to assess the positioning of the implant and the surrounding bone structure. If necessary, they can recommend additional interventions, which may include adjustments to the rehabilitation program or, in rare cases, surgical revision.

In summary, while it is not uncommon for patients to experience some differences in leg angles after hip replacement surgery, it is crucial to monitor the situation closely. If your mother is not experiencing pain and her mobility is improving, it may be a positive sign. Engaging in a comprehensive rehabilitation program can help address any concerns regarding leg alignment and enhance her overall recovery. Always consult with her healthcare providers to ensure that her recovery is progressing as expected and to address any specific concerns she may have.

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