Hip Talk at Surfacehippy

Hi all. I had a left BHR in December 2024. Now 16 months out and my primary issue is not pain — it's function, though pain is present and contributes.

Specifically I cannot actively flex my hip past 65° standing, which means I still have to lift my leg into the car and struggle with anything requiring hip flexion against gravity. From a sitting position, I can only lift my leg off the ground about one inch with a ton of effort, wheras the non operated leg can get lifted a foot or more. If I lean back, I get a little more range of motion, just super painful.


Hardware is well-positioned on imaging, no loosening, no infection, metal ions normal. Small heterotopic ossification noted at the greater trochanter. Psoas tendonitis has been suggested clinically by a specialist physiotherapist, though no formal diagnosis has been made by a physician.

Had a fluoroscopically guided iliopsoas bursa injection in February 2026 that gave about 25% temporary improvement, now wearing off. 26 visits of PT with limited progress. Currently working with a specialist hip physiotherapist on a targeted program.

My original surgeon is stumped and has referred me to a colleague for a second opinion. No formal diagnosis of iliopsoas impingement has been made. Femoral nerve injury has been considered and largely ruled out — quad fires normally, knee extension normal.

Interesting finding: my PROM is 105°, I can actively flex further lying down than standing, but cap at 65° standing with pain and effort. Load-dependent restriction rather than a fixed block.

Has anyone experienced persistent hip flexion weakness and restricted AROM specifically — not just groin pain — after BHR? And has anyone had a similar presentation resolved, and how?

Any guidance appreciated.

What does your post op x ray look like?