Thigh pain after cementless total hip replacement (Page 2)

i am 33 and had my total hip over 2 years ago, i have had hip/groin/back/knee/thigh pain ever since, i go to the gym at least 3 times a week and walk my dogs everyday, plus all the other walking about i do in my job. I have seen my surgeon several times about the pain i have had steroid injections which have done nothing. I am going out of my mind i currently have severe pain in my back, hip, groin and front tip of the pelvis have had to start taking pain killers again. not sure whether to see my doc or just grin and bare it and see if it settles.

I had a total hip in 2007. Everything went well and I was going to PT after the hospital stay. I started getting this pain in the front of my thigh whenever I was walking after about 6 months, or so, post-op, but not always. Had MRI's, X-rays and the whole nine yards. My Dr. said I had some muscle wasting, so I went back to PT, but they discharged me b/c it wasn't getting better. After an MRI of the knee, b/c they couldn't figure out where the pain was coming from, it shows bone on bone and suggest a total knee, as the knee may be the cause of this pain. any ideas? I'm 55- does it matter?

nortoy,

It is a well known fact that thigh pain is very common after a total hip arthroplasty. It tends to be more common in press fit and in-growth prostheses, but can also be seen in cemented ones also. It occurs at the tip of the femoral stem. It is thought to be from micromotion of the stem. In most patients, it resolves with time. However, there is a small portion that have continued pain or episodic pain.

Pain from degenerative joint disease in the knee most often causes knee pain. Just because you have a study (x-rays, MRI, etc) which shows DJD, does not necessarily mean that that is the cause of any discomfort. That is why it is necessary to correlate the results of a study with a patient's symptoms. If they do not match, look for another reason. A surgeon should treat the patient, not the x-ray (MRI, etc)

I don't know, but it sounds like the surgeon is grasping at straws. Oh, I found this DJD in the knee, so let's blame the problems on it. And, we can get another procedure out of it. I would get a second opinion, before having another major joint operation, and then have two prostheses that might cause you problems.

Good luck.

I am 58, female, and had a THR in late December 2010. I had minor thigh pain even right after the surgery, but I could usually "walk it out". After walking it would usually go away. It was especially painful when I would get up from sitting. There was never pain felt unless walking or weight bearing. At 6 months, the pain became excruciating, and I could hardly walk. The area from my knee to my hip joint felt like it was in a painful vise. At other times, I felt a stabbing pain at the end of the femur implant. Went back to orthopedic surgeon who took x-ray and found bone thickening near the lower part of the implant. He said if the pain didn't improve I would need a revision. I don't understand why bone thickening would cause pain and why a revision would remedy this. I cannot find anything on the Internet about bone thickening as a complication of THR. Any feedback would be welcome. I have to use my cane frequently now, and am limping worse than before my surgery when the pain is there. The pain however is intermittent. Sometimes it is there, and sometimes it isn't. I haven't been able to discern a pattern or cause. It is relieved by Advil. I'm at wits end over this.

WOW, this is my exact story... I was 59 female and had this done Dec. 2010. I have had every test know to man... Bone thickening, was also found, or said that i am having a "reaction" Like a spur on the bone. I am very crippled with this, walk okay for 20 to 25 min, then it puts my thigh in a vice like feeling, and I just can't go anymore.. Please write to me. I am going to a dr. at mayo clinic in jacksonville, florida. I would like to know if your any better, or have found any answers. I am so sorry for what you are going thru. Mary

How are you doing, I have had the same problem, and was operated on one month before you.

InPainColorado,

In press fit, or cementless, total hip replacements, the femoral component is pushed into the intramedullary canal of the femur. The canal has been prepared to accept the prosthesis by reaming of the marrow and cancellous bone. When the surgeon hammers the prosthesis down into the canal, the fit becomes tighter and tighter, as the remaining cancellous bone is compressed.

The outside of the prosthesis has been coated with a special coating, that allows the bone to grow into the little nooks and crannies. This way the prosthesis is stabilized by being placed very tightly into the canal and by the bone growth around it.

Thus, in press fit components it is very common to have mid thigh pain at the beginning. There is a tiny amount of motion of the prosthesis as the patient walks, and it is concentrated at the tip of the femoral component. With time, as the bone grows into the coating on the prosthesis, the micro motion becomess less and less and the pain goes away.


However, in some cases, the fit is not quite as tight as it should be (it's a balancing act between too loose and breaking the femur), the bone ingrowth did not occur like it should, there is an indolent infection, or a combination of problems. And as such, the patient continues to have pain in the thigh.


As to the thickening of the bone, that is a response of bone to stress being applied to it. As the tip of the femoral component moves back and forth, however so slightly, it presses against the inside of the femoral canal. In response to this stress, the body lays down callus (new bone).

When callus is seen on x-ray it can be inferred that that segment of bone is undergoing extra stress. So, if it is at the end of the femoral component in a THR, then it is presumed that the component is toggling. If the pain does not resolve, then the femoral component usually has to be revised. If the acetabular component is seated firmly, it can be left in place, and only the femoral one replaced.


Hope that helps. Sorry that you did not get the relief that you needed. Good luck in the future.

Thank you a million times. I also have bone thickening, it shows on x-ray. It also shows the component was put in on a angle touching the femoral canal. I also am wondering if my allergy to NICkle would also cause this vice like pain that has crippled me. I do however have a ceramic uncemented hip.
Are you a Doctor, and where could I go and see you...
Thank you so much....so much... Mary (irish girl)

Gaelic, Thank you for your thoughtful detailed post. I don't have a solution to anyone’s problems but I wanted to share what I am experiencing so others can relate. It helped me reading others posts.

I am a 51 yr male who is 4 months along with anterior approach THR. I was fitted with an OXINIUM implant. I have pain and numbness in the incision area. The numbness runs from the area above the incision to the outside of my knee. I have nerve pain, muscle pain and pain in the joint area. Sometimes I can not tell what is causing the pain. It is pain that I can bear but at times is debilitating. I stopped taking pain meds several weeks ago and am getting by.

There is also an abnormal bulge area just below the lower end of the incision. The bulge area is the most numb and seems to be the source of most of the problem. I have been having a tough time of it because during the 10 years I waited to have this done I anticipated the day when I would get it fixed and feel better, only now it is worse and I can’t reverse it.

What is really annoying is my surgeon has not been very receptive to my complaints. He did allow for blood tests and aspiration to rule out infection. His last response to my concerns was that my problems were not medically relevant. When I asked about the bulge area he replied that it should go down in time. What concerns me is I don’t believe him, it has not changed in 3 months. I am trying to hold onto hope that it will improve, there are good days and bad.

Thank you Gaelic for a most insightful and informative reply. Indeed it is a powerful explanation for the problem I'm experiencing. I'm grateful for your time and expertise. I'm wondering if readers out there have experienced a similar problem with loosening and/or bone thickening at the tip of the femur implant and how you coped with it. A revision surgery is an absolute last resort. Have others coped in various ways and successfully avoided another surgery? Gaelic, if you have any suggestions to try and cope with what is pretty clearly a complication of this surgery, I would appreciate any recommendations. I had the anterior method, BTW. The thigh pain was evident from the very beginning, but I just assumed it was part of the normal healing process. Although I'm in good physical condition, it was a month from the surgery that I could walk without a cane or walker. Will the bone keep thickening? If it continues to thicken, will it get more and more painful? What are my chances of just leaving it alone? Revision surgery is likely to create more pain, risk and disability, so I'm fearful of having to go this route.

Hipsterman, I emphasize with your frustration. I also carefully considered the surgery and surgeon and was hopeful to lead a normal life after surgery. But now, I'm right back where I started. One thought about the bulge area (warning I'm not an MD or expert) is that it might be scar tissue. After my surgery, I was told to massage deeply the scar area to reduce the scar tissue, which I did. The scar has healed nicely, but there is still numbness in the area, and going down a couple of inches from the end of the scar.

InPainColorado,

In the few cases of this I have seen, usually the femoral component had to be redone. A couple of patients did tough it out, and their prostheses finally did become stable, and the pain went away. However, it took a long time, over a year in one case and 18 months in the other.

Other patients just could not put up with the pain, and as such had the femoral stem replaced. Often, the acetabular component does not need to be replaced.

One thing that does need to be ruled out before a revision is decided upon, is that there is no infection. Some times an indolent infection can cause continued pain around a prosthesis, and may also cause a bony reaction.

But, if an infection has been ruled out, and you continue to have pain, then it is a tough decision. Do you wait a little while longer or just bite the bullet and have the femoral component replaced?

Sorry, there is no easy answer.

But, I do hope you do well in whatever you decide to do. Good luck.

Thank you Gaelic, you have given me hope! I will endure almost anything to avoid another surgery. I will definitely follow-up to make sure there is no infection. Since the surgery, I've run a 99 degree temp, and also low blood pressure but no one seems to have thought anything about that. I will press to see if there is any connection there to possible infection. I have noticed that after sitting especially, when I get up and the leg is very painful, if I stand with one leg on the operated leg, sometimes it helps ease the pain, as though it is repositioning itself in a more comfortable position. I've noticed also that if I can keep walking through the pain (20 minutes or more), it does seem to get better. I'm very grateful to know that others have toughed it out, and I will try to do so also. Thanks a million.

Gaelic, one question. Most posts I have read talked about recent (few months)and up to 2 yrs after THR. I am in my sixth yr (bi-lateral hips 2006) and have never had the pain we are discussing, until recently. Only experienced on right thigh and on getting up and putting weight on that leg. Returned to active life-style 6 mos after on M.D. approval, calm water kayaking, comfort biking, golf (cart user), mild hiking.

All annuals have shown thickening to look great. No other issues until now.

Any thoughts?
Thanks,

RR1nVA

Gaelic, thank you for your detailed response and information. It's the best explanation I've seen of the reasons behind mid-thigh pain after a THR. Thank you SO much.

I'm a 63 year old female who had an uncememted THR in April 2010. The mid-thigh pain developed in August/September. Since that time it's continued, usually reaching a pain level 7 or 8 (on a scale of 1 to 10) on a daily basis, always after walking or standing. There's no pain at rest. At first I thought it was sciatic pain, since I have a history of sciatica in that leg. But the mid thigh pain was at the front of thigh - wrong place for sciatica My surgeon said that I should do stretching exercises. They haven't helped. Recently I've been taking shiatsu massage treatments since the thigh muscles are very tight in that leg. That provides some relief, but so far not longterm. I'm thankful that my partner quietly takes on my share of duties around the home, looks after me when I just can't cope, and generally makes it possible for me to get through each day. Without him I'd be in a real mess.

It provides hope to learn that there's a chance the femoral component may settle in if I tough it out. It's been 16 months, and I can't imagine spending the rest of my days in this amount of pain. It's hugely debilitating, and robs a person of any real quality of life.

And to top if off, I'm due to go in for my other THR in 3 weeks. I'm terrified that I'll end up with two legs in the same condition - but the only way to get rid of the joint pain is to proceed with the THR. Talk about being between a rock and a hard place.

You have no idea how happy I am to hear that I'm not the only one who is having groin pain(I was beginning to think I was imagining this pain) after THR in Jan of 2011,this is my second time around (I was one of the lucky? ones who had one of the recall hips)...since this second surgery I have had constant groin pain exactly as others have described. Like others, my Dr. has no explanation either. He did mention more surgery since the cup is large...not a particular fan of the surgery..
Since the first surg. in 2007, I have had a limp and have to walk with a cane. Doc said that I had leg muscle weakness, and that with the recent THR, I may or may not be able to get the strength back in my leg. I'm still walking with a cane and recently the Therapist put me on crutches to take some weight off of the groin area. It has helped with the pain, but as soon as I try to bend to do anything or sitting for a period of time, I have pain in my groin when I straighten up. I'm in the pool everyday walking, and doing my stretch exercises, and the pool is the ONLY relief I have, but when I get out, I'm back to square one. From reading all the posts, there doesn't seem to be a solution for any of this.
I'm only 65!

First and foremost, thank God for this forum! I thought I was going nuts and was the only one with this problem. Secondly, THANK YOU Gaelic! Your posts have been most informative and helpful.

I am a 58 yr. old male who had a right uncememted Titanium, ceramic THR on 6-14-11. This was on the heels (4-9-11) of decompression surgery for my L-3, L-4 region. I have been dealing with this since the middle of February this year.

I originally thought my thigh pain was a quad pull due to my leg muscles being so weak after the two surgeries. I had home, and also some out patient therapy but could not continue due to the thigh pain getting progressively worse. The only thing that seemed to give me some relief was my therapist deep massaging the thigh. The area tightens up into a painful ball. The message loosens it but only for an hour or so.

My Ortho surgeon just sent me for an MRI to determine if the pain is from the femoral component or muscle, tendon related. I am almost at my ends rope since I've also be dealing with scar tissue sciatica on my left side for over 15 years. I am now back on crutches per my doctors orders. Living in pain, and off the kindness of others for so long is starting to really wear me down. The only good thing for me is that my doctor seems to be very responsive to my situation and committed to finding a resolution.

Sorry to ramble on, but having no one else to relate this to (if they aren't going though it, they don't understand)it's at least nice to vent a little.

I sincerely wish all here going through this luck in finding a resolution.

if you feel an excruciating pain, there might be another reason. Have you seen the recall of faulty hip implants? take it into consideration.

I have just read through this forum with great interest, I guess it's re-assuring to read other peoples stories (and realise I am not the only young one!)

I had a total cementless hip replacement at the age of 15 and a revision of the replacement aged 19. I am now 33. The only thing I would like to add to this conversation is that it is on occasion that I feel incredible pain and think "that's it another revision" but the pain passes over a few days with rest.

I found this forum today as I googled "hip replacement shooting back pain" knowing full well that I did a relatively high impact exercise class on Monday so I am now paying the price for that.

It is my feeling that people with hip replacements feel minor underlying pain constantly, most of the time we can ignore it so from time to time we over stretch the ability of the false joint. Then body fights back by reminding us of the fact that we have a false joint; usually with pain. It's easy to panic and think the time has come for another replacement. But normally when I feel true pain I know the reason why and the pain improves with rest.

That said, my experience is that it takes years for hip replacements to 'settle' in the body. My new replacement needed about 3 years to settle itself pain wise. I am sure that's not what you want to hear but it may also be exacerbated by refusal to limit my life because of a hip replacement.

On the subject of groin pain, this is the only pain that never shifted so eventually I took myself to a podiatrist who gave me insoles for my shoes. The repositioning of my feet helped with the groin pain, I think my feet were somehow causing the hip to rotate inwards and almost collapse into the ball socket (if that makes sense?). I informed my orthopedic consultant of this and he said "I don't think the two are linked" with a smirk like I was thinking simplistically. But I can assure you they are linked. When I don't wear the insoles within a few days the groin pain returns. As soon as I wear them groin pain goes. For those suffering groin pain it's certainly worth a try!

Good luck to all of us! And healthy hips

I am a 47 year old male and have had both hips replaced with biomet hips (Anterior) within the last year.
after my 2nd surgery I resumed my sport fencing, recently I would have pain in right quad down to my knee. after talking to a freind I went to a massage therapist who explained my pain was caused by scar tissue between my ITband and my skin. after 1 session I feel lots better I hope thishelps.

Hmm. Let me start by saying this blog has provided me with some relevant and good information.
I had my THR in January this year. For the most part it has been pretty good though I developed mid-thigh pain a couple months ago. It can be pretty bad sometimes.
It mostly occurs after weight-bearing exercises, standing too long, and after riding in the car for more than a few minutes. It does subside after some time. Walking doesn't seem to aggravate it. Coming out of a squat or dead-lift or walking after getting out of the car can be challenging though after I get going it seems to dissipate.
Like a couple of posters, my doctor kind of blew me off. I did get a second opinion. That surgeon told me it was not uncommon and that it was most like due to the difference of tensile strength of the bone and the implant. He also said that it could be toggling slightly though it should resolve itself in 18-24 months. Pretty informative I thought. I haven't been checked for infection but will soon.
My range of motion has improved though not as quickly as I would like. I work on it. I can tie my shoes if I'm in the right position. I just recently have been able to sort of squat to the floor to pick up things.
I had groin pain early in my recovery that resolved as my leg got stronger and with some deep tissue massage. My PT worked on the muscle and tendon there. She mentioned something about strengthening the hip flexors. It worked for me.
I will say that I really made a lot of progress once I started doing a low-impact walking aerobic program from Leslie Sansone that requires hip flexor as well as abduction movement.(Start with the cardio-slimdown. You can find her on your cable In-Demand section under sports-fitness>exercise>walking. Do mon-wed-fri to start. OVER-DOING it will set you back.)
One poster mentioned orthotics helping him which makes sense as foot pronation( ankle rolling inward during the gait cycle) can aggravate hip flexors. Weak quads(which they will be after THR) can cause inward rotation of the hip and thus a pronative effect on the foot as your adductors over-power your abductors.
All this to say that maybe some of you might respond to exercises aimed at helping you regain leg strength. Find a good PT for help, be disciplined, don't over-do it. More is not always better.
Thanks for everyone's story and to the great information here.

Be very careful and skeptical if your doctors postpone needed testing or don't recommend tests that are relevant for your pain. Look up the symptoms for peroneal nerve damage and you can bet if your symptoms match and you don't get scheduled for an EMG really soon to verify proper nerve transmission, you might find out that you are the victim of surgical errors, but you won't realize it until 24 months after the operation, after the statutes of limitations have run out and you're left with the likelihood of lifetime debilitating pain with no legal recourse no matter how negligent the surgeon may have been.

Hmm. Let me start by saying this blog has provided me with some relevant and good information.
I had my THR in January this year. For the most part it has been pretty good though I developed mid-thigh pain a couple months ago. It can be pretty bad sometimes.
It mostly occurs after weight-bearing exercises, standing too long, and after riding in the car for more than a few minutes. It does subside after some time. Walking doesn't seem to aggravate it. Coming out of a squat or dead-lift or walking after getting out of the car can be challenging though after I get going it seems to dissipate.
Like a couple of posters, my doctor kind of blew me off. I did get a second opinion. That surgeon told me it was not uncommon and that it was most like due to the difference of tensile strength of the bone and the implant. He also said that it could be toggling slightly though it should resolve itself in 18-24 months. Pretty informative I thought. I haven't been checked for infection but will soon.
My range of motion has improved though not as quickly as I would like. I work on it. I can tie my shoes if I'm in the right position. I just recently have been able to sort of squat to the floor to pick up things.
I had groin pain early in my recovery that resolved as my leg got stronger and with some deep tissue massage. My PT worked on the muscle and tendon there. She mentioned something about strengthening the hip flexors. It worked for me.
I will say that I really made a lot of progress once I started doing a low-impact walking aerobic program from Leslie Sansone that requires hip flexor as well as abduction movement.(Start with the cardio-slimdown. You can find her on your cable In-Demand section under sports-fitness>exercise>walking. Do mon-wed-fri to start. OVER-DOING it will set you back.)
One poster mentioned orthotics helping him which makes sense as foot pronation( ankle rolling inward during the gait cycle) can aggravate hip flexors. Weak quads(which they will be after THR) can cause inward rotation of the hip and thus a pronative effect on the foot as your adductors over-power your abductors.
All this to say that maybe some of you might respond to exercises aimed at helping you regain leg strength. Find a good PT for help, be disciplined, don't over-do it. More is not always better.
Thanks for everyone's story and to the great information here.

What many may be experiencing is neurological symptoms coming from the back. The dermatome for the lateral aspect of the thigh is from the lumbar spine. I would also return to the physical therapist and be assessed as to the flexibility of the gluteul muscles. There are many reasons for thigh pain. As a personal trainer I have worked with individuals who have had a great reduction in the pain after an appropriate prescribed exercise regimen.

I HAD SURGERY THR NON-CEMENTED CERAMIC ON METAL ON FEB. 22 2012. I HAVE HAD HORRIFIC THIGH PAIN THAT RUNS DOWN BACK OF THIGH, THE MORE I TRIED TO WALK THE WORSE IT GOT. NOW I HAVE THIGH PAIN WITH REALLY BAD SWELLING, PAIN RADIATES DOWN TO FOOT WITH NUMBNESS. I HAVE BEEN BACK TO THE DR. DONE XRAYS SAID BONE HAD STARTED TO GROW WOULD TAKE UP TO 3 MONTHS TO STABILIZE. THE ENTIRE LEG PAIN DIDN'T START UNTIL I TRIED WALKING OUTSIDE ON A CANE. IT KEPT GETTING WORSE & WORSE, NOW I HAVE HAD TO GO BACK ON 2 CRUTCHES & KEEP WEIGHT OFF IT, THE PAIN IS SO BAD. I ALSO HAVE SCIATICA NERVE PROBLEM, MY LEG GOES NUMB AFTER WALKING FOR 2-3 DAYS, HAVE BAD FOOT PAIN ALSO. I AM TOUGH BUT I CAN NOT WALK ON THIS HIP REPLACEMENT, SOMETHING IS WRONG. I HAVE LUPUS, IN 1998 I HAD A LEFT KNEE REPLACEMENT & THE BONE WOULD NEVER GROW & STABILIZE THE JOINT AFTER 1 YR. HAD REVISION & CEMENTED THIGH ITS DONE FINE EVER SINCE. I AM 57 WITH OSTEOPOROSIS, I REALLY FEEL THEY SHOULD HAVE CEMENTED MINE I FEAR I AM FACING A REVISION. I CAN'T LIVE IN THIS KIND OF PAIN! BUT MY THIGH PAIN HAS ALWAYS BEEN BAD RIGHT AFTER SURGERY, THE NERVE FIRED UP 3 WKS. POST OP. DON'T KNOW WHAT I AM GOING TO DO!

I HAD SURGERY THR NON-CEMENTED CERAMIC ON METAL ON FEB. 22 2012. I HAVE HAD HORRIFIC THIGH PAIN THAT RUNS DOWN BACK OF THIGH, THE MORE I TRIED TO WALK THE WORSE IT GOT. NOW I HAVE THIGH PAIN WITH REALLY BAD SWELLING, PAIN RADIATES DOWN TO FOOT WITH NUMBNESS. I HAVE BEEN BACK TO THE DR. DONE XRAYS SAID BONE HAD STARTED TO GROW WOULD TAKE UP TO 3 MONTHS TO STABILIZE. THE ENTIRE LEG PAIN DIDN'T START UNTIL I TRIED WALKING OUTSIDE ON A CANE. IT KEPT GETTING WORSE & WORSE, NOW I HAVE HAD TO GO BACK ON 2 CRUTCHES & KEEP WEIGHT OFF IT, THE PAIN IS SO BAD. I ALSO HAVE SCIATICA NERVE PROBLEM, MY LEG GOES NUMB AFTER WALKING FOR 2-3 DAYS, HAVE BAD FOOT PAIN ALSO. I AM TOUGH BUT I CAN NOT WALK ON THIS HIP REPLACEMENT, SOMETHING IS WRONG. I HAVE LUPUS, IN 1998 I HAD A LEFT KNEE REPLACEMENT & THE BONE WOULD NEVER GROW & STABILIZE THE JOINT AFTER 1 YR. HAD REVISION & CEMENTED THIGH ITS DONE FINE EVER SINCE. I AM 57 WITH OSTEOPOROSIS, I REALLY FEEL THEY SHOULD HAVE CEMENTED MINE I FEAR I AM FACING A REVISION. I CAN'T LIVE IN THIS KIND OF PAIN! BUT MY THIGH PAIN HAS ALWAYS BEEN BAD RIGHT AFTER SURGERY, THE NERVE FIRED UP 3 WKS. POST OP. DON'T KNOW WHAT I AM GOING TO DO!

I had bilateral THR. The left leg (which was the worst) was done in January of 2011 and the right one was done that February. The left one already had hardware from surgery done at age 13 because of a slipped epiphysis. The right hip also had the same but went undiagnosed for all these years. I am now 39. The left hip is GREAT! No problems at all, but the right one, even a year and 3 months later, hurts SO BAD! I've had a bone scan done to see if the fractures were healing (both femurs cracked during surgery) and the bone scan showed nothing wrong. But this mid thigh pain is unbearable! I am on my legs many hours a day, and some days feel that I need my cane again. I now have a diagnosis of "chronic pain" and have to take pain meds on a regular basis. At the end of a work day, the mid thigh area of the right leg looks like it has a large band around it. Now the pain is in my inner groin area. I'm tired of hurting just as bad this long after surgery as I did before. Wish the right leg did as well as the left!! Will this pain ever go away? Orthopedic doctor tells me "do more therapy". Is it nerve damage, when any prosthetic concern has been ruled out? Is there anything else I can do to speed up the healing process?

On thigh Pain after THR Thank all who posted about this topic. I have gained much more knowledge about the cementless type of replacements. I am 2 months Post -OP still dealing with thigh pain, Bursitis, Sciatica nerve problem also. My surgeon shook his head like he didn't know what could be the problem. My Rheumetologist says he thinks it will take time but all this will settle down eventually. I think I started off pushing really hard to REHABILITATE myself back as quickly as possible. that was a big mistake, we are all different & our bodies heal differently. I'll do anything to avoid a revision, YES even deal with Severe Pain if I think there is apossibility of of subsiding eventually1 Thanks to all & good luck to eah one suffering this i feel your PAIN!