Hip replacement pain after one year? ML is a 69 year old woman who we first evaluated in June and who now claims we have performed a “miracle”. I don’t know if I would use the same terms other than we were able to get to an accurate diagnosis of what was wrong. Prior to having a hip replacement, the patient had a long history of low back problems and had a failed back surgery. Her physical therapist thought her hip pain was coming from her SI joint, while her orthopedist thought it was her hip. The surgeon won and she eventually had a metal on metal hip replacement, which seemed to help her hip pain for a few months, but then it returned with a vengeance. So she had hip replacement pain after one year of trying to recover. Based on her lack of recovery, she was then told by another surgeon that she may need a low back fusion. At that point she ditched the whole concept of more surgery and began looking for answers. On her initial exam it seemed clear that either her hip pain was from the metal on metal wear particles caused by her prosthesis or was being caused by her low back and SI joint. We investigated all of this by first numbing up what was left of her hip joint under x-ray guidance. When this numbing block didn’t help we then tried her SI joint and SI joint ligaments, which helped her hip pain. We now had a diagnosis, her hip pain was coming not from her hip, but the SI joint. The SI joint is the area between the tailbone and the back of the hip. How can the SI joint cause hip pain? This is discussed in our practice’s book (Orthopedics 2.0) but briefly, most patients with SI joint pain have pain that they describe as the back of the hip and sometimes the groin. However most patients with hip joint pain describe it as in the groin area. Many times there’s no accurate way to tell which joint is causing the hip pain (the SI or hip joint) outside of taking a good history (she had a fall off a horse at a young age and landed on her SI joint and sacrum) and performing a numbing block of the hip and the SI joint to see which injection helps more. Because either joint could be causing hip pain, just looking at an x-ray of the hip and concluding that since it looks like it has arthritis it’s causing pain is a bad idea. So how did we help this patient? We injected her own blood platelets and stem cells into the SI joint and associated ligaments three times under x-ray guidance (Regenexx-SCP). Today she reports long-term pain relief for the first time in years. She’s reduced her pain medications significantly and is finely getting more active. She states that it’s a miracle. It is not; it’s really just taking the time to tease through a correct diagnosis of the cause of her hip pain. The upshot? Even though you feel hip pain doesn’t mean it’s really coming from the hip joint! It could be your SI joint or even a pinched nerve in your back. Insist that a doctor numbs your hip under x-ray or ultrasound guidance to prove that your hip is causing most of the pain before they surgically remove the hip joint. If all of your pain doesn’t go away, then your pain isn’t coming from the hip joint!
NOTE: Regenexx-SCP is a medical procedure and like all medical procedures has a success and failure rate. Not all Regnexx-SCP patients experience the same results.
About the Author
Christopher J. Centeno, M.D. is an international expert and specialist in regenerative medicine and the clinical use of mesenchymal stem cells in orthopedics. He is board certified in physical medicine as well as rehabilitation and in pain management through The American Board of Physical Medicine and Rehabilitation.…