My sister had a hip replacement a few years ago and developed what appeared to be a fat embolus. It wasn't. Her symptoms were fatigue and respiratory difficulties. After a couple years of various testing and muscle biopsy, she was diagnosed with acetyl l-carnitine palimitotransferase deficiency (effecting complex 3, and long chain fatty acid metabolism). I have neurological problems suspected as being MS, but my MRI has been stable.

I get muscle fatigue with exercise.

I don't know whether this recessive mitochondrial definciency might be part of my peripheral problems as I have not been tested for this.