Knee pain after broken hip

2010-12-18 11:20 PM

Extreme Veteran

1332

Subject: Knee pain after broken hip

Just over 2 months ago I suffered a broken femur, an intertrochanteric break, internal rod was used to fix it. As I've been recovering I've noticed a grinding feeling near the knee that seemed to be scar tissue to work out, but it felt centered right on a nerve and was difficult to work out.

Over the last day I've seen a large increase in how much this is bothering me, I went up some stairs and just about collapsed, then getting out of the chair, and back up the stairs at my own house. This time I did fall, and just about smacked my broken hip on the ground doing so.

I've been able to get around fine with a cane up til now and the only time my knee bothered me was either while I was trying to work out the scar tissue, or an expended duration of pool walking.

The pain itself feels like a grinding, almost like it's clicking, and it's much worse as I extend the leg out sitting, than putting it down. It will mostly glide if I don't touch the area, I can definitely feel the grinding if i touch it, and if i put more than a little pressure on it and try to move it, it's pretty excruciating.

I do have an appt. with my ortho in 2 weeks where I'm scheduled to get more x-rays of the hip and such, I was wondering if anyone here had and idea what's going on, if this is just scar tissue working out, or if there is a bigger issue at play.

Thanks.

p.s. picture of the left leg, I used pen to show the area around the "grinding"

Edited by dfquigley 2010-12-18 11:22 PM

dietcoke

2010-12-19 6:23 PM

in reply to: #3253745

Subject: RE: Knee pain after broken hip

not a doctor but have had my share of injuries.

some times when we have a severe injury and we focus on the worst part of it. but in reality we have injured other areas also: example : i broke my arm in a fall and healed very quickly. however once the sling and cast was off i then realized just how much of a hit i took to my neck/spine.

another thought :i have heard read about hip weakness causing the bone to come in contact with the knee cap causing the grind. hope all goes well and you can slowly work through this.

2010-12-19 6:33 PM

in reply to: #3254233

Extreme Veteran

1332

Subject: RE: Knee pain after broken hip

Thus fas the slight grinding feeling was explained as scar tissue, but it was painful to try to work out sice it's right on a nerve, so I've had a hard time getting rid of it.

Went to see a doctor just to be on the safe side, they couldn't pinpoint a cause for the pain, most likely either the scar tissue tore and is causing inflammation which makes the nerve more sensitive, and tightens the area making it easier to pinch, or there is a slight muscle tear.

I need a followup with my ortho, and I already have an appt jan 3rd to see him, so until then I have a zimmer ( long length knee brace ) for outings and am back in the walker instead of the cane for a while.

Socks

2010-12-19 7:13 PM

in reply to: #3253745

Champion

7704

Williamston, Michigan

Subject: RE: Knee pain after broken hip

I think as I recall from your xrays you had a long nail locked at the knee. The scew near you knee could be causing trouble. Also as you were hit by a car its certainly possible you sustained a knee injury at the timeof the injury and its worthhaving your ortho look at your knee at your next visit. You really are not that far out from your surgery, so you are doing Ok really. Your femur is your biggest bone inyour body it takes a while to heal

2010-12-20 12:48 AM

in reply to: #3254265

Extreme Veteran

1332

Subject: RE: Knee pain after broken hip

We took another x-ray to see if the hardware had moved at all, and it was still exactly where it should be, and the doctor even doubted that was the issue because oh how suddenly onset the issue was.

I am seeing the ortho soon and he'll definitely be looking at the knee. I definitely sustained tissue damage since I've had to work out so much scar tissue, this just popped up so suddenly after walking fine on a cane for a month and a half!

We'll see what happens!

2010-12-20 8:44 AM

in reply to: #3254432

Pro

5011

Twin Cities

Subject: RE: Knee pain after broken hip

My hardware never bothered me until recently--now I get snapping over the plate/screw heads (which is almost totally erratic in when it occurs) and a nasty burn where the screws come through the bone to the other side.

Mine was a late-stage thing, too, and when I asked my surgeon (I thought I had maybe re-injured one of the breaks or something) he said that as I built up more muscle and started using the leg more, I woudl notice that pain more often.

Dunno if that's what happened in your case, at all, but...

2010-12-20 7:41 PM

in reply to: #3254654

Extreme Veteran

1332

Subject: RE: Knee pain after broken hip

mmrocker13 - 2010-12-20 8:44 AM My hardware never bothered me until recently--now I get snapping over the plate/screw heads (which is almost totally erratic in when it occurs) and a nasty burn where the screws come through the bone to the other side.

Mine was a late-stage thing, too, and when I asked my surgeon (I thought I had maybe re-injured one of the breaks or something) he said that as I built up more muscle and started using the leg more, I woudl notice that pain more often.

Dunno if that's what happened in your case, at all, but...

If this is the issue, and the pain is only going to get worse, then I need to get those screws extracted as soon as the bone is strong enough to allow so. This is VERY debilitating.

The rubbing was always there after the accident so it is a possibility, but for the extreme pain to be so sudden instead of more gradually coming on may not fit. In addition I'm doing LESS now than I was a month and a half ago, and much less than before the accident, so if anything I'd expect muscle atrophy rather than it building up.

It's definitely possible though, which is why we took a new x-ray, but nothing had changed, so now it's up to the ortho to determine if that's the cause :p

Thanks for the replies

Edited by dfquigley 2010-12-20 7:42 PM

2010-12-21 5:05 AM

in reply to: #3255583

Extreme Veteran

1332

Subject: RE: Knee pain after broken hip

I've changed my opinion

mmrocker13 I now fully agree with your opinion.

When I did some bikework, I couldn't touch this spot at all, blamed it on scar tissue buildup. I could only try to work it out after a couple days off the bike.

When I was first walking with a cane, the knee was straight, and now I am walking on the cane again, with the knee straight, it was more recently I was able to get a better bend in the knee. Perhaps this went on long enough to finally cause some massive irritation at the site of the screwtips.

This explains the irritation after biking, why it hurts when I flex that area but not when the leg is lifted ( since that muscle tightens around the screws ) and why as soon as I apply direct pressure it hurts. Whatever glides there, is catching, and causing exactly what I am going through.

I will verify this with the ortho when I see him, only thing I can do about it, is remove the screws once my hip is healed enough to fully bear the weight I suppose. Until then I Just gotta be aware of my knee, and not use the knee that hard to allow the area to be less inflammed until this is all done!

2010-12-21 8:37 AM

in reply to: #3255744

Pro

5011

Twin Cities

Subject: RE: Knee pain after broken hip

I've talked to a few folks (there was a thread over on ST about it) who have said that they had a similar thing happen--no pain or irritation, then a lot...and then eventually, it goes away. Not SOON--maybe a year, 18 months, 2 years--and not 100% everyone, but it seems like it does eventually abate. Maybe bone calcifies over the screw ends? Maybe the muscles can build up a "callous"? Not sure what the mechanism is...

At any rate, it seems like the minimum time most of them will make you wait is 12-18 months.

My surgeon is almost 100% opposed to taking mine out--he said MAYBE after 18 months, we could discuss it, but he would strongly be against it. I do have the issue that my procedure for the first break also corrected my leg length and joint angle, though, so he wants to make sure that isn't jeopardized as well, I guess. Dunno--maybe you'd have more luck.

2010-12-21 12:18 PM

in reply to: #3255887

Extreme Veteran

1332

Subject: RE: Knee pain after broken hip

mmrocker13 - 2010-12-21 8:37 AM I've talked to a few folks (there was a thread over on ST about it) who have said that they had a similar thing happen--no pain or irritation, then a lot...and then eventually, it goes away. Not SOON--maybe a year, 18 months, 2 years--and not 100% everyone, but it seems like it does eventually abate. Maybe bone calcifies over the screw ends? Maybe the muscles can build up a "callous"? Not sure what the mechanism is...

At any rate, it seems like the minimum time most of them will make you wait is 12-18 months.

My surgeon is almost 100% opposed to taking mine out--he said MAYBE after 18 months, we could discuss it, but he would strongly be against it. I do have the issue that my procedure for the first break also corrected my leg length and joint angle, though, so he wants to make sure that isn't jeopardized as well, I guess. Dunno--maybe you'd have more luck.

Oh man, I sure hope that it goes away then ;_; This is a WHOLE lot of unnecessary pain restricting me a LOT. I'm pretty sure I remember hearing my doctor talk about eventually removing the screws if they did cause a problem, but I could be mistaken. The timeframe makes sense though, since the bone takes about 18 months to be "full strength" once it does start healing.

I'll keep you updated.

2011-01-10 6:12 PM

in reply to: #3256368

Extreme Veteran

1332

Subject: RE: Knee pain after broken hip

Well it's been confirmed!

The screw placement sits the tips right in the middle of where a quad muscle attaches and the PT can feel the tips while looking at my knee now. Most likely there was scar tissue over them that gave way once it was worked more which was the reason for sudden severe pain.

They pretty well have to be removed in the future because of the placement, and the left quad won't be properly balanced with the right until that happens.

Fairly minor problem, so I'm happy

In other news, I had a follow-up X-ray 3 months out and my body is finally starting to show some callous on the femur break. My collarbone already has a HUGE know and is ready for circuit work, but still 50% on the leg.

Very good progress so far, if only the bone kept up with the rest of me

2011-01-11 9:07 AM

in reply to: #3291095

Pro

5011

Twin Cities

Subject: RE: Knee pain after broken hip

You're doing awesome! At three months, I had just gotten off bed rest, so I am very jealous! :-)

I am glad to hear that it is "just" the screws poking through. Can tell that on Xray, or did the doc just confirm it with a manual exam?

I am adjusting to the snapping of my scar tissue and IT band over the plate (it's squicky, but not overly painful), but the screws are getting worse. This AM, I was hobbling up the stairs. It's lame--the better shape I get in, the worse that (and my "good" leg) hurt! :D CAN I live with pain? Sure...but the whole point of the first break was to get RID of daily pain, right? :p

I have my one-year follow up two weeks from tomorrow (Good lord, has it been a YEAR already???), and I am going to ask again.

Your progress sounds great! Keep us posted :-)

2011-01-12 3:14 AM

in reply to: #3292107

Extreme Veteran

1332

Subject: RE: Knee pain after broken hip

I am glad to hear that it is "just" the screws poking through. Can tell that on Xray, or did the doc just confirm it with a manual exam?

I had already gone in for a VERY substantial exam 2 weeks prior to this where they x-rayed my, did a manual exam, and twisted my leg every way they could imagine. This combined with the quick once over from the Ortho and a look at the current X-ray confirmed it for him.

I have a really good physiotherapist too, and she did a really good once over of the knee just to be safe as well, and she can feel the tips of the screws near the knee, but she also couldn't feel anything else wrong.

Last 2 days I've been back at the gym on the bike ( still waiting for my bike to be repaired so I can throw it on a trainer in my living room ) and doing some pool walking. The pain is better than it was, though a plain leg lift from sitting still has me squirming a bit.

I'll post the next time I have news, good or bad

2011-01-12 8:21 AM

in reply to: #3293930

Pro

5011

Twin Cities

Subject: RE: Knee pain after broken hip

You know...we're very close to seeing your good bits in that xray

2011-01-13 11:25 AM

in reply to: #3294204

Extreme Veteran

1332

Subject: RE: Knee pain after broken hip

mmrocker13 - 2011-01-12 8:21 AM You know...we're very close to seeing your good bits in that xray

At least I didn't post the full front x-ray showing the break on my avatar

Edited by dfquigley 2011-01-13 11:25 AM

2011-01-13 6:58 PM

in reply to: #3297253

Pro

5011

Twin Cities

Subject: RE: Knee pain after broken hip

OKay, so as you are aware of what a full xray looks like :p I have my full length (well, from the waist to feet) xrays. You can see, ah, well...you know, girl bits. Fine. Makes me giggle when I'm sitting in the room with my doc and he's talking about my alignment with a taco pic right there, but whatever.

When they rolled me into the OR, I had a spinal, and had not yet been given a sedative, so I was awake and chatting. I had two surgeons, like 6 nurses, and a bunch of other"supporting" folks, as well as some interny types. I was all like "YAY! I have a TEAM! This is awesome."

Then I look up, and there, on the wall, blown up to larger than actual life size are my films (it's so they can draw on them and do the angles and all that jazz). All of these people will be spending the next several hours looking at, and drawing on, a giant image of my whoopter.

Then the sedative started kicking in and A) I was giggling in amusement again and B) I realized I was naked from the waist down ANYWAY. :p

2011-01-15 7:01 AM

in reply to: #3298385

Extreme Veteran

1332

Subject: RE: Knee pain after broken hip

You know, thinking about that...... They actually had put a lead square to apparently "protect" the boy bits from being exposed to radiation, but on the main x-ray where it was important that completely missed the mark, and you can see them all, with a large triangle right below it blocking out some dead space.

They tried, but failed ^_^
Made me laugh when I realized it.

2011-01-17 11:01 AM

in reply to: #3301052

Pro

5011

Twin Cities

Subject: RE: Knee pain after broken hip

You can use that as a point of pride--"My man bits are so prodigious, they couldn't find a lead shield to contain them!" :-)

phoenixazul

2011-01-17 12:37 PM

in reply to: #3298385

Pro

4189

Pittsburgh, my heart is in Glasgow

Subject: RE: Knee pain after broken hip

mmrocker13 - 2011-01-13 7:58 PM

OKay, so as you are aware of what a full xray looks like :p I have my full length (well, from the waist to feet) xrays. You can see, ah, well...you know, girl bits. Fine. Makes me giggle when I'm sitting in the room with my doc and he's talking about my alignment with a taco pic right there, but whatever.

When they rolled me into the OR, I had a spinal, and had not yet been given a sedative, so I was awake and chatting. I had two surgeons, like 6 nurses, and a bunch of other"supporting" folks, as well as some interny types. I was all like "YAY! I have a TEAM! This is awesome."

Then I look up, and there, on the wall, blown up to larger than actual life size are my films (it's so they can draw on them and do the angles and all that jazz). All of these people will be spending the next several hours looking at, and drawing on, a giant image of my whoopter.

Then the sedative started kicking in and A) I was giggling in amusement again and B) I realized I was naked from the waist down ANYWAY. :p

Hahaha, you and I can bond over that experience. I had a left acetabular fracture in April 2009, and had the same. damn. thing. happen. Except that not only could you see my girl bits, but my IUD and my insulin pump site (which was on my non-broke hip). I can't tell you how many times I got asked, "WHAT IS THAT?!?!" by med students. And of course, every follow up film, I had to go through the same. damn. experience.