Post-Operative Concerns After Hip Joint Replacement Surgery

Postoperative hip joint care

Hello Doctor: I just got discharged after my total hip arthroplasty surgery on the 11th, and I have a few questions I would like to confirm.
After the failure of my previous femoral decompression surgery, it was delayed for another month before proceeding with the total hip arthroplasty.
During the consultations in that period, the doctor mentioned that due to collapse, my left leg is shorter.
X-rays and visual inspection while lifting both legs confirmed that my left leg is indeed about 3 centimeters shorter.
Therefore, during the total hip arthroplasty, the doctor mentioned that they would lengthen my left leg a bit.

Now, four days post-surgery, I am experiencing numbness and pain in the heel of my left foot.
When sitting and comparing both legs, I visually estimate that my left knee is about 1.5 centimeters longer than my right knee.
I have also measured in other positions, and visually, my left leg appears to be about 1.5 centimeters longer than my right leg.
Could this be due to excessive correction? When walking, it feels like my left leg is longer, which is really concerning me.

This is my second surgery, and it is still a total hip replacement.
I would like to know what is causing the numbness and pain in my left heel, whether the 1.5-centimeter lengthening of my left leg is normal, and what kind of postoperative rehabilitation is needed to address the slight length discrepancy in my left leg.
Alternatively, did the doctor lengthen it too much? What should I do? Having undergone two surgeries on one leg and still not being normal is driving me crazy.
I sincerely request detailed answers from the doctor, as the statements from the primary physician and observers can often be inconsistent.

Ahan, 40~49 year old female. Ask Date: 2022/07/13

Dr. Shi Guozheng reply Orthopedics

Numbness in the feet may be caused by nerve involvement or compression, which can improve over time.
Regarding unequal leg lengths after surgery, it is sometimes observed following hip joint surgery.
To determine the actual difference, X-rays are needed for accurate measurement.
Typically, a discrepancy of less than one centimeter can be managed with shoe inserts.

Reply Date: 2022/07/13

More Info

Post-operative concerns after hip joint replacement surgery can be quite common, especially in the early days following the procedure. It’s essential to understand that recovery from hip replacement surgery is a gradual process, and various factors can influence the outcome, including the complexity of the surgery, the patient's overall health, and adherence to rehabilitation protocols.

Firstly, regarding your concern about the length discrepancy between your legs after the surgery, it is not uncommon for patients to experience some differences in leg length post-operatively. This can occur due to the surgical technique used, the positioning of the implant, or even pre-existing conditions. In your case, the surgeon's intention to lengthen the left leg slightly to correct the previous shortening due to the failed decompression surgery may have resulted in the observed 1.5 cm difference. However, it is crucial to communicate with your surgeon about this concern, as they can provide the most accurate assessment based on your specific situation.
The sensation of numbness or pain in the heel of your left foot could be attributed to several factors. One possibility is nerve irritation or compression, which can occur during surgery or as a result of swelling in the surrounding tissues. It is also possible that the adjustment in leg length has altered your gait, leading to discomfort. In the early stages of recovery, it is not unusual to experience such sensations, but they should gradually improve as you continue to heal and engage in physical therapy.

As for your worries about the leg feeling longer and the potential for over-correction, it is essential to follow up with your orthopedic surgeon. They may recommend imaging studies, such as X-rays, to assess the alignment and length of your legs accurately. If there is a significant discrepancy or if the discomfort persists, they may suggest further interventions or adjustments in your rehabilitation plan.

In terms of rehabilitation, it is vital to engage in a structured physical therapy program tailored to your needs. This program should focus on strengthening the muscles around the hip joint, improving flexibility, and restoring normal gait mechanics. Your physical therapist can provide exercises that help alleviate discomfort and promote healing. Additionally, they can guide you on how to manage any leg length discrepancies through specific exercises and gait training.

It is also important to be patient with your recovery. The initial weeks after surgery can be challenging, and it may take time for your body to adjust to the new hip joint and any changes in leg length. Regular follow-ups with your healthcare team will help monitor your progress and address any concerns that arise.

In summary, while it is understandable to feel anxious about your recovery after two surgeries, many patients experience similar concerns. Open communication with your surgeon and physical therapist is key to addressing these issues effectively. They can provide reassurance, monitor your recovery, and make necessary adjustments to your rehabilitation plan to ensure the best possible outcome. Remember, recovery is a journey, and with the right support, you can achieve significant improvements in your mobility and quality of life.

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