Total hip replacement knee and leg length discrepancy

Bones, joints and muscles
1

Hi all

I had total hip replacement 10 weeks ago. Since then I have had major knee issues where I can not bend my knee a lot, I can't even put my own shoe on. My leg looks longer my surgeon has told me my pelvis has dropped 1.5cm during and since surgery causing my leg to look longer. I can not walk unaided and have a massive waddle (limp) I did not have this before. Only now am I waiting on physio. My operated leg turns outwards when sitting as it seems to long to naturally sit in my normal position. I researched some exercises and found a lady in YouTube that said the waddle is caused by weak gluteus (bum muscles) so I've now started to do bum crunches 3 times a day they are tough after you've had your muscle sliced through. Anyway has anyone else had the same problem? And has it corrected itself?

Thanks Penny

2

You are describing me before surgery! Why do you not look into doing Pilates it will help strengthen and with the alignment of your body. It will also make you feel good.

3

Is it to soon for that? I can't even bend lol

4

see the dislocation risk graph from my website.

See my address is in my personal info here ...

   http://patient.info/forums/profiles/rocketman-sg6uk-907025

and at the bottom of the moderator's "useful resources" page at

   http://patient.info/forums/discuss/thr-useful-resources-487147

Best wishes

Graham - 🚀💃 🤸    ¯\_(ツ)_/¯

5

With some Pilates moves you do not need to bend and if he asks the physio guys if it okay. He is not far off finishing the 3 months precautions therefore could probably ease slowly into it.

6

I had my knees replaced 20 years ago and have never had a single problem with them. After my hip surgery I was okay for a few months and then the knee started hurting. The surgeon took x-rays of them and study them at length and said everything looks fine. It's just that my legs are the same length for the first time in my life and everything has to align and adjust. Should take about 3 months well it's now exactly 3 months and they are no better in fact they may be a little worse. It really is horrible rolling over in bed getting out of bed taking my first couple of steps I put ice on them they feel swollen and they feel warm they don't necessarily look it so I don't know what's going on and I don't have another appointment until July

7

Wow 20 years ago and you have ongoing issues... That's crazy I'm expecting it to either resolve its self or surgeon said he will correct in a year.. So looks like my new best friend is a crutch.

8

There are two types of leg length discrepancy, actual and perceived, actual can be checked by physio for you.

​Surgeon if he was doing his job correctly should have checked,

​Procedure, lying on back, on hard table or bench, you must be straight through feet, ankles, knees, hips, shoulders, best way to check is for someone to stand at your feet, and check for you lying straight, then you draw up your knees towards the roof, with ankles as far as you can go towards your bum, keeping your feet flat on the table, again you need someone to check your ankles are even distance to pelvis or bum.

​Only then can you see a leg length difference, looking down your body, knee height is lower leg, and friend or family looking from the side, one kneecap  in front of other upper leg difference.

​Other way to check is with a tape measure, on the front of your pelvis near your waist is a prominent point on pelvic bone, end of tape measure there, other point is prominent ankle bone or point inside of ankle, use both points for both legs, physio did mine and came back with 22mm or 3/4 inch difference, that is how I learnt so much about this issue, and surgeon, different one to surgeon who did my surgery, showed me how he measured LLD.

​Percived, - weakness of muscles in and around pelvis, butt crunches are only part of the exercises needed, you also need to be doing clam shell exercise, even if you cannot do it, the fact you are trying exercises the right muscles, the trick is to get advice about how to do it correctly, I was shown by physio, and also how to feel the muscle twitching, even if you cannot lift your leg, the lift comes with time and lots of practice and strengthening of the muscle.

​As the 2nd surgeon told me, in 12 months you will not know your old self, he was right.

​But in my case I do have to wear a shoe lift on my opposite foot as with a lot of research my issues were found to be a natural LLD in lower leg of 10mm and 12mm added when surgeon did hip replacement, only 12mm needed to be corrected as the 10mm natural had been with me my entire life, had grown with it from childhood.

Hopefully this some help for others with LLD.

9

My surgeon had my leg length checked by X-ray just after the op, which I think is also a method used. 

10

my x-ray just after surgery shows no problems, or so I am told, but after some begging on my knees to my local GP he arranged for a LONG-LEG-XRAY, from the floor to above your waist, and then they measure each bone, from the floor up, that showed an entirely different story.

​From my understanding recently the hospital where I was operated on now does the long leg xray before surgery, told this by nurses on the hospital, and they use this as their base line for comparing post surgery x-rays.

My natural leg length difference was not identified prior to my surgery, I was not aware of it, apparently it is something that should be identified before any hip or even knee surgery if the surgeon is doing his job correctly.

11

I am 13 weeks post op and I have. Waddle, too. Mine feels like it is the front of my leg, tho. My therapist has been emphasizing butt exercises. Good luck! 

12

Hi Mary

I'm doing them as much as I can but I'm so impatient and want visible results now lol it's a bit like my weight loss journey diet for one day and expect to be a size smaller 😆