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• Is chronic tendonitis in my right hip due to the injury in my left hip?
  
  

  I will need a left hip replacement at some time due to a traumatic injury 25 years ago. At this point the pain is manageable. However, I have developed chronic tendonitis in my right hip. Is this due to the condition of my left hip and can anything be done? - Maureen, West Roxbury, MA

  This is a good question, one that we often tend to see in cases such as yours. Most likely, your gate pattern (the way you walk) has changed and you have increased demands on your right hip because of the damage you have in the left hip. Physical therapy to recondition the hip muscles has been helpful in managing this problem. Sometimes this, combined with some light exercises or water aerobics, can be really beneficial. But you must understand that the way you walk will not change, and the demands of the degenerated hip will still be working against you. An evaluation from your orthopaedic doctor as well as a physical exam will be necessary to guide you in the right direction. Thank you for your question! Geoffrey VanFlandern, MD, Orthopedic Surgeon

  
  
  
• I had a hip replacement this year. I exercise regularly, but still can't walk any distance without getting a pain in my thigh. What could be the problem?
  
  

  I am a 61-year-old male. I had a left total hip replacement this year after a core-decompression failed. I was about 50 pounds overweight and have lost approximately 28 pounds. I exercise regularly, but still cannot walk any distance. I feel fine, but after walking a few blocks, I get pain in my thigh. It's not as bad as before my surgery, but it restricts my activities. What could be the problem? - Craig/Connecticut

  Thigh pain after a total hip replacement is not uncommon, occurring in up to 10% of patients after surgery. The pain felt in the thigh may be coming from the thigh bone (the femur). Bones are living tissues and are sensitive to pressure and stress. When a cementless stem is implanted into the femur, stress must be transmitted from the ball, through the stem, and into the femur. This stress transfer occurs along the stem, but is greatest near the tip of the stem. The thigh pain associated with activities may represent either a stress concentration near the tip of the stem, or an area of motion where the stem tip rubs on the inside of the bone. In any event, if the stem is well fixed, the thigh pain is usually temporary, as the bone will remodel over time to accommodate the changes in stress. In general, thigh pain will occur 3 to 6 months after surgery and can last for 6 to 12 months, gradually resolving. Increased activity, such as walking, can make it worse. Generally, reduced activity with a cane or crutches can help if the pain is moderate to severe. Anti-inflammatory medications may also be helpful. If the pain persists, observation of the femoral stem with serial x-rays should be considered to look for other causes of pain, such as implant loosening. You should talk with your orthopaedic surgeon about your problem so he or she can determine the best remedy. Thank you for your question! James Bono, MD, Orthopedic Surgeon