Post-Hip Surgery Recovery: Pain and Complications

Postoperative hip joint care?

Hello Doctor: I underwent hip joint surgery on June 2nd, and today marks the 11th day post-operation.
Before the surgery, I consulted several major hospitals in Tainan regarding my symptoms of sciatica and avascular necrosis of the hip, which were causing muscle soreness in my knee and hip.
The troubling part is that I had not experienced symptoms of either condition prior to the surgery.
The symptoms of avascular necrosis typically include severe pain in the hip area, which I did not have.
As for the sciatica, I still have normal mobility in my lower back and do not experience any nerve compression pain, although I do feel general discomfort in the lumbar region around the L3 to L6 vertebrae.

However, by mid-May, I was already experiencing significant pain in my knee, particularly on the left side of my body above the knee.
The pain worsens with rain, to the point where it makes me want to cry.
After compiling my symptoms and medical history, I was quickly referred to my primary physician, who recommended a hip joint decompression surgery, with the possibility of sciatica treatment depending on the situation.

Now, 11 days post-surgery, I have some concerns about my recovery.
My knee started to feel sore again five days after the surgery, and the surgical site has been intermittently painful nine days post-operation.
Additionally, I am experiencing a sensation in the hip area that resembles the symptoms of avascular necrosis, but it is not pain; rather, it feels like a pressure or cracking sensation in the bone.
Is this normal? Why is the knee the most painful area? I underwent a femoral head decompression surgery, and the doctor mentioned that a significant amount of necrotic bone tissue was removed, more than expected, and that they added a graft to support the area.
Is the recovery related to the surgical technique used? How should I approach follow-up appointments and further treatment options?

Ahan, 40~49 year old female. Ask Date: 2022/06/11

Dr. Shi Guozheng reply Orthopedics

Hip joint lesions often lead to knee pain due to nerve conduction, as the nerves near the hip joint also radiate to the knee area.
Typically, it takes some time for pain relief after decompression surgery, and you will need to return for follow-up in the outpatient clinic.

Reply Date: 2022/06/11

More Info

Post-hip surgery recovery can be a complex and sometimes frustrating process, especially when pain persists beyond the expected timeline. Based on your description, it seems you are experiencing a range of symptoms that are causing concern. Let's break down your situation and address your questions.

1. Understanding Pain After Surgery: It is not uncommon to experience pain after hip surgery, especially within the first few weeks. The healing process involves not only the surgical site but also the surrounding muscles, tendons, and nerves. The pain you are feeling in your knee and hip area could be due to several factors, including inflammation, muscle tightness, or even referred pain from the hip joint itself. It’s important to note that while some discomfort is expected, significant or worsening pain should be evaluated by your surgeon.

2. Postoperative Expectations: After a hip joint decompression surgery, it’s typical for patients to experience varying degrees of discomfort as the body heals. The fact that you are feeling pain in your knee and hip, especially after a period of relative comfort, may indicate that your body is adjusting to the changes made during surgery. The sensation you describe as "similar to a bone crack" could be related to the healing of the bone and soft tissue, which can sometimes feel unusual as they recover.

3. Recovery Timeline: Generally, the initial recovery period after hip surgery can last several weeks to months. Pain and discomfort may fluctuate during this time. If your symptoms persist or worsen, it’s crucial to follow up with your orthopedic surgeon. They may want to assess the surgical site, check for any complications, and ensure that the healing process is on track.

4. Potential Complications: While complications from hip surgery are relatively rare, they can occur. Issues such as infection, blood clots, or improper healing can lead to prolonged pain. If you are experiencing new or worsening symptoms, it’s essential to communicate these to your healthcare provider. They may recommend imaging studies or additional evaluations to rule out any complications.

5. Rehabilitation and Physical Therapy: Engaging in a structured rehabilitation program is vital for recovery. Physical therapy can help strengthen the muscles around the hip and improve mobility, which may alleviate some of the pain you are experiencing. A physical therapist can also provide exercises tailored to your specific needs and monitor your progress.

6. Managing Pain: Pain management is an integral part of recovery. If over-the-counter medications are not providing relief, discuss this with your doctor. They may prescribe stronger pain relief or recommend alternative therapies, such as ice, heat, or transcutaneous electrical nerve stimulation (TENS).

7. Follow-Up Care: Regular follow-up appointments with your orthopedic surgeon are essential to monitor your recovery. If you feel that your current treatment plan is not addressing your concerns, don’t hesitate to seek a second opinion or consult a pain management specialist.

In summary, while some discomfort is expected after hip surgery, persistent or worsening pain should be evaluated by your healthcare provider. Engaging in physical therapy and maintaining open communication with your surgical team will be crucial in navigating your recovery. Remember, recovery is a process, and it’s important to be patient with yourself as you heal.

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