Acetabular Labrum tear

[james french]

Dear hipsters

For the past six odd years, Ive struggled with knee and (buttock) hip pain, and seen whats seems like hundreds of different docs. Finally found a physio who stuck with me, and on his advice, I hit the gym with a trainer.

Hip pain was initially diagnosed as Gluteus Medius tendonopathy. Did loads of butt work.. didnt improve. Meanwhile my patello femoral knee pain improved dramatically after a few months, but the butt kept on aching! Was doing some heavy adductor work in the gym which felt good for the knee, but one morning i woke up and there was a pain in the groin part of my hip, which hurt when i tried squeezing the knees together..

Suspected labrum tear...MRI showed a tear traversing the full width of the base of mid anterior acetabular labrum. Of course then came the injection. The anasthetic was supposed to be long acting so that i could take my time to really check it out but the doc decided short one would do "too bloody expensive" were his words, and I couldnt really tell. Pain on adduction was still there. Cortisone had a flare up effect that night and it hurt in the butt very badly.... The next few days were relatively blissfull. Felt good!! Groin pain was there butt i could live with it.

On the third day I did my ususal chores and the butt pain was back.. Now about to see a surgeon to get his opinion.

My questions are.

1) whats the chance that my tear has been with me for 6 years and been the cause of all the butt pain?

2) If its been with me for so long, why has it emerged only now?

3) My surgeon is Michael O'Sullivan in Sydney.. will see him next week, but any comments on success or failures or anything?

Cheers

[Unregistered]

You might want to ask your Orthopeadic about Femoral Impingment. This is a very undiagnosed problem that results in hip pain, sometimes in the butt. Effectively the head of the femur is ever so slightly misshaped (not visible on a standard x-ray) and over time as it 'hits' the acetabular it will finally tear the labrum. The excercises you described will have agravated such a condition. Have a look at the following link for more information.

http://www.physsportsmed.com/issues/2005/1005/larson.htm
It can be very effectively treated with either an arthroscopy or hip surgery.

[Unregistered]

You might want to ask your Orthopeadic about Femoral Impingment. This is a very undiagnosed problem that results in hip pain, sometimes in the butt. Effectively the head of the femur is ever so slightly misshaped (not visible on a standard x-ray) and over time as it 'hits' the acetabular it will finally tear the labrum. The excercises you described will have agravated such a condition. Have a look at the following link for more information.

http://www.physsportsmed.com/issues/2005/1005/larson.htm

It can be very effectively treated with either an arthroscopy or hip surgery.

[Binningsley]

Sounds like the same history for the athletes i have seen in the past. I have now rehab`d 8 athletes who have undergone labrum repair.

Recently, two problem cases have suffered from quite sizeable osteophytes both on the acetabular rim and the femoral neck which were butting up against each other and destroying the labrum. With arthroscopy the labrum was destroyed and was delaminating in the socket at the superior aspect (imagine between 11 and 1 on a clockface).

The surgeon i have used recently is Dr Philippon in Vail, Colorado. He is pioneering loads of hip arthroscopy work and is a fantastic man to speak too.

Good luck


Sunderland FC (UK)

[james french]

thanks for the reply.... Its now exactly 3 weeks after my arthroscopy and while i'm still tender in the groin region, im quite surprised to say that the butt pain has decreased quite dramatically. Im scared to actually believe it since im loving it too much to ever go back, but there are a few factors that are making me pessimistic, which are that i've been taking it extremely easy since the op, and It might be the effects of the cortisone i had injected prior. I guess i should remain positive or at least enjoy it while it lasts

I wonder. If the tear was caused by my femur hitting it repeatedly because of its deformed shape, and the surgery removed that part of the labrum that it was hitting, do i have more space for hip flexion. the reason i ask is because im not entirely sure what debridement looks like or how much was removed.

The scope revealed that the rest of the joint was clean and undamaged but would the surgeon be immediately aware if my femur was misshaped? Or could they have missed it in the MRI because they werent looking for it?

Its early days yet, but so far im so glad its done.
Thanks for your replies again.

[Unregistered]

James,

I am currently booked in for an arthroscope early Feb, with Dr M. O'Sullivan as my surgeon.

Can you tell me a little about the operation and how is the recovery going.

thanks

Dan

[Unregistered]

Hi James,

I too have been diagnosed with your condition. I have had had a rough 6 months. After Xray, MRI and CT investigations, they found that I had not only acetabular tear but also lesions on femoral head which resulted in further investigation and delay in treatment for labral tear. Lesions turned out to be nothing to worry about however I still am in a great deal of pain. I have had 2 cortisone injections to no avail (I reacted badly to the last - flare and fever for 1week post injection) and am scheduled to see Dr Michael O'Sullivan for a surgical opinion.

Can you tell me a little about the operation? How long was it before you were up and about?

All the best with your recovery,

Amy.

[Unregistered]

Hi Amy,
I had no other chondral damage other than a great big tear in the labrum, so I believe just a straight labral debridement is easier post op than when they have to clean up the ball and/or socket as well. To answer your question, i limped out of the hospital without crutches and it took about a week before i could walk around the house without much difficulty. Two weeks later and i could walk some distance. Now its a month later and im walking up and down Bondi on the soft sand daily and it feels great. Its still painfull at the end range of flexion, (bringing knees to chest) and full extension is also a bit painfull, but this is normal. i was worried that i would be out of action for much longer than this, but I was surprised to find that a nagging pain in the buttock region had significantly reduced almost immediately, so I can basically say that I am better off almost immediately after the operation.

I am curious to know your symptoms, and others with labral tears. No one gave me a straight answer as to why a tear in the groin region would refer pain to the upper buttock region, except my physio who suggested that a the tear changed my bio-mechanics which caused weak gluteus muscles and eventually inflammation in them. this sounds good except why the sudden relief in the butt pain.

Anyone else out there with suggestions on why??

Hope it goes well for you Amy. Dr O'sullivan was very friendly and helpfull and i'm told he does this procedure very well

[james french]

Ps that last post was from me... i forgot to sign in and sign my name.

James

[Unregistered]

James,

Noted your response to Amy.

Initially my condition was misdiagnosed as torn muscles, which then changed to nerve damage.

Eventually ended up with Dr O'Sullivan following successful diagnosis by another specialist.

My injury is a radial tear in acetabular labrum with incomplete tear at chondro-laberal junction. Including chondral wear at acetabular rim, possibly from femoral head rubbing.

I have suffered ongoing pain in the top of the buttock area since July last year, with associated numbness down my leg to the knee and sometimes beyond.

Had cortisone injection just before Christmas, which didn't work.

Your physio is on the right track. Prior to the correct diagnosis, I had accupuncture sessions when regular physio didn't work. In hindsight the pain must have worked its way outwards from the joint, affecting the muscles. These sessions helped deal with the local pain in greater trochanter muscles, which must have become inflamed.

regards

Dan

[Unregistered]

Hi, I'm living in Tauranga, New Zealand.
I'm to go for Arthroscopic surgery on my right hip, for a labral tear repair and removal of a cyst. This is booked for Tuesday, 14th February.
Although I've had several other unrelated surgeries, I'm a bit nervous about this one as I can't seem to get much information.
I've only recently heard that surgery isn't always successful long-term.
As I've had the problem for 9 years -
(was doing an exercise in aquarobics when I felt a "snap", and it's taken 8 1/2 years to get a correct diagnosis with a new surgeon I visited last August. He knew straight away what it was because of my symptoms and an MRI confirmed it) -
I'm keen to get some relief at long last, but now having second thoughts if the surgery won't be long term relief from the pain.
Can anyone give me peace of mind I'm doing the right thing going ahead with the surgery, as it's not too late to pull out.
My surgeon is very hard to get hold of and is only here once a week.
Thanks, Lynne

[South Florida]

I am 7 days post Hip arthroscopy to repair/"clean" out the labral tear I had as well as remove some cysts. I had Perthis Disease as a child (causing avascular necrosis) which caused my left hip joint to be flattened thus causing a tear of the acetabular labrum.

So far the pain that I had in the groin and the buttocks region has been resolved. I have had no pain since the surgery which so far seems to good to be true.

My first day of therapy was on the fourth day and was placed in the bike to do some cycling and leg lifts. Yesterday was my second day of therapy and they had me do some strengthening exercises after cycling for about 15 minutes. By the way, the first five minutes of cycling yesterday were painful as I felt my hip get "stuck". I was told it was probably from adhesions that were forming. After the initial onset, the pain went away and the hip was doing good.

I started having some pain today in the buttock region; however, it is probably from being on my feet for about two to three consecutive hours. My ortho specialist did tell me to take it easy for a week or two.

For those who are having the surgery, My BEST TO YOU...For me it was the best decision I could have made... The ortho said I was too young for a hip replacement (I'm 36 yrs old) and that this would at least lengthen the time before I need one.

[Unregistered]

Lynne,

I'm currently at day 4 post arthroscopy for a labral tear. I had a labral debridgement & chondroplasty. My post-op has been similar to James. I have pain in the butt region, however I also have pain in right calf muscle, which is similar to a severe cramp. My whole leg was numb for about 15 hours after the procedure, which was a lot longer than the anaesthetist stated it would be. Calf muscle may have cramped as a result without me feeling it.

I fully understand your concerns about having the procedure, as the specialist who diagnosed my condition stated he would not recommend an arthroscopy as it would only give short term relief.

I decided to take a leap of faith, place my trust in the Orthopaedic Surgeon and go ahead with the procedure. At this stage I'm glad I did.

Dan

[Unregistered]

Title of previous posts incorrect - should have been as above.

Dan

[Lynne]

Thanks for the replies guys.
After a lot of soul-searching, I've decided to go ahead with the surgery on Tuesday, as after living with the damn pain for 9 years, it can't be any worse having the op, and it's worth a try to be, hopefully, pain free.
Thanks again.
Kindest regards, Lynne

[Lynne]

Me Again,
After reading some of the messages re groin pain, etc can I just say that instead of being mis-diagnosed as I have been for 8 1/2 years, suggest a labral tear to your doctor. My surgeon tells me a labral tear in the hip joint is the most mis-diagnosed problem.
Physio makes the problem worse, which I can certainly verify, as after 2 different physio sessions, I could hardly walk with the pain, for over a week afterwards.
Acupuncture was a waste of time and money. Nothing will fix a labral tear except surgery.
Don't be fobbed off as I was, to about 6 different doctors. One wanted to do exploratory surgery in the groin. Thank god I declined, and found a good Orthopaedic surgeon who after 5 minutes of listening to my symptoms, diagnosd a labral tear, and this was confirmed with an MRI.

[Unregistered]

Hi,
I am 4 days post-op from a left hip arthroscopy. I am progressing quite well, but It has been a long, hard road to diagnosis and treatment of a torn labrum.

In April of 1999, I tripped, fell down the stairs, and landed on my buttocks. At first, I thought I had escaped injury. Ten days later, I experienced pain in my hip, groin, buttock, and lower back to the extent that I could hardly walk. My hip x-ray was normal. After several weeks of Physical Therapy, my pain subsided, but the buttock pain remained. Eventually, I consulted two different orthopedic physicians and had a MRI and bone scan. Both the MRI and bone scan were normal. I tried deep tissue massage therapy and while it offered some relief, I still had buttock pain. I was convinced that the medical community could not determine the cause of my pain and eventually, I started taking Celebrex. The “stink” over Vioxx and Bextra last year (2005) caused me question the wisdom of continuing on Celebrex. By this time, my hip was snapping more than 60 times a day, the buttock pain was worse, and I had quit my twice-daily walks. I decided to see another (third) orthopedic physician, who suggested that I might have a torn labrum or loose body. He ordered a MRI arthrogram that turned out to be a technically poor study (due to artifact), but it did suggest a superior-lateral labral tear. I was referred to Dr. John Clohisy, Associate Professor, Orthopaedic Surgery, Washington University School of Medicine, St. Louis, MO, who specializes in disorders of the hip and knee. Dr. Clohisy first tried conservative measures. He sent me to a Physical Medicine specialist at Washington University for a direct injection of cortisone into my hip, followed by Physical Therapy. Neither the cortisone injection nor Physical Therapy provided relief. Dr. Clohisy then offered to perform a diagnostic arthroscopy, and I was ready!

Undoubtedly, the pain after surgery hasn’t been any worse than what I have experienced for the past almost seven years. I would describe the post-operative pain as more a “soreness”. I only needed crutches for the first 48 hours. I am to start Physical Therapy one week post-operatively, and follow-up with Dr. Clohisy two weeks post-op. I am grateful that Dr. Clohisy didn’t “write me off” as did the first two orthopedists. If you reside in the St. Louis area, Dr. Clohisy has an excellent reputation.

To Lynne: I'm glad I had the surgery

June Bg

[Unregistered]

Greetings all,

I'm glad to have found this forum to check out the experiences of others and share those of my own. I'm a 42 y.o. fairly avid cyclist who experienced my first hip pain in Jan. 2004 while doing plyometric exercises (giant skipping, explosive sprints, etc.) during a "boot camp" workout program. My initial symptoms were a dull ache and pressure when taking long strides and pain when running. I saw a PT and had some deep muscle work soon after the injury but without any real improvement. I was able to ride strenuously that cycling season but still unable to run so I visited a local orthopedist and after an MRI discovered I had a labral tear.

The ortho also diagnosed "pistol grip" deformity - referred to as femoroacetabular impingement (FAI) – and recommended an open surgical dislocation procedure to reshape the head of my femur. Since I had never experienced hip problems before, the thought of undergoing this fairly major surgery seemed excessive. The ortho also said he could simply arthroscopically remove the torn labrum but that it wouldn’t address the underlying impingement issue.

Thinking I was being conservative, I opted for arthroscopy and in early Dec. 2004 had the surgery without incident and with really good results – at least initially. I was off crutches and pain meds in 2 days, back at the gym riding a stationary bike in 2 weeks and out riding my bicycle in early Jan 2005 (on an unusually warm Maine winter day). By mid-Jan I was weight training with no apparent ill effects.

Unfortunately, in early Feb 2005 I had a cycling accident where my bike slid out from under me and I ended up doing a split on my recovering hip. The pain was intense and I knew immediately that I had really messed it up again. Upon my visit to the local ortho a couple weeks later, I was informed that even if I had re-torn my labrum the underlying pistol grip had to be addressed in the course of repairing the tear. I still wanted to avoid the open surgical dislocation and sought out a second opinion with one of the most prominent hip arthroscopists in the US.

In July 2005, I had another MRI and CT scan done and the “expert” wasn’t able to find any obvious signs of labral tears. He also wasn’t a big proponent of the impingement theory for explaining why tears often occur in the first place. So I had my local orthopedist recommending open surgical dislocation and the “expert” telling me I was fine and not to worry. The trouble was (and continues to be), my hip still hurts and I can’t strenuously ride my bike, run, hike or ski.

After the fair amount of research I’ve done on FAI I’m now convinced I should’ve taken the initial advice offered by my local orthopedist (address the impingement with the open procedure) and that the “expert” probably misjudged my case. In fact, there seems to be a growing body of literature that supports the idea of FAI as a significant underlying cause of labral tears. Much of this literature also suggests that if left untreated, FAI will almost inevitably develop into degenerative arthritis and that reshaping the femoral head can slow or halt this process.

Consequently, I’ve got an appointment in a few weeks with my local ortho to finally accept that I need to have the open surgical dislocation. I can’t bear the thought of being consigned to a life of inactivity and hope to regain some of my previous physical capabilities and remain active well into my later years. I’m too young to have an old worn out hip! And it sounds like all of you are, too!

Thanks for the opportunity to share my story and I’ll check back frequently to see how you’re all doing. Also, if any of you would like links or PDFs of the documents I’ve found in my research just send me an email (fdillon1@maine.rr.com) and I’ll send them to you. (You could also do a Google search for “femoroacectabular impingement” or “pistol grip deformity.”)

Good luck!

Fred Dillon
Portland, Maine (USA)

[Unregistered]

Great article from the journal Physical Therapy
Lewis CL, Sahrmann SA. Acetabular labral tears. Phys Ther. 2006;86:110 –121.
http://www.ptjournal.org/PTJournal/Jan2006/ad0010600110p.pdf

[GJB]

Hi South Florida,
I have a few years on you at 56, no 57 today. I was being attacked by a BIG dog whilst running before Christmas and propped then turned to face dog, about 130 deg.behind on other side. A car arrived so dog didn’t get a taste but when I tried to start running again a sharp pain made me limp home.

Deteriorated over week, had x-ray..... untreated Perthes, no sign of recent trauma? (never diagnosed since infancy but couldn’t win foot races at school)..... 2 Months later, condition worse & still cant work, saw specialist and asked for MRI- now waiting to get result.

Always loved running, yoga, riding bike, bushwalks, farmwork, carpentry & building. This hip has had a serious workout and I have been on glucosamine with chondroitin & MSM, for all my joints, for 5yrs.and felt great. Right leg 20mm short and not as flexible in hip as left.

Now I am a serious cripple and have my bet on acetabular labral tears, from femoroacetabular impingement. I have the groin and butt pain and one down the front to the kneecap and below; a sharp pain also where my leg threatens to give way and the nagging pain in bed that interferes with sleep. I experience discomfort whilst sitting, on feet or lying down.
From utter defeat after sitting on the ground with head in hands I have stood up and walked away normally without a limp and only a slight hint of discomfort at extent of gait. But not for long because its unstable and can be anywhere inbetween at any moment.

I have had problems with both knees in the past, the left needed a small piece of damaged cartilage shaved off that would become displaced in the joint and a cyst that formed because of the cartilage damage, then strangely in the right, the arthroscope found nothing wrong.....Hmmm! (I now suspect the pain was referred from the hip)

Please keep us informed of your progress. I would also like to hear more about your Perthes history and anyone else’s experience, as this diagnosis is new to me. I have not heard of Perthes before.

All the best
Greg
Aus

[Unregistered]

Hello,
I am a physical therapist in the U.S. and I have been experiencing low back buttock and leg pain for the past 10 years on and off. Recently, it was made worse by taking up golf. I had two sessions of physical therapy in the last 4 years, which helped temporarily and many deep tissue massages which also helped temporarily. My symptoms are now localized to the groin and buttock. I finally decided to consult an orthopedic surgeon because I am no longer able to play any sports, do yoga or dance like I used to. Preliminary x-rays and physical exam point to labral tear of the hip and I am scheduled for an MRI in 3 days. The surgeon stated that arthroscopy is only successful in 30% of cases. Is this what you all have found?? He basically said I'd have to live with it. What is your advice?
S

[Thihan]

Hi S, I'm a physio in Melbourne, Australia with a special interest in chronic hip, groin and LBP mainly because I spent years sorting out my own problems as well as my patients. The simple answer to your question about hip pathology and hip scopes is that we don't really know. If we compare the historical progression of a similar pathology and procedure in the knee, for example the first knee scopes, it took many years before sufficient evidence was avaliable regarding best practice in managing those conditions. Comparatively, hip joint pahtology (excluding OA) ia a relatively new phenomen and as such we are still exploring the best methods for both assessing severity of pathology as well as the most appropriate management. At Melbourne University they have a specialised hip study group who investigate just that. At the end of the day hip pathology is not an isolated problem, the compensations and interactions with other musculoskeletal components are complex and require sound clinical assessment and reasoning when deciding on an individualised treatment plan. As a PT a good starting point is a thorough look at a your lumbo-pelvic biomechanis and stablity as wellas looking at your aggravating activites to decide on the best ways to impove your weakness and manage your hip load. Pilates can be a good way of implementing it into a busy lifestyle (it worked for me). There's another whole thread on the surgical side of things on this forum so check that out too.
Cheers
Thihan - sorry about the long post.

[Thihan]

Quick addit: to properly answer the question about what to do, have a read of the acetabular labral tear article someone posted the link to earlier (damn .. wish I'd written that one). If the MRI is inconclusive then I would say explore all rehab and conservative measures fully before undergoing surgery. If however you have a tear then it needs invasive treatment (this may be just an injection or a full arthroscope or both). I have found this stepwise approach has saved quite a few (me included) from surgery but of course it all depends on the chronicity/severity of the problem and the pain of course.

[Unregistered]

Thihan,
Thanks for the reply. I have had two rounds of PT in the last 4 years, and I am a Pilates instructor. When I can do Pilates, it does really help, but overall the problem is getting worse. The MRI will confirm if it is a tear, but it most likely is. I read the referenced article by Shirley Sahrmann et.al. and another by Dr. Farjo from University of California. It seems that arthroscopic surgery is becoming more popular for the hip, but still very few surgeons are performing it....I will certainly seek a second and possible third opinion before signing up for surgery. And I may also try a very concentrated round of self-PT with a combo of Sahrmann muscle balancing exercises and Pilates just to be conservative first.
Thanks for the advice.
S

[Claire]

Hello All,

I am a 20 year old female who has a history of joint problems. I had a capsular shift performed on my shoulder at the age of 17.

After 5.5 months of frustration and misdiagnosis I am 7 days post op from Hip Arthroscopy + Labral Debridement.

I presented with severe pain in groin for no apparent reason. I am an active cyclist and whilst I had had a fall some months prior to the onset of pain, the sudden onset meant that there was no link to the fall.

Xray, CT and MRI investigations showed an Acetabular Labral Tear and moderate non-specific synovitis. Lesions on the Femoral Head were also shown which were possibly an indication of an Osteoid Osteoma (a benign bone tumor which causes night pain). This was later ruled out after they scared me by telling me that it might be a malignant tumor! The injury was so severe that I was basically on crutches for 5 months.

I was treated with 2 cortisone injections to no avail.

I have heard a lot about arthroscopy patients having little success after surgery and was fairly sceptical about the procedure but I have to say one week out I have no pre-op pain at all.

I was in hospital for three days (usually this is a day procedure but I had quite a lot of debride taken out).

A little about the procedure: it takes about 2.5 hours. Both legs were placed into vascular stockings and the leg that was to be operated on was placed into traction.Two small incisions are made on the outer thigh region where probes are inserted.

I walked out of hospital aided by crutches and continue to use them now one week later.

I had physio two days ago - passive movement is fantastic. I am still very sore and sorry but it is only going to get better from here in. My physio expects that I will be able to walk unaided in another week (slower than what other people have posted but we all heal differently!). The main thing that the groin pain is gone.

After months of chronic pain I now have relief and can get on with life.

To people who feel that there are no non-evasive treatment options left - I say "GO FOR IT". What have you got to loose?

[DiverDan]

:confused: Anyone interested in post-op recovery.

It is now 3 weeks, + 3 days since procedure. I've had a couple of physio sessions, including weight bearing exercises.

Still experiencing pain while sitting, with hip not taking any weight. Any change in direction, or sudden rotation of the hip causes it to "catch", resulting in sharp pain. Hopefully ongoing physio will strengthen muscles around joint, aiding recovery.

Anyone experienced similar symptoms?


Dan

[Unregistered]

Hi -
I'm a 26 year old female distance runner. After 4 months of groin pain, I finally went for an MRI. I have an acetabular labral tear in my right hip. I am scheduled for surgery on the 22nd of this month. I was wondering if any of you have had arthroscopy or have any insight as to whether or not I should follow through with it.
I have spend January and February swimming and riding the stationary bike, getting electric stim and ultra sound.
Thanks so much.
Rory

[injuryupdate]

It is interesting that the stats show that 8 times as many hip arthroscopies (per head of population) are done in Victoria than NSW. I know of some people who have flown down from Sydney to Melbourne to get one done.

I would only recommend hip arthroscopy if other management fails. I think guided injections of local into the joint help a lot with diagnosis. Still a lot to learn for the orthopods about this procedure, although like anything else, there will be some surgeons who do hip scopes to make money and others who will be selective.

[Claire]

Hi Dan,

I know what you mean. I have had other joint surgery in the past (shoulder capsular shift - very invasive) and the body takes time to heal. It took around 6 weeks with my shoulder before I stopped getting the "catch" sensation.

I am sure that once you have regained muscle stability in and around the joing that you will no longer experience that "catch" sensation.

I am finding at the moment that I am compensating for pain by overusing my glutes at the moment and as such I am unbalanced. Did you have this problem? My physio keeps telling me off for walking with a stiff leg!

All the best.

[Unregistered]

Dan,
Sounds like you are still having some difficulties, which you may want to discuss with your physician and physiotherapist. Your pain in sitting may be due to pulling of your hip flexor muscle, specifically iliopsoas, when unsupported. Use back support when sitting and try not to sit with knees below the hip as this cantilevers the joint forward somewhat. Twisting and sudden movements are probably not a good idea at this stage in your healing. Remember, the body takes at least 6-8 weeks to heal injured tissue, then you have to regain the proper muscle control and strength which can take another 6-8 weeks. Be patient, but be an advocate for your rehab, make sure you get all your questions answered.
S
PT in US

[rorycasta]

It is interesting that the stats show that 8 times as many hip arthroscopies (per head of population) are done in Victoria than NSW. I know of some people who have flown down from Sydney to Melbourne to get one done.

I would only recommend hip arthroscopy if other management fails. I think guided injections of local into the joint help a lot with diagnosis. Still a lot to learn for the orthopods about this procedure, although like anything else, there will be some surgeons who do hip scopes to make money and others who will be selective.
Hey I'm not sure if you were writing that response to me. In regards to the "guided injections of local" would that be the same procedure as the injection for the MRI?
Thanks,
Rory

[Unregistered]

Hey everyone, its 2 months to the day since the op. Reading back on all these replies reminded me how fast time has gone. I'm into my next phase of physio which involves riding an excersise bike, and slowly strengthening the glutes and light core work. My range of movement has increased since last post (bout a month ago), which is re-assuring that all is looking good. My butt pain is sooo so different to how it was. Spent a few lazy days at home and by the end of it was quite comfortable in bed.... looking back to pre op days that would have been an unbearable amount of inactivity. I recently flared up the hip by doing something silly, and the annoying butt pain came back. few days later, all was calm again. So in comparison, Im doing fine. My physio told me not to have any expectations till at LEAST 6 months which i was prepared for, so by using my progress as a timeline i reckon everything is pretty good.

Dan, I reckon you had a few more things wrong with your hip joint and so more fiddling around, probably explains the slower recovery. Don't despair mate, if you get to do some light slow cycling, ( I hired a little excersise bike) you'll find that it loosens up the joint and gets the blood flowing around the hip..but only after you get the go ahead. Sitting means your femur is close to the part of the labrum where they worked on (assuming your's was like most others, in the front) so naturally it will hurt more, but in time your pain free range will increase.

Cheers all.
J. French

[Rebecca43]

Hi

I'm a PT working in the UK and have had all the recognised symptoms of a labral tear. The results of the MRI arthrogram are inconclusive showing a cyst and degenerative changes only. Has anyone else had these symptoms and similar MRI findings and subsequently been found to have a labral tear?

[Unregistered]

:D Hey Jeff, PT, Claire & others,

Thanks for the replies fellow painsters. Jeff, this discussion has expanded somewhat from your original post and based on the global responses, this is the only forum on the subject. Shame it was not available when many of us were being misdiagnosed.

I have been undertaking physio, including light stationary bike work etc for the past couple of weeks. Originally advised my recovery would take 3 months to return to pre-injury status. Based on previous posts, I will need to discuss with surgeon and re-evaluate. My age may also be a factor in recovery, as I'm 44.

Dan

[Unregistered]

My appoligies James. That will teach me for attempting to reply to two forms of media at the same time.


Dan

[Fred Dillon]

Greetings,

I've been following these posts with interest and some perplexity in that none really seem to address what may be the underlying cause of labral tears in many cases, namely femoroacetabular impingement (FAI). I appreciated Thihan’s observations that hip pathologies can be very complex and not very well understood, but in the case of FAI it would seem to be a relatively straightforward mechanical issue. As I mentioned in my Feb 13th posting, there seems to be a growing body of literature that supports the idea of FAI as a significant underlying cause of labral tears. Much of this literature also suggests that if left untreated, FAI will almost inevitably develop into degenerative arthritis and that reshaping the femoral head can slow or halt this process. Have any of you other folks posting to this thread had any experience with surgical procedures to address FAI?

Any assistance / feedback would be greatly appreciated.

Fred Dillon, Maine, USA

Below are excerpts from an article by Dr. Tom Sampson from San Francisco.

INTRO
Hip pain in younger individuals has been associated with abnormal morphology of the hip joint itself. In recent times, there’s been more attention paid to acetabular and femoral morphology and its association with femoroacetabular impingement syndrome. Femoroacetabular impingement may reduce motion due to pain typically in flexion and internal rotation. This is due to the impinging bump of femoral head neck bone either overloading the articular cartilage causing chondral injury or delamination defects of the anterior acetabulum with separation and tearing of the adjacent labrum. There are two types of FAI; 1) Cam impingement in which there is an increase in the anteriolateral radius of the femoral head mismatching with the radius of the acetabulum 2) Pincer impingement in which there is a short offset between the head and the neck allowing the neck to abut against the rim of the acetabulum and labrum...

CONCLUSIONS
Femoroacetabular impingement occurs in late adolescents and young adults and may be a precursor to early hip arthritis. Reinhold Ganz and his Bern Hip Group and Jeff Mast have made significant contributions to our understanding of femoroacetabular impingement. They have demonstrated that its early correction may alleviate pain and prevent the progression of arthritis of the hip. An arthroscopic equivalent to the open surgical dislocation has been presented. Our experience has shown it can be done safely and effectively with favorable early results. Patients are off crutches quickly and no hardware is left behind as with the trochanteric osteotomy done in the open procedure. Only after a thorough study will we be able to compare the long term outcome with those of the open procedure, however the early results are very favorable and is a less invasive procedure is more desirable...

For the full article, see the following link:

www.aana.org/pdf/FallCourse/dr.%20sampsons%20arthrocopic%20treatment%20of%20fa i_syllabusaanafall05.pdf

[Thihan]

I completely agree with you Fred, FAI and femoral bossing (as well as other mechanical dysplasias) are a big contributor to soft tissue pathology of the acetabulum. However in Australia just getting the "establishment" to agree on what is dysplastic and what isn't can be a long process. The best example is my own hips, which presumably started off poorly designed (labrador hips) but were exacerbated by 10 years of competitive karate and kickboxing. I had every scan avaliable (all NAD on report) and saw multiple orthopods with many different opinions. It was only as a physio ,when I was able to do my own research on hip dysplasia and met a Melbourne Sports Doc with a particular interest that we were able to diagnose the problem. If you look at my xrays now, it's bleeding obvious what the problem was. Treatment wise in Melbourne, hip athroscopy is the only real option but as you say doesn't treat the problem of impingement, just gets rid of some of the damaged tissue. I've rehabed quite a few post op hip scopes in the last 5 years (more every year) and outcomes are quite varied (especially in chronic cases), but my gut feeling is that the best responders are those with minimal dysplasia and straight internal hip derangement. It looks like the US is well ahead regarding awareness of the hip as a pain source in younger populations as well as the more invasive surgical procedures (ie osteotomies) which may be required to treat them.

I'm a conservative type at the best of times so I suppose the whole idea of taking a hammer and chisel to my femoral neck just gives me the willies especially when my symptoms are managable. Your thoughts and experiences would be most appreciated on outcomes for more extensive surgical intervention.

[Fred Dillon]

Hi again,

Thanks for the quick reply, Thihan - and despite your sense that the US may be further along in hip awareness, I still had to go all the way to Australia to find this forum! Wonder if it says something about the general state of affairs in the US health care system? But that's for another thread entirely...

I also appreciate your conservatism before resorting to bone carpentry - although in my case it appears I may have been better off having the surgical dislocation and femoral head reshaping (or preferably the arthroscopic equivalent) instead of the simpler arthroscopy to remove torn labral tissue.

I'm now faced with a second surgery on the same hip with thinning cartilage. My biggest fear is that the "horse is already out of the barn" and there's not enough cartilage remaining to justify the procedure. If this is the case, I guess I become a candidate for total hip replacement - which would really be a bummer since I probably won't be able to resume any of my pre-injury activities - at least not at the same intensity that maintains the fitness level to which I've become accustomed.

I’ve got an appointment with the local ortho doc in another week and a half and will keep you posted on how I make out. In the mean time, I’ll also probably check with Dr. Sampson in San Francisco and / or Dr. Philippon in Vail, Colorado.

Cheers,

Fred

[Bob the Vagrant]

Femoral-acetabular impingement is just the latest trendy diagnosis. Could be thought of as the sports hernia of the 00's. Seems a good excuse to push patients into premature surgery and secure another mortgage repayment

[Bob the Vagrant]

Also need to consider that hip arthroscopy is HEAVILY operator dependent.

[Unregistered]

From the number of posts on this forum, it appears that labral tears go undiagnosed for a number of years. Is it possible that femoro-acetabular impingement is a direct result of long term chondral wear, with the femoral head articular cartilage eventually changing shape to fit with the new groooove???

In my particular case, it was a matter of 11 months from injury to surgery. Is it possible that any predisposing factors such as carrying rigid weight around the hips could speed the process of chondral wear, following a labral tear???

:confused: DiverDan

[Fred Dillon]

It would be great if Bob the Vagrant were right about the trendiness of FAI so that my hip pain would simply go away and I could resume my active / athletic lifestyle. Unfortunately, after rest, PT, deep muscle massage, cortisone injection and arthroscopic surgery to remove torn labrum this has not been the case. And while I can’t claim to be anything resembling an expert in these matters, it would seem the impingement hypothesis has merit and is easily understandable even by non-medical laypeople like me.

To wit: an ideal healthy hip joint consists of a spherically shaped femoral head centered on the femur shaft and fitting properly into the hip socket. Deviations from this ideal (i.e., non-spherical or offset femoral head) result in impingement and scuffing of articular cartilage, acetabular delamination or labral tears. I realize this explanation is way over-simplified and there are many other biomechanical factors to consider, but based on the research I’ve done it makes a lot of sense.

I’ll try and find the reference to a study that examined a bunch of (not sure how many) human skeletons with arthritic hips and found an overwhelming majority had pistol grip deformity or FAI. I believe the same article asserted that 8-10% of the population has some form of FAI. I guess the implication is that FAI has been with the human species for a while and really may not be very trendy after all…go figure.

[Fred Dillon]

...I’ll try and find the reference to a study that examined a bunch of (not sure how many) human skeletons with arthritic hips and found an overwhelming majority had pistol grip deformity or FAI. I believe the same article asserted that 8-10% of the population has some form of FAI...

Didn't find the article to which I referred above, but found a couple others that are relevant (sorry to load the posting with so much info, but I thought it might be of interest to folks):

American Academy of Orthopaedic Surgeons - Academy News - 2003 Annual Meeting Edition Bulletin

What causes ideopathic hip arthritis?
Poster No. P027

Is idiopathic osteoarthritis of the hip really a misnomer? Could anterior impingement of the femoral neck on the acetabulum be the real cause of hip arthritis? Researchers for Poster Exhibit P027 make the case that "ideopathic" osteoarthritis of the hip is really due to loss of anterior femoral offset.

Idiopathic arthritis is the primary reason for the majority of total hip arthroplasties (THA). However, a pistol grip or post-slip deformity of the proximal femur is also common, affecting 8 percent of the population. This deformity results in the loss of anterior offset and impingement of the femoral neck on the anterior acetabulum. Researchers wanted to know the incidence of anterior hip impingement secondary to a pistol grip deformity in patients undergoing total hip arthroplasty for "idiopathic" osteoarthritis.

Radiographs and charts of 200 consecutive THA patients were evaluated for the presence of acetabular or femoral pathology. Femoral pathology was then graded based on the degree of slip and posterior slip angle. Of the 200 patients, 125 (62.5 percent) were diagnosed with "idiopathic" osteoarthritis. All 125 patients had a pistol grip deformity.

In 95 percent of the cases, the slip angle was categorized as mild. The degree of slip was measured as mild or moderate in 75 percent of the patients. No patients had evidence of osteoarthritis in the posterior aspect of the joint. Additionally, where there was anterior impingement, 94 percent of the patients had obvious sclerosis, osteophytes or cysts on the femoral neck.

As a result of this analysis, researchers concluded that osteoarthritis of the hip commonly results from anterior impingement of the femoral neck on the acetabulum due to loss of anterior femoral offset. They recommend that future surgeries be directed at this anterior offset deficiency in order to prevent further progression of osteoarthritis in young, active individuals.

The researchers were Nicholas Noiseux, MD, and Michael Tanzer, MD, both of Montreal, Quebec, Canada.


Osseous Abnormalities and Early Osteoarthritis: The Role of Hip Impingement.
Clinical Orthopaedics & Related Research. (429):170-177, December 2004.
Tanzer, Michael MD, FRCSC; Noiseux, Nicolas MD

Abstract:
The purpose of this study was to establish that anterior hip impingement, secondary to an anterior femoral offset deficiency from a pistol-grip deformity, was a common etiology of hip disorders. This impingement results in a spectrum of injury ranging from anterior hip pain, labral tears, damage to the acetabular articular cartilage and idiopathic arthritis. This was accomplished through three separate but closely related studies: (1) an arthroscopic labral tear study of 38 patients who had hip arthroscopy for a labral tear (2) a hip cheilectomy study of 10 patients who had a cheilectomy for anterior femoroacetabular impingement and (3) an idiopathic arthritis study of 200 consecutive patients having THA. In all three studies, a common etiology was identified. Repetitive anterior femoroacetabular impingement resulted in anterior groin pain, labral tears, chondral damage and eventually arthritis. This impingement was caused by a pistol-grip deformity of the proximal femur in 97% of the cases in the arthroscopic labral study and 100% of the cases in the idiopathic arthritis study. The identification of anterior hip impingement as a cause of labral tears and idiopathic arthritis may allow surgeons to correct it early in its natural history and delay or prevent end-stage arthritis.

Debridement of the Adult Hip for Femoroacetabular Impingement: Indications and Preliminary Clinical Results.
Clinical Orthopaedics & Related Research. (429):178-181, December 2004.
Murphy, Stephen MD *++[S]; Tannast, Moritz MD *++[S]; Kim, Young-Jo MD, PHD *+++; Buly, Robert MD [//]; Millis, Michael B MD *+++

Abstract:
Untreated femoro-acetabular impingement is a common cause of osteoarthrosis of the hip. Surgical debridement of the adult hip with femoro-acetabular impingement recently has been advocated with the aim of relieving symptoms and slowing or halting progression of the arthrosis. At surgery, femoral sources of impingement are relieved by debriding the aspheric peripheral portion of the femoral head and the adjacent femoral neck. Acetabular sources of impingement can be relieved by debridement of the anterior rim. The most fundamental questions concerning these procedures relate to the preoperative and postoperative function, postoperative survivorship of these hips and the incidence of osteonecrosis. The current study assesses a group of 23 hips in 23 patients treated by surgical debridement for impingement. Twenty-two patients were treated by full surgical dislocation and one patient was treated by relief of impingement without dislocation. Followup ranged from a minimum of 2 years to 12 years. At most recent evaluation, seven patients had been converted to total hip arthroplasty, one had arthroscopic debridement of a recurrent labral tear, and 15 patients have had no further surgery. No hips developed osteonecrosis. Of the seven patients who had to have their procedure converted to total hip arthroplasty, three of these hips failed early and four patients' hips recovered and functioned well and subsequently deteriorated with total hip arthroplasty done between 6.4 and 9.5 years after debridement. Hips at greatest risk of failure have advanced arthrosis or a combination of impingement and instability preoperatively. The procedure effectively treats hips with impingement and without considerable secondary arthrosis or instability.

Anterior Femoroacetabular Impingement: A Clinical Presentation.
Sports Medicine & Arthroscopy Review. Hip Injuries in the Athlete. 10(2):134-140, June 2002.
Ferguson, Tania A. M.D. *; Matta, Joel M.D. +

Abstract:
SUMMARY: Femoroacetabular impingement is a cause of groin pain, which frequently afflicts young, active patients. Patients with irregularities in the morphology of the proximal femoral head-neck junction are at risk for developing impingement of the acetabular labrum. Furthermore, the cam effect causes compression and avulsion of acetabular cartilage and can result in irreversible degenerative changes in the joint of these relatively young patients. Understanding the anatomy responsible anterior impingement and disorders of the acetabular rim is essential for joint preservation. Arthroscopic debridement may alleviate acute labral symptoms but does not address the underlying osseous anatomy; treatment should include osteoplasty of the proximal femur to improve the anterior head-neck offset and allow clearance of the anterior acetabular rim. A case is presented to highlight the presentation, exam, diagnosis and treatment recommendations for patients with anterior femoroacetabular impingement.

Arthroscopic Treatment of Femoroacetabular Impingement.
Techniques in Orthopaedics. Hip Arthroscopy. 20(1):56-62, March 2005.
Sampson, Thomas G. M.D.

Abstract:
Summary: Femoroacetabular impingement (FAI) is condition that occurs commonly in young adults and middle age that causes hip pain felt mostly in the groin. X-rays often appear "normal" to the untrained observer, however, on careful analysis an anterior to lateral bump may be visualized at the head neck junction as an extension of the physeal line. Reinhold Ganz with the Bern Hip Group have developed an outstanding open technique using a safe surgical dislocation of the hip to alleviate FAI. An arthroscopic equivalent of the open technique has been developed and performed for 22 months and will be described. The early results are favorable and may be comparable to the open technique.

[Unregistered]

Fred,

I am in a similar situation as you, except never had arthroscopic surgery and am about 20yrs younger. After about 2 years of hip pain, I realize my fate if nothing is done. It is quite clear that FAI surgery will correct the femoral head-neck offset, thus reducing bone and articular cartilage shearing. My main concern with this procudure is the risk of complications (ie, AVN, femoral fracture, nerve damage, hetertopic ossification etc.). Hopefully an experienced surgeon will minimize these risks. Have you looked into Dr. Millis (boston)? Also check out the Femoro acetabular impingement and Hip Scope groups on yahoo.

-patrick

[Unregistered]

I thikn I have a hip problem like what you guys are describing. Anyone know a doctor in melbourne, aus who specialises in this type of stuff?

[Fred Dillon]

Hi Patrick,

Thanks for the leads on Dr. Millis in Boston and the Yahoo group on femoroacetabular impingement. It's made for some very interesting reading.

I'll probably be having open surgery soon to reshape the head of my femur. Is there a chance you can avoid the open procedure and have the arthroscopic one done instead? Sampson in San Francisco (see the last abstract I posted above) and Philippon in Vail, CO are a couple of the names I've seen mentioned frequently in my research. A posting on the Yahoo group mentioned that a colleague of Philippon's (forget his name) had recently moved to Boston Children's.

A potential caveat to the arthroscopic procedure as noted by my local ortho is that you can only have torn cartilage / tissue in the joint repaired with the open procedure. Apparently, they haven't come up with a way to tack loose cartilage back down arthroscopically and instead just remove it.

Since it seems the underlying premise in having the procedure in the first place is to preserve joint cartilage (i.e., prevent arthritis), if you've got lots of loose tissue flapping around in your hip joint it might be better to save as much as possible with the open procedure - even though it's WAY more invasive? Not sure about the answer, so good question to pose to prospective surgeon.

[Lynne]

Hi Everybody,
Just thought I'd let you know I had the surgery on 14th Feb. for a labral tear and cyst. Surgery went well, and apart from going into post-operative shock the day after surgery and unwell for 2 days after that which was pretty unpleasant (and frightening), my recovery is going well. Now coming up in 3 days time to be 4 weeks since the op.
I found post surgery was pretty uncomfortable, but then having lived with the pain in the groin/front of thigh/knee for 8 1/2 years, it was nothing new.
Saw the surgeon 2 weeks after the op and he was pleased with my progress. I needed crutches for about a week after the surgery, as without them I just couldn't walk properly and it was putting too much stress on my other leg.
So, up to now glad surgery is over, pain gone from the usual places and only a "tightness" and "pulling" sensation in the groin at the moment. I see the surgeon again - and hopefully for the final time - in 2 weeks time.
It's a novelty over the last couple of days to actually be able to get out of a chair and stand and immediately walk, without pain and having to wait until the pain subsided before I started walking which is what usually happened pre-surgery.
Only thing I'm a bit concerned about is I've read that the arthroscopic surgery for the repair/cyst removal may not be long-term. My surgeon didn't mention this, and I must remember to ask him when I see him.
Anyway, thanks to all who were interested.
Good luck to anyone contemplating hip surgery.
Best wishes,
Lynne

[Unregistered]

I also had a labral tear and arthroscopy to fix it-- its' been a little over 8 weeks. Most my pain is gone but i still have some on the front of my hip joint. Can anyone who has had this done tell me when I can *hope* to be pain free? I can cycle now, but I want to start running again!

[Luke]

Fred

Without being too cynical, have you considered that an invasive procedure like open reshaping of the femoral head may also lead to OA changes down the track. Due to its nature I expect there is not a lot of evidence or research on this to date. Not trying to talk you out of it though. I'm 2 weeks post-op open chondral grafting and tibial tubicle transfer of my knee and know what its like to have exhausted all other options. Sometimes you have to bite the bullet and take the chance to try and regain that former glory.

[Fred Dillon]

Hi Luke,

I don't think you're being cynical, just careful. I definitely share your concerns about the potential long term consequences of such a heavy duty and invasive surgery. My hope is to be fit and active well into my later years (if I live that long). Unfortunately, I'm no longer able to do the kinds of things that will allow me to maintain the level of fitness to which I've been accustomed. Additionally (and as I mentioned in an earlier posting), my research on femoroacetabular impingement (FAI) has all but convinced me that if I choose to do nothing, my prospects for an active lifestyle decrease significantly with each passing day (unless I choose to become inactive – which I hope to avoid). I tried just about every conservative measure available before finally opting for surgery. So I guess it just becomes a matter of trying to determine the relative risk of choosing to do nothing vs. having a surgery that may actually improve my prospects for maintaining some level of fitness and activity. For me it’s a no-brainer…

Thanks for your concern and good luck with your recovery!

[Unregistered]

Hi all,

I just recently found this forum. I am a 27 year-old female in New York City and am scheduled for hip arthroscopy on March 30 to repair a labral tear in my left hip. I've been having pain for several months, and after trips to many different doctors, weeks of PT, and an MRI, I finally learned what the problem is. I don't know how I injured myself, but a good bet is that I recently joined the gym and started working out on a regular basis (running, elliptical, yoga, weights).

My orthopedic surgeon (who specializes in hip arthroscopy) made the procedure seem very simple. However, after talking with my sports medicine doctor, I am now a little more wary. He warned me of how awful I will feel post-op, and that I need to really prepare myself for the procedure. Now I'm quite terrified, especially after reading Lynne's comments about her procedure.

Can others tell me what to expect and/or reassure me in some way?

Thanks.
Heather

[Unregistered]

Check out the hip scope community at yahoo - heaps of info there and people's insights.
http://health.groups.yahoo.com/group/hipscopecommunity/

Also the labralicious group

http://health.groups.yahoo.com/group/labralicious/

And the hipscope website run by patients

http://www.hipscope.net/

[Unregistered]

Heather,

I just had a hip arthroscopy on February 8, 2006 at Barnes-Jewish Hospital, St. Louis, MO. I had a 15 millimeter anterior labral tear. I am 59 years old, and I didn’t find the surgery to be all that bad. Perhaps the skill of my surgeon, Dr. John Clohisy, helped things to go smoothly for me. Three incisions in my groin area were closed with steri-strips. When the steri-strips came off (about 10 days to 2 weeks later), the incisions were only about ¼ inch long and were healed! I only took 2 pain pills on the day of surgery, and 2 the next day. After that, I only took extra strength acetaminophen. Dr. Clohisy prescribed ketorolac tablets (a potent anti-inflammatory) every 6 hours for 5 days, which undoubtedly minimized the pain. The first couple of days, I sat around on the recliner with an ice pack to my groin. I used my hand and arm to push myself up from a sitting to standing position, and I used crutches to walk. By the third day, I didn’t use the crutches that much. I’ve found that it helps to sleep with a pillow between my legs. I let comfort be my guide. I went to PT one week post-op. All they did in PT for the first 5 weeks was apply heat, distraction (pulling on my leg, which felt good, believe it or not) and they had me do some gluteal strengthening exercises. You definitely need to take it easy on the hip for a while to let it heal. I am just now starting some gentle stretching, strengthening, and the bike. When I saw Dr. Clohisy at 5 weeks post-op, he gently moved my hip every way possible, except backwards, and it did not hurt!!!!

Since your orthopedic surgeon specializes in hip arthroscopies, I’ll wager that everything goes smoothly for you as well. Hope this helps to allay some of your fears.

Patrick, Fred, Dan, Thihan, and others I may have overlooked:

Dr. John Clohisy, the orthopedic surgeon who did my hip arthroscopy, has published a scholarly article about a minimally invasive two-stage operation for anterior femoroacetabular impingement: "Treatment of Anterior Femoroacetabular Impingement with Combined Hip Arthroscopy and Limited Anterior Decompression". First, he does a hip arthroscopy to inspect the severity of disease and address labral and articular cartilage lesions. Then, he performs a limited open anterior decompression of the hip. I don’t know if anyone where you live performs this combined procedure. I discovered while talking with others in Dr. Clohisy’s waiting room that people come to St. Louis from all over the USA for Dr. Clohisy to perform their surgery.

The link below should get you to Dr. Clohisy’s article. The second link is to Dr. Clohisy’s credentials from the Washington University Physician’s Directory, if you’re interested.

http://www.uihealthcare.com/depts/med/orthopaedicsurgery/research/ioj/ioj2005/sports/treatmentofanterior.pdf

http://wuphysicians.wustl.edu/physician2.asp?PhysNum=2246

Best of luck to each and every one of you!

June Bug

[Unregistered]

Hello Heather,

I am a 41 year old man living in the SF Bay area. I started doing martial arts when I was 14 and started having hip problems about 3-4 years ago. I have had femoral acetabular re-shaping of my hip twice now. Apparently, two years after it was done the first time, I had a recurrence.

I would say that the surgery itself is very minor. Compared to my orbital blow-out fracture repair, or abdominal hernia repair it was actually quite minor and I was up and walking around (with crutches) in a couple of days and w.o crutches in a couple of weeks. The first two days are a little uncomfortable, but I found just leaving the ice pack on my hip for 2 hours at a time with a half an hour off alleviated about 90% of my discomfort.

As far as I am concerned this surgery was a god-send. I could not walk very well before it was done the first time, and was in serious and constant pain. I am only hoping that I had it done early enough to avoid hip replacement.

Good luck!







Hi all,

I just recently found this forum. I am a 27 year-old female in New York City and am scheduled for hip arthroscopy on March 30 to repair a labral tear in my left hip. I've been having pain for several months, and after trips to many different doctors, weeks of PT, and an MRI, I finally learned what the problem is. I don't know how I injured myself, but a good bet is that I recently joined the gym and started working out on a regular basis (running, elliptical, yoga, weights).

My orthopedic surgeon (who specializes in hip arthroscopy) made the procedure seem very simple. However, after talking with my sports medicine doctor, I am now a little more wary. He warned me of how awful I will feel post-op, and that I need to really prepare myself for the procedure. Now I'm quite terrified, especially after reading Lynne's comments about her procedure.

Can others tell me what to expect and/or reassure me in some way?

Thanks.
Heather

[Unregistered]

I would recommend Dr John O'Donnell in Richmond, seems to be the most experienced and well recomended guy within Vic / NSW.
Good luck!

[Unregistered]

I just wanted to thank everyone who wrote (and for those great links to other forums). I'm feeling a bit calmer now, as the surgery date approaches (March 30). FAI has been ruled out by a CT scan, and the surgeon tells me that my procedure looks pretty straightforward at this point, but that it's always possible he'll see more when he gets in there.

However, what's been a bit of a mystery to the doctors and myself is the pelvic pain that I've been having. They're not entirely convinced that it's related to the labral tear. The pain is about an inch above the pubic bone on the left side, and is bothersome when sitting or standing for a length of time. The surgeon thinks it could be weak rectus muscles or something ovarian (Ob/Gyn says no so far). It's also accompanied by pain around the SI joint (which looked fine in the MRI, just a little bit of fluid). Did anyone else have a similar front pelvic pain?

Thanks!
Heather

[sscardenas]

Hello,

It would have been nice to find this forum prior to my surgery. I'm 36 and and I had AFI surgery 4 weeks ago.

I also did significant research and felt that the surgery was a no brainer considering my condition would worsen and hip replacement was an eventuality. However, I've made some assumptions (right or wrong) based on what I read and what my Doc (Dr. Crane - Denver CO at Rose Hospital) told me. Those being: assuming recovery goes well I can expect to return 100% to what my activiity level was (after 6-12 months)?? I can only hope that is true. The good news for me was that I had a 'smooth' tear of the labrum and it went back in to place well and had zero arthritis in the joint?

The shocker is - appartently the probabiltiy is high that people have AFI in both hips. So - I'm going to wait and see how recovery goes and have an MRI on the other hip in a couple of years.

My recovery has been a little rough - in my mind. (4) weeks in and my mobility is severly limited and I have two more weeks on crutches (+ a fair amount of paint aroung the 7' incision). It is major surgery and I have been told I won't feel 'normal' until after three months. Anyway - time will tell but I wanted to share my story and progress.

Any one else have this and if so where and how are you doing in your recovery?

[Unregistered]

Hi

I'm a PT working in the UK and have had all the recognised symptoms of a labral tear. The results of the MRI arthrogram are inconclusive showing a cyst and degenerative changes only. Has anyone else had these symptoms and similar MRI findings and subsequently been found to have a labral tear?
Rebecca, I just had a labral tear repaired and there was a cyst also. I'm
told by my surgeon that they are common to tear sites. Mike in U.S.

[Unregistered]

Hello,
I am a physical therapist in the U.S. and I have been experiencing low back buttock and leg pain for the past 10 years on and off. Recently, it was made worse by taking up golf. I had two sessions of physical therapy in the last 4 years, which helped temporarily and many deep tissue massages which also helped temporarily. My symptoms are now localized to the groin and buttock. I finally decided to consult an orthopedic surgeon because I am no longer able to play any sports, do yoga or dance like I used to. Preliminary x-rays and physical exam point to labral tear of the hip and I am scheduled for an MRI in 3 days. The surgeon stated that arthroscopy is only successful in 30% of cases. Is this what you all have found?? He basically said I'd have to live with it. What is your advice?
S
See another ortho. My surgeon has a 90% + success rate. Dr Marc Philippon
in Vail. I'm 5 weeks out and starting to walk a little w/ light crutch help.
No pain after 2+ years of agony. He's done pro golfers and hockey players
There are probably others I just couldn't find many that have done more
than a few operations. Philippon has done 100's. Mike in Sactown

[Unregistered]

I just wanted to thank everyone who wrote (and for those great links to other forums). I'm feeling a bit calmer now, as the surgery date approaches (March 30). FAI has been ruled out by a CT scan, and the surgeon tells me that my procedure looks pretty straightforward at this point, but that it's always possible he'll see more when he gets in there.

However, what's been a bit of a mystery to the doctors and myself is the pelvic pain that I've been having. They're not entirely convinced that it's related to the labral tear. The pain is about an inch above the pubic bone on the left side, and is bothersome when sitting or standing for a length of time. The surgeon thinks it could be weak rectus muscles or something ovarian (Ob/Gyn says no so far). It's also accompanied by pain around the SI joint (which looked fine in the MRI, just a little bit of fluid). Did anyone else have a similar front pelvic pain?

Thanks!
Heather

Heather,
There’s a several page article on the web, entitled, “Hip overuse syndrome”, http://www.emedicine.com/sports/TOPIC49.HTM. If the doctor thinks your pelvic pain might be caused by a muscle, Section 6 of the article talks about various muscle groups that support the hip.

I personally did not have pelvic pain. However, the Physical Therapist says my muscles learned to be pretty dysfunctional in order to compensate for the 7 years of chronic hip pain before my arthroscopy. Perhaps you, too, have muscles that physio therapy can help you to strengthen after your hip arthroscopy.

Best wishes!
June Bug

[Unregistered]

Hello,
I am a physical therapist in the U.S. and I have been experiencing low back buttock and leg pain for the past 10 years on and off. Recently, it was made worse by taking up golf. I had two sessions of physical therapy in the last 4 years, which helped temporarily and many deep tissue massages which also helped temporarily. My symptoms are now localized to the groin and buttock. I finally decided to consult an orthopedic surgeon because I am no longer able to play any sports, do yoga or dance like I used to. Preliminary x-rays and physical exam point to labral tear of the hip and I am scheduled for an MRI in 3 days. The surgeon stated that arthroscopy is only successful in 30% of cases. Is this what you all have found?? He basically said I'd have to live with it. What is your advice?
S

I concur with Mike in Sactown . . . I would find another orthopedic surgeon who is more experienced in hip arthroscopies. The scholarly literature reports a 67%-91% success rate for arthroscopic treatment of labral tears - see, "A Review Of Hip Arthroscopy And Its Role In The Treatment Of Adult Hip Pain",
http://www.uihealthcare.com/depts/med/orthopaedicsurgery/research/ioj/ioj2005/sports/areviewofhip.pdf

June Bug,
(Successful hip arthroscopy for torn labrum 2/8/2006: Dr. John Clohisy, Washington University/Barnes-Jewish Hospital, St. Louis, MO)

[Unregistered]

Heather,
My name is Heather as well, I had arthroscopic surgery to remove a labrum tear on the 10th of March. The surgery was successful and I had minimal damage to the cartilage in my hip. I have run competitively for 20+ years and was experiencing severe groin pain 9 months after having my third child. It was an unusual pain that felt like very ache-y and was not something you could point to and say it hurts here. I had two months of physical therapy with a PT that specializes in women's pelvic injuries; she mentioned the possibility of a labrum tear after 4 weeks of PT. The PT helped different muscles start working again put the pain would start immediately after running and after 30 minutes of walking. I had an MRI arthrogram - my Dr could see the labral tear. I was on crutches for 3 days but I didn't need them much. I'm walking normally 12 days after surgery and I start pool therapy next week. Another running friend of mine, male, had the same surgery done by the same Dr and he is running 40+ miles a week 10 months later pain free. I anticipate doing the same very soon. Good luck - Heather

[Unregistered]

I am so glad to find this website. I could really use some help. I have been having groin/butt/low back pain off and on for 5-6 years. I finally went to see an orthopedic surgeon who stated that I had torn the labrum in my hip. He also said that I had femoral acetabular impengment and hip dysplagia and that I would need to have the labrum repaired as well as a triple pelvic osteotomy. I think that this is a bit extreme, considering I have always been active (soccer and long distance running) and I would have thought that I would have had trouble before now. Does anyone know of any orthopedic surgeons in Oklahoma or Texas that I could go to for a second opinion. Also, does anyone have any suggestions for exercises that I can do to maintain strength until something can be done. Any info would be helpful, thanks ,
Kris

[Unregistered]

Hi all,
My name is Kristi; I am a casual runner/dancer. I have had a deep ache in my medial hamstring for years, over the last few months it has progressively gotten worse, with a deep ache in the buttocks and now sharp pain in my hip with a combined flexion and lateral or medial rotation. I went to the PT this week for some help and he strongly suggested that I had a hip labrum tear and recommended I have an MRI and if the Dr concurs to have surgery. I am very against surgery and am looking for alternative therapies (id homeopathies , herbs, energy healing, acupuncture, etc) I am open to most alternative therapies if anyone has heard of or tried any alternative and had some success please let me know. Thanks for a place to talk about this.
kristi

[Unregistered]

Hi all,
My name is Kristi; I am a casual runner/dancer. I have had a deep ache in my medial hamstring for years, over the last few months it has progressively gotten worse, with a deep ache in the buttocks and now sharp pain in my hip with a combined flexion and lateral or medial rotation. I went to the PT this week for some help and he strongly suggested that I had a hip labrum tear and recommended I have an MRI and if the Dr concurs to have surgery. I am very against surgery and am looking for alternative therapies (id homeopathies , herbs, energy healing, acupuncture, etc) I am open to most alternative therapies if anyone has heard of or tried any alternative and had some success please let me know. Thanks for a place to talk about this.
kristi

Though I don’t claim to be an expert, I’ve read a number of articles about labral tears. Most scholarly articles list some combination of the following conservative treatments for labral tears: Physical Therapy, rest (from bed rest to crutches), non-steroidal anti-inflammatory drugs (NSAIDS), glucosamine & condroitin, and direct injection of cortisone and local anesthetic (marcaine, lidocaine) into the hip joint. I assume glucosamine & condroitin classifies as a homeopathic remedy. I don’t recall any sources mentioning acupuncture or energy sources.

There’s a very good article in the Jan. ’06 Physical Therapy journal about labral tears. If you have PT, it’s good to know what they should and should not be doing with regards to your hip:
http://www.ptjournal.org/PTJournal/Jan2006/v86n1p110.cfm

This Dancing Smart newsletter does a nice job of explaining the problem of labral tears:
http://www.thebodyseries.com/newsletters/2005/01/01_28_05%20Labral%20Tears.html


The British Journal of Sports Medicine gives a thorough explanation of labral pathology and treatment, including conservative treatment:
http://bjsm.bmjjournals.com/cgi/content/full/37/3/207


Another good article that covers the whole gamut of hip problems. As with most sources, it says arthroscopy is the preferred method of treatment:
http://www.aafp.org/afp/991015ap/1687.html

I cannot blame you for not wanting surgery. From what I’ve read, however, a majority of patients with labral tears have unsatisfactory results from conservative measures and end up having arthroscopic surgery. Whatever your decision, I would base it upon scholarly writings by experts, rather than testimonials by businesses that sell herbal products or clinics that offer alternative treatments. If you decide to have surgery, I would choose a surgeon who has performed a significant number of hip arthroscopies.

I had a hip arthroscopy with removal of a torn flap of labrum 6 weeks ago, and I didn’t think the surgery was all that bad. In fact, I wish someone would have determined my problem a lot sooner. Over an extended period of time (7 years), my body/muscles learned to compensate in some very dysfunctional ways. Now, it’s going to take a lot of Physical Therapy to get me straightened out!

Best of luck!
June Bug

[Unregistered]

See another ortho. My surgeon has a 90% + success rate. Dr Marc Philippon
in Vail. I'm 5 weeks out and starting to walk a little w/ light crutch help.
No pain after 2+ years of agony. He's done pro golfers and hockey players
There are probably others I just couldn't find many that have done more
than a few operations. Philippon has done 100's. Mike in Sactown

I agree with your advice for S. I'm scheduled with Philippon in early May having been diagnosed with FAI. I just received his paperwork today and under post-op instructions I've noticed the 12 hr/day (8 at night and 4 additional during the day) use of a CPM (Continuous Passive Motion) machine. How are you doing with this? Is it cumbersome?

Happy to hear your healing well.

James in Portland, OR

[Unregistered]

I am so glad to find this website. I could really use some help. I have been having groin/butt/low back pain off and on for 5-6 years. I finally went to see an orthopedic surgeon who stated that I had torn the labrum in my hip. He also said that I had femoral acetabular impengment and hip dysplagia and that I would need to have the labrum repaired as well as a triple pelvic osteotomy. I think that this is a bit extreme, considering I have always been active (soccer and long distance running) and I would have thought that I would have had trouble before now. Does anyone know of any orthopedic surgeons in Oklahoma or Texas that I could go to for a second opinion. Also, does anyone have any suggestions for exercises that I can do to maintain strength until something can be done. Any info would be helpful, thanks ,
Kris

Hi Kris -

Check out the Steadman-Hawkins Clinic dot com. Like you, I to am very active and I think you will like what you read despite it's location. I'm scheduled with Dr Marc Philippon in early May for FAI. Of all the research I've done - his name was one of a few that kept coming up.

I hope this helps.

James in Portland, OR

[Unregistered]

Hi Amy,
I had no other chondral damage other than a great big tear in the labrum, so I believe just a straight labral debridement is easier post op than when they have to clean up the ball and/or socket as well. To answer your question, i limped out of the hospital without crutches and it took about a week before i could walk around the house without much difficulty. Two weeks later and i could walk some distance. Now its a month later and im walking up and down Bondi on the soft sand daily and it feels great. Its still painfull at the end range of flexion, (bringing knees to chest) and full extension is also a bit painfull, but this is normal. i was worried that i would be out of action for much longer than this, but I was surprised to find that a nagging pain in the buttock region had significantly reduced almost immediately, so I can basically say that I am better off almost immediately after the operation.

I am curious to know your symptoms, and others with labral tears. No one gave me a straight answer as to why a tear in the groin region would refer pain to the upper buttock region, except my physio who suggested that a the tear changed my bio-mechanics which caused weak gluteus muscles and eventually inflammation in them. this sounds good except why the sudden relief in the butt pain.

Anyone else out there with suggestions on why??

Hope it goes well for you Amy. Dr O'sullivan was very friendly and helpfull and i'm told he does this procedure very well





I too have been experiencing pain in my groin/hip and butt to knee for quite some time. I started noticing something was bothering me about 2 years ago. Gradually becoming worse. Soooooooooooo tired of gimping around and not sleeping. Forget long walks. I am a mural and faux artist so my work is getting harder to do all the time. The ladders and toting bins is killing me. Saw various Dr.'s ....was MRI'd and X-ray'd......Physical Therapy...quit working out.....High dose ibuprophen..........another Dr. MRI'd again........now Anti Inflammatory with Tylenol........twice a day without fail. Then MRI with Arthrogram (Dye in my hip).............FINALLY!!!!!!!!!!!!!!!!! Praise God and Name...............Tear in my Labrum ie: labral tear! YEAH! Now I can be fixed! I am scheduled to have Hip Arthroscopy on May 19. I can't wait! I just want to be "Normal" again.

[Unregistered]

I too have been experiencing pain in my groin/hip and butt to knee for quite some time. I started noticing something was bothering me about 2 years ago. Gradually becoming worse. Soooooooooooo tired of gimping around and not sleeping. Forget long walks. I am a mural and faux artist so my work is getting harder to do all the time. The ladders and toting bins is killing me. Saw various Dr.'s ....was MRI'd and X-ray'd......Physical Therapy...quit working out.....High dose ibuprophen..........another Dr. MRI'd again........now Anti Inflammatory with Tylenol........twice a day without fail. Then MRI with Arthrogram (Dye in my hip).............FINALLY!!!!!!!!!!!!!!!!! Praise God and Name...............Tear in my Labrum ie: labral tear! YEAH! Now I can be fixed! I am scheduled to have Hip Arthroscopy on May 19. I can't wait! I just want to be "Normal" again.

I forgot about the 2 Chiropractors that I was seeing for treatment too. BTW..........wouldn't you have thought the 1st Ortho I saw would have suggested Arthrogram with the MRI??? I researched this on my own (online) and found about the Labral tear. 1st Ortho dismissed it. JJjjjjjjjeeeeeeeeeeeeeeeezzzzzzzzzzzzzzzz the $$$$$$$$ and time I could have saved!!
And the PT's ...........you think they would have had an inkling? Is it so rare that everyone is clueless??

[Unregistered]

I found this thread today and am so glad.
I have had right hip, thigh, and buttock pain for 5 yrs. I have seen approximately 9 docs during this time. I have been diagnosed with arthritis in the hip, herniated disks, pinched nerves, and osteitis pubis yet all my X-rays and MRI's were normal. I went through the cortizone injections for each diagnosis. I had a total of 12 cortizone shots. Treatment for each of these conditions cost me thousands of dollars. I missed 5 months of work because the pain was so excrusiating and I wasn't able to get relief unless I was doped up on pain pills (which I hate taking). I finally was referred to an orthopaedic surgeon here in Nashville. He is the first doc I have seen that even mentioned a labral tear. He ordered a flouroscopy with a steroid injection, but this didn't work. Found I also have calcification buildup on the tissue surrouning the hip joint. I am now scheduled to see him on 04/03 to discuss the surgery. I hope after I have the surgery I too will be pain free.

Wish me luck!

[Unregistered]

Hi Heather,
I am now 21 and had an arthirscopy on my L hip for a labrum tear when I was 17. My advice is that you make sure this is really what's going on before you do the surgery, b/c as it turns out after I went through the surgery and recovery, it didn't help at all because that wasn't really the problem, just a common diagnosis. I now 4 years post injury, 3.5 post surgery, and countless amounts of xrays, MRIs, and Drs. later, looking at a Femoral Acteabular Impigement (FAI) surgery to fix a problem that was misdiagnosed. So my advice would be to get all the opinions you can that this is really the problem. Make sure they xray the outside of your hip to check for FAI. Good luck!!


Hello Heather,

I am a 41 year old man living in the SF Bay area. I started doing martial arts when I was 14 and started having hip problems about 3-4 years ago. I have had femoral acetabular re-shaping of my hip twice now. Apparently, two years after it was done the first time, I had a recurrence.

I would say that the surgery itself is very minor. Compared to my orbital blow-out fracture repair, or abdominal hernia repair it was actually quite minor and I was up and walking around (with crutches) in a couple of days and w.o crutches in a couple of weeks. The first two days are a little uncomfortable, but I found just leaving the ice pack on my hip for 2 hours at a time with a half an hour off alleviated about 90% of my discomfort.

As far as I am concerned this surgery was a god-send. I could not walk very well before it was done the first time, and was in serious and constant pain. I am only hoping that I had it done early enough to avoid hip replacement.

Good luck!

[Unregistered]

I too would see a different ortho. however I wouldn't see Dr. Phillipon. I had a terrible experience w/ his office. There are plenty of other orthos that are highly recommended and who work in an office that knows what bedside manner is. Good luck.



See another ortho. My surgeon has a 90% + success rate. Dr Marc Philippon
in Vail. I'm 5 weeks out and starting to walk a little w/ light crutch help.
No pain after 2+ years of agony. He's done pro golfers and hockey players
There are probably others I just couldn't find many that have done more
than a few operations. Philippon has done 100's. Mike in Sactown

[Heather]

Well, surgery for my labral tear is tomorrow. They are pretty sure that FAI is not the problem after MRIs, a CT, and X-rays. Today, they're delivering the brace, CPM machine, and ice machine to my apartment. When I see all of this equipment, I think it will make the whole thing a reality. Kind of scary. I hope that my experience will be similar to the other positive ones I've read online. Wish me luck! I'll post here about the surgery when I'm up to it.

[Unregistered]

Hi, Heather.

Good luck with the surgery. I too have been diagnosed with an acetabular labral tear and cyst but have been pursuing an ObGyn work-up for pelvic pain. After looking at all of the postings, I'm now wondering if the pelvic pain is related to the tear and cyst. I have had terrible right lower quadrant pain and some tenderness since a traumatic medical procedure four months ago. I am almost convinced that the pain is associated with a tear emanating from that procedure. Good luck! Mimi

[Heather]

Hi everyone,

Well, I made through to the other side. Surgery went well, though I got quite ill afterward from the effects of the anesthesia, despite having an anti-emetic and any remaining contents of my stomach pumped during the procedure. Even pumped full of anti-nausea drugs post-op, I was still so dizzy and nauseous for about eight hours and was nearly admitted into the hospital overnight.

The OS debrided the labrum and cleaned up some debris. No sign of FAI, which is good. He did, however, find some cartilage delamination, which he said is a little unusual at my age (27) and is likely to lead to early arthritis. I will find out more about this when I see him next Monday, though.

Post-op has been better than expected. I am not in too much pain. In fact, I didn't even take any of the Vicodin for fear of more nausea and vomiting, so I've just been on Tylenol for pain (and lots of ice). The worst part is sleeping with the brace and these horrible booties, but I realize they're for my own good (not my own torture).

It's good to have some time to slow down, I think.

Heather

[Unregistered]

I am a 21 year old female athlete competing at the collegiate level. I was diagnosed with a Labrum tear and will have surgery hopefully in the next couple of weeks. I am meeting with the "Hip specialist" next week who will be doing my surgery. Any recommendations on questions I should ask the doctor and things for which I should prepare myself going into surgery? My tear was supposively caused by an osseous bump that rubbed down the labrum and there is now a femoral acetabular impingement. I need to have the bump removed and the tear "cleaned up." I am hoping to compete in the Fall season (starting August)....is that far too optomistic? I'm a strong kid with a great work ethic, but I know that healing takes much more than hard work. Perhaps I should be looking into taking a year off???

Heather - Thanks for the updates, please keep them coming. I am very curious to see how all of this goes, I have never heard of this surgery and I have seen a lot of surgeries having been around college athletes for the past 4 years.

Jenny

[Larry]

I am planning surgery by Dr. Marc Philippon for a Labrum tear in my hip. Does anyone have experience with this Dr or others for this surgery? Please email me at larry@go2collegesolutions.com Thanks.

[Keren]

Hi,
About two years ago I was onstage doing improv comedy and while doing a James Brown impersonation I went down into the splits and felt something pop-Ouch! I had always been super flexible-but this time something went wrong. The pain in my my upper left groin was bad-but I just assumed that I had just pulled a muscle. When it didn't get any better-especially after shows-I went to an ortho who gave me an MRI and x-rays and said all that he could say was that it could be arthritis. As time goes by (a year and a half) pain comes and goes intermittenly with some popping but I get progressively worse. I go to see another Doctor-who thank goodness thinks he knows what it is and that it could be a labral tear in my hip. We try physical therapy which makes it WAAAYYYYY worse. Now I can't even do everyday activities like grocery shopping or vacumming and forget about dancing, improv, or excercising (and the pounds are creeping on). So, my Dr. sends me for an MRI - Arthogram which confirms the tear. He recommends a specialist-the only one in this state who does this kind of surgery, but the problem is that I can't get in to see him for 4 weeks-but I make the appointment anyway. In the meantime my Dr. suggests someone else-who I went to see today-well what a major mistake! He takes a regular old x-ray and tells me I also have two cysts and arthritis in this hip!!! He also tells me that surgery for the tear (which I will hopefully be able to have when I get in to see the specialist) may or may not help! He said I could just have rhuematoid arthritis or some other awful disease!!! He wants to do blood work and give me some shots which may or may not do anything. I just told him that I will pass and wait to see the specialist! Can someone that has had this please give me some guidance? Can a labral tear cause cysts? Or arthritis? Also what is FAI? I would really appreciate your response. Thank you.
Keren

[Fred Dillon]

Hello,

It would have been nice to find this forum prior to my surgery. I'm 36 and and I had AFI surgery 4 weeks ago.

I also did significant research and felt that the surgery was a no brainer considering my condition would worsen and hip replacement was an eventuality. However, I've made some assumptions (right or wrong) based on what I read and what my Doc (Dr. Crane - Denver CO at Rose Hospital) told me. Those being: assuming recovery goes well I can expect to return 100% to what my activiity level was (after 6-12 months)?? I can only hope that is true. The good news for me was that I had a 'smooth' tear of the labrum and it went back in to place well and had zero arthritis in the joint?

The shocker is - appartently the probabiltiy is high that people have AFI in both hips. So - I'm going to wait and see how recovery goes and have an MRI on the other hip in a couple of years.

My recovery has been a little rough - in my mind. (4) weeks in and my mobility is severly limited and I have two more weeks on crutches (+ a fair amount of paint aroung the 7' incision). It is major surgery and I have been told I won't feel 'normal' until after three months. Anyway - time will tell but I wanted to share my story and progress.

Any one else have this and if so where and how are you doing in your recovery?

Hi "sscardenas,"

I’m almost 2 weeks out from a surgical dislocation to treat FAI in my right hip. The first week was pretty rough due to some unpleasant complications from a pre-op epidural they gave me for pain management. The past week has been much better and I’m able to toddle around on my crutches quite nicely.

In terms of the prospects for full recovery following such a surgery, my understanding is that it depends largely on the post-op condition of the joint and the extent to which arthritis has progressed...or as my surgeon said, “I can’t make a silk purse out of a sow’s ear.” Fortunately, I had very little evidence of arthritis and most of my cartilage and labrum were intact, so my ortho doc thinks there’s a pretty good chance my new and improved hip joint may actually last a lifetime…here’s hoping. Unfortunately, I’m also one of the folks who has bilateral FAI so I’ll probably need to have my left hip done in the not-too-distant future (I’ve already got some early symptoms).

In terms of how long before I’m off crutches and starting to resume some of my pre-injury activities, I think it’ll be a fairly lengthy recovery process. I’ve got an incision about 18” long with 38 staples in it that still spooks me every time a look at it. Surgical dislocation is a pretty heavy procedure. I’ve read postings from other folks who have had similar procedures and they say it may take up to a year to fully regain their strength…so it’s probably best to prepare for the long haul.

Given the invasiveness of the open procedure, I’m definitely more inclined the second time around to consider traveling to have the arthroscopic equivalent if it’s appropriate. Apparently, the best candidates are those with most of the excess bone on the anterior lateral head of the femur. Perhaps the less invasive procedure should allow for a quicker recovery process?

Good luck to all who undergo surgery to improve their quality of life!

Fred Dillon - Portland, ME - USA

[Fred Dillon]

I am a 21 year old female athlete competing at the collegiate level. I was diagnosed with a Labrum tear and will have surgery hopefully in the next couple of weeks. I am meeting with the "Hip specialist" next week who will be doing my surgery. Any recommendations on questions I should ask the doctor and things for which I should prepare myself going into surgery? My tear was supposively caused by an osseous bump that rubbed down the labrum and there is now a femoral acetabular impingement. I need to have the bump removed and the tear "cleaned up." I am hoping to compete in the Fall season (starting August)....is that far too optomistic? I'm a strong kid with a great work ethic, but I know that healing takes much more than hard work. Perhaps I should be looking into taking a year off???

Heather - Thanks for the updates, please keep them coming. I am very curious to see how all of this goes, I have never heard of this surgery and I have seen a lot of surgeries having been around college athletes for the past 4 years.

Jenny

Hi Jenny,

I'm 2 weeks out from a surgical dislocation to treat FAI in my right hip and feeling better with each passing day (in fact I got my staples removed today). At 43, I've had symptoms for a little over 2 years and have seen 4 ortho docs during this period. As an avid cyclist, my primary goal is to get to the point where I can (hopefully) ride at my pre-injury intensity and duration levels, so I can certainly empathize with your wanting to get back to a competitive fitness level ASAP.

The first doc I saw diagnosed a labral tear (via MRI / arthrogram) with the underlying cause of femoroacetabular impingement (FAI). He recommended the open surgical dislocation procedure, but since I had never had any hip problems before this seemed too radical. I opted instead to have the torn labrum removed arthroscopically. I did very well with this procedure (which was done in 12/04) and was riding my bike and weight training within 1 month. Unfortunately, I had a cycling accident in 2/05 and re-injured my right hip again very badly.

I went back to the surgeon who did the initial arthroscopy and he said he wouldn't recommend going back in to remove the torn labrum without addressing the underlying FAI. He referred me to a colleague in his practice who does the surgical dislocation procedure. I met with this fellow and he was great in terms of treating me as a partner in the treatmet planning process. However, I was still hoping to avoid surgical dislocation since it's such a heavy procedure. I went for a second opinion to one of the most renowned hip arthroscopists in the country. Unfortunately, not only was he a condescending jerk, but he also didn't subscribe to the impingement hypothesis. After another MRI and CT scan, he said my hip was fine (contrary to my symptoms) and sent me on my way.

I had also been doing some research on an arthroscopic alternative to the open surgical dislocation procedure, which apparently can be very successful (and much less invasive) for folks where most of the excess bone that needs to be removed on the femoral head is located on the anterior / lateral side. There are a number of docs who do this procedure around the US (see the Yahoo Group's Femoroacetabular Impingement forum for more info). Ultimately, I decided it would be easier logistically to have the open procedure done locally, but I'd definitely recommend considering the arthroscopic version (if appropriate) since it's much less invasive and I think the recovery process isn't as lengthy.

So I guess this is all a long winded way of suggesting that you may need to give yourself more time than this August before being competitive again if you decide to go with the open surgical dislocation procedure. This may still be the case even if you're a good candidate for the arthroscopic alternative depending on how quickly you're able to have the procedure done.

Some questions for your doc:

1. How many of the procedures have you done?
2. What's been the outcome for your other patients who have had the same procedure?
3. How many of your patients have been young / active / athletic and have they been able to resume their preinjury activities?
4. What's the recovery time and what kind of PT do you recommend?
5. What are the potential down sides to the procedure?

Hope this helps and good luck!

Fred Dillon - Portland, ME - USA

[DiverDan]

I am a 21 year old female athlete competing at the collegiate level. I was diagnosed with a Labrum tear and will have surgery hopefully in the next couple of weeks. I am meeting with the "Hip specialist" next week who will be doing my surgery. Any recommendations on questions I should ask the doctor and things for which I should prepare myself going into surgery? My tear was supposively caused by an osseous bump that rubbed down the labrum and there is now a femoral acetabular impingement. I need to have the bump removed and the tear "cleaned up." I am hoping to compete in the Fall season (starting August)....is that far too optomistic? I'm a strong kid with a great work ethic, but I know that healing takes much more than hard work. Perhaps I should be looking into taking a year off???

Heather - Thanks for the updates, please keep them coming. I am very curious to see how all of this goes, I have never heard of this surgery and I have seen a lot of surgeries having been around college athletes for the past 4 years.

Jenny


Jenny,

I am approaching 12 weeks post surgery. I had labral debridement for torn cartilage with chondroplasty to the bone for a small worn section. I am still getting pain while sitting and the catching pain during abduction/adduction. I recently found a hip brace called a Bledsoe Philippon which limits abduction/adduction. You may want to ask your surgeon about having one these fitted.

Dan

[Unregistered]

I had surgery 7 weeks ago wednesday and its getting better some days are better than others. My surgery consisted of repairing a minor tear in the labrum and to remove some bone on the neck of my right femur to fix the impingement that caused the tear. I am 1 week out of crutches and still in pain mostly when I am on my feet and walking, has anyone else had something similar to this surgery and what can I expect from the rehab stand point? is it too early to tell the long term outcome?

[Keren]

Hi,
Can anyone that has gone through arthoscopy for a labral tear in their hip give me some feedback as to what to expect after surgery?
Thank you.

[DiverDan]

Hi,
Can anyone that has gone through arthoscopy for a labral tear in their hip give me some feedback as to what to expect after surgery?
Thank you.

Keren,

I used crutches for about a week after the surgery. Started physio on recommendation from surgeon about 2 weeks after op. I am now doing hydrotherapy and in hindsight I believe this should have been recommended first or in conjunction with physio. See my reply to Jenny for current pain. I am in the process of obtaining a Bledsoe Philippon brace in an attempt to assist with "catching" pain while sleeping. I have spoken to the OZ marketing manager about this brace and my current symptoms. This person is also a physiotherapist. If you reside in OZ, you may want to ask/ request the use of this device by your surgeon. See the links below for this product. For the Bledsoe website, click on Special braces then Philippon. Hope this helps.

www.orthomedico.com.au
www.bledsoebrace.com

Dan

[Unregistered]

I had surgery 7 weeks ago wednesday and its getting better some days are better than others. My surgery consisted of repairing a minor tear in the labrum and to remove some bone on the neck of my right femur to fix the impingement that caused the tear. I am 1 week out of crutches and still in pain mostly when I am on my feet and walking, has anyone else had something similar to this surgery and what can I expect from the rehab stand point? is it too early to tell the long term outcome?

I am glad you are doing well from FAI surgery. It seems as though you had the open (full dislocation) procedure. If you want to talk to others, who had this procedure, join yahoo's messageboard group "femoroacetabular impingement" (http://health.groups.yahoo.com/group/Femoroacetabular_Impingement/). I am scheduled for FAI surgery in mid-august. Good luck with recovery.

-Patrick

[Surfchick]

I forgot about the 2 Chiropractors that I was seeing for treatment too. BTW..........wouldn't you have thought the 1st Ortho I saw would have suggested Arthrogram with the MRI??? I researched this on my own (online) and found about the Labral tear. 1st Ortho dismissed it. JJjjjjjjjeeeeeeeeeeeeeeeezzzzzzzzzzzzzzzz the $$$$$$$$ and time I could have saved!!
And the PT's ...........you think they would have had an inkling? Is it so rare that everyone is clueless??

Hi, just seen this site for first time! I have had loads of lower back, hip, groin, thigh and knee pain since Feb 2005. Numerous hospital admissions with no diagnosis. Normal MRI's, loads of physio etc. Even had a steroid injection in my hip, better for 2 months but told it was coincidence and not my hip - maybe psychological! I have done the rounds just like you. The trauma surgeon in March 2005 thought it could be a lbral lesion and referred me to a hip surgeon who did the injection, when you are told it's not your hip - you believe them. Paid for 2nd opinion to hip professor. He is convinced of have a labral tear. I am having MR arthrogram-contrast injection on 19th May to see if I really do have a tear!

I am interested to know how you get on - I thought I was alone on this!

[Keren]

Dan,
Thanks so much for the reply regarding your labral tear surgery. I hope that you are doing better with the pain and therapy. I finally got in to see the ortho specialist today and he said that arthoscopic surgery won't help my tear because they are now telling me that I have hip dysplasia and want me to undergo an Osteotomy-extensive surgery for hip dysplasia where they would re-locate my pelvic bone! I don't know. I am afraid and unsure. But thanks for your guidance.
Keren

[MichaelF]

Hi,
Can anyone that has gone through arthoscopy for a labral tear in their hip give me some feedback as to what to expect after surgery?
Thank you.
Gday Keren, I'm a 35 old male police officer and received a nagging injury to my left groin buttocks area which was so debilitating some days I could barely walk. In August '05 I underwent a hip arthroscopy for a labrum tear which was somewhat successful, but the pain remains and today it is just as bad. So in two weeks, to cut a long story short, I will be having a Total Hip Replacement.

The major contributing factor in this injury causing the labrum tear and now hip replacement, was the 6-7kg police appointment belt I've worn for 16 years, and this has now been documented by several surgeons. I would be interested if there are any other cops out there with the same problems or would like some further information about this.

Mick

[DiverDan]

Gday Keren, I'm a 35 old male police officer and received a nagging injury to my left groin buttocks area which was so debilitating some days I could barely walk. In August '05 I underwent a hip arthroscopy for a labrum tear which was somewhat successful, but the pain remains and today it is just as bad. So in two weeks, to cut a long story short, I will be having a Total Hip Replacement.

The major contributing factor in this injury causing the labrum tear and now hip replacement, was the 6-7kg police appointment belt I've worn for 16 years, and this has now been documented by several surgeons. I would be interested if there are any other cops out there with the same problems or would like some further information about this.

Mick

Mick,

Which country are you from, Australia or the U.S.A? Interesting to hear about the appointment belt. I asked a similar but non-specific question a number of posts ago about carrying weight around the hips. Will the Total Hip Replacement allow you to remain operational? My service is a lot less than yours. I suffered a HOD last year which after a number of months was eventually diagnosed as a labral tear. I have been on restricted duties since.

Dan

[Unregistered]

Hi everyone,
I live in Victoria. I have been reading through the thread with much interest. I am a cyclist and skier. My main interest here is whether or not anyone has had chronic lateral knee pain associated with a labrum tear. If interested, please read on.

I had hip and groin pain for about 12 months. Confirmed labrum tear (by MRI) with a small cyst. I had a cortisone injection which did very little. I had two surgical opinions - one surgeon wanted to do an arthroscope whilst the second recommended waiting/rest/reduced activity. Interestingly the doctor who came recommended to me as more 'aggressive' took the more conservative approach. I opted for conservative management - ie reduced cycling. Hip and groin pain reduced dramatically but started getting knee pain when I resumed training. I now have lateral knee pain on both knees (side with confirmed labrum tear is much worse). The forced rest with knee pain has further improved my hip - now little symptoms at all.

My knee symptoms are very similar to ITB Friction Syndrome or Patellofemoral Syndrome (classic cycling overuse) but wondering if anyone with labrum tears has had accompanying knee pain?? My physio hasn't excluded that hip pathology could refer pain to the knee.

Thanks!!
Damian

[Thihan]

I've treated a lot of cyclists over the years, and a high proportion have presented with primary knee pain but gone on to find that the problem is actually their hip. Mechanism can be somatic referred pain from the hip joint (usually presents as anterior knee pain) or biomechanical irritation causing overactivity of hip rotator muscles - tension on ITB and then ITB fricition or PFPS.

Treatment options vary depending on severity of the problem and whether it is and intrinisic or extrinsic hip pathology problem. Conservatively, high on the treatment list is bike set up modification to unload the hip. This must be coupled with a specific exercise programme designed to correct the lower limb and pelvic biomechanical issues which are occuring while on the bike. Pedalling techinique must also be addressed to increase efficiency. That's usually the first port of call before more invasive options are suggested.

Hope that helps.

[damo]

Thanks for the response Thihan. The problem I have at the moment is that the inflammation is so bad that I can't even ride short distances to experiment with bike position. I am looking at pedal float, saddle height and fore/aft position - have you had luck with any other adjustments?

If the knee pain is simply from overuse or bike position it seems fairly straightforward. The real nagging question in my mind however is that if the knee pain or say tight ITBs are as a result of the labrum tear, then will it recur as my training increases? For the moment I have to recover from the inflammation to do the required strengthening and then bike adjustments.

Still keen to hear from anyone who has had labrum tears with referred knee pain and in particular, lateral knee pain.

Thanks again!

[Unregistered]

check out these articles on bike specific problems by a SPORTS physio/commonwealth games mountain biker - Emma Colson.

www.topbike.com.au/physio.htm

[Unregistered]

As I mentioned i another post i had arthroscopy for FAI with Dr Sampson in San francisco late last year. I didn't have that much pain going in to surgery but had had a lot of pain in the two years previous to that. However now i am not so happy with the rate of my recovery. The doctor removed a subchondral cyst (in addition to reshaping eh femoral head) and he says this is the reason i still have pain (more than when i started). He says to give it until august to see if the cartiledge repairs, fill back in. Orginally he was going to do a graft where he took out the cyst but didn't ---now he say it might not grow back! I'm not sure if this is really what is causing the pain though. A bigger question is what leads to the femoral head getting a growth on it. Mine started with an injury where I fell and torked my other hip. I think if the pelvis/back or whatever is out of wack for an extended period it creates stress on the hip joint and the bone grows from the trauma so there is a need to correct the underlying alighment problems as well. Just my theory...the orthos don't really talk or care about this end of it.

Megan

QUOTE=Unregistered]Fred,

I am in a similar situation as you, except never had arthroscopic surgery and am about 20yrs younger. After about 2 years of hip pain, I realize my fate if nothing is done. It is quite clear that FAI surgery will correct the femoral head-neck offset, thus reducing bone and articular cartilage shearing. My main concern with this procudure is the risk of complications (ie, AVN, femoral fracture, nerve damage, hetertopic ossification etc.). Hopefully an experienced surgeon will minimize these risks. Have you looked into Dr. Millis (boston)? Also check out the Femoro acetabular impingement and Hip Scope groups on yahoo.

-patrick[/QUOTE]

[Unregistered]

Hi,
Can anyone that has gone through arthoscopy for a labral tear in their hip give me some feedback as to what to expect after surgery?
Thank you.
Hi Keren - I am in my early 30s and had a labral tear arthroscopic repair June 2004. I live in Boston and had the surgery with the hip group at Childrens (Kocher & Millis). I was on toe-touch with crutches for 3 weeks, and then went to one crutch and a cane over the next 2-3 weeks. I found walking in chest-deep water in the pool very helpful after week 2. My main problem initially was that I lost proprioception (the sense required for position/balance) for a few weeks afterwards and my balance on that leg was terrible. It cam back to 100% with PT though. I tried to, but couldn't go back to playing hockey.

I am now being re-assessed for ongoing groin pain that occurs with flexion (walking up hill, riding a bike, sitting forward). Another MRA was neg for a tear and they didn't see FAI on the plain Xrays. I'm going for a 2nd opinion in a couple of weeks. My symptoms seem like FAI from what I've read. Anyone else with a similar experience? I am really eager to know whether I need more surgery or not. I am not very excited about the thought of it, but am tired of feeling like I'm 65. I can barely walk on the treadmill fast enough to get my heartrate to 125 (I can't use any incline or I get severe pain). Any ideas more than welcome :-)

Thanks! jcannuck@hotmail.com

[Tracey]

Hi, so glad to have found you all! Took a fall 4 1/2 years ago, (I was 40.) Night pain, pain when standing, sitting, became unbearable. Went to a sports medicine doc with back, hip and knee pain in 1/04. Initially diagnosed as SI problem with referred hip and knee pain. One year later, hip MRI showed labral tear. Cortisone injection gave 1 month of relief. I was sent to specialist in San Jose,Ca. who had experience in arthroscopic repair. After surgery, he said to wait and see because he noticed a problem with the bone and he was not able to deal with that arthroscopically. Gradually got better, then worse. I was then referred to Dr.Sampson in San Francisco. ( He is wonderful! ) He diagnosed me AFI. Had second hip scope in October 2004. Once again, got better over a period of months and then began to deteriorate. MRI in 9/05 showed bone growth and labral tears. I chose to have a total hip replacement since my experience with the scopes wasn't so great. After surgery Dr. Sampson said it was a good choice, arthroscopy would not have worked, too much deterioration, arthritis, bone growth.( He is able to do minimally invasive surgery with only a 3 1/2 inch scar.) I had my THR in 10/05. Recovery has been challenging. I can now walk without pain and it is definitely better than before. I am still having problems with the back and knee pain. Had back and knee MRI last week and will get results on Friday. I am sorry that others are having similar problems. It has been a long hard journey. I am glad to know that I am not the only one because I have really begun to wonder what the heck is wrong with me. Thank you for sharing your stories! Tracey

[Unregistered]

Hi

I'm a PT working in the UK and have had all the recognised symptoms of a labral tear. The results of the MRI arthrogram are inconclusive showing a cyst and degenerative changes only. Has anyone else had these symptoms and similar MRI findings and subsequently been found to have a labral tear?

Rebecca in my experience a labral cyst is a result of a labral tear! althogh the tear is not detected on the MRI. Sometimes intra articular studies can cause false positive tears and cysts. Orthopaedic surgeons always state to us that we understate labral tears .



cheers Mark

[Rebecca43]

Thanks Mark

I've subsequently been seen by an orthopeadic surgeon who has attributed my symptoms to articular cartilage damage. I'm not aware that articular damage gives similar symptoms to labral damage and am now seeking a second opinion!

Rebecca

[Anthony]

Hi Hippies :)

I'm new to this forum but not new to the subject. This is my story and i hope it helps as trying to get information out of the medical profession is like looking for a needle in a haystack.
History prior to seeking medical help. Prior to May 2000 I was working as a manager, hadn't had a sick day in years, didn't play any physical sports but worked hard and averaged a minimum of 60hrs a week mostly debt driven. I was 31 years of age then and had no hip pain at all. In May 2000 at the end of a long day I went to fetch some product for a customer in a department where all the staff had knocked off for the day. In their cleaning up process they left a grid off a drain which I managed to step into as I was walking along. My Right leg stepped into a hole just big enough to put your foot in and about 18 inches deep. At the time of injury pain was negligible and i figured it was either bruised or slightly strained and continued with my duties. When I got home and relaxed a bit the pain intensified and was relieved with a hot tub. I was stiff in the right hip the next morning and after getting it moving and warmed it up I went to work. The pain nagged me for days after but wasn't bad enough to seek medical attention. 3 weeks after my other side was hurting for a few days then switched back to my right side. This settled down to an occasional niggle and on a number of occassions friends had asked me about a slight limp i was developing. Which foolishly I shrugged off as an old war wound :mad:
Over an 11 Month period I gradually got worse and had forgotten about the drain incident. I was easily becoming tired and worn out doing the same duties i'd been doing for years before hand , blaming it on my back, bending over a counter etc all day. I was going home from work and hitting the lounge or recliner and thats where i'd stay until it was time to get moving again.
Just after Easter 2001 I went off work with severe pain in my right side and went to see my GP. The pain covered my right side just below my ribs right down to my right leg and radiated across my back. I was not very well and at this stage had forgotten about the drain incident and didn't know what was wrong with me. ( Hadn't had an accident or injury apart from bumping my head on a door handle when I stood up since the drain which was 11 months prior and no apparent immediate injuries within last few weeks of going to see GP)
First Diagnosis: Shingles come back in 10 days if the pain persists
Second Diagnosis: Get some blood tests, Xrays ( Normal ) and referred to a gastroenterologist
Gastroenterologist:Booked in for a Colonoscopy, all clear no Cancers, tumours, growths etc their ( This took up 6 months during which I tried to return to work which only lasted 4 weeks and I was back to being in complete agony constantly).
Back to GP: Arranged full body bone scan, MRI of back and referred me to an orthopaedic surgeon at local public hospital. ( 9 Months wait list )
Went private: MRI done on hip and Xrays. Result normal but looks like you might have early arthritis but that shouldn't be causing you all the pain.
Back to GP: Referred to physiotherapist and Pain management clinic, here i was awoken to the idea that some injuries can develop further and to back track everything i'd done. Tens machine was causing extremely sharp pain in hip on certain spots and not giving any relief. He tried a stretch machine and this relieved the pain in my hip.
Pain Management Clinic: Agreed I had a problem, 6 weeks of Hydrotherapy to study my movements with their physio and their 3 day psychatric course with a shrink on pain management.
6 Weeks up and physio recommended their was a problem with the Right hip and would like to try a cortisone injection to confirm it. Was injected next day and had 2 days of heaven until it wore off with no pain.
Then referred to Their head Orthopaedic Surgeon and sent off for another MRI of the hip which came back normal however he said he was suspicious of a darkened area in the image and would like a second opinion and was going to send me to see another specialist in the field. 6 weeks later I was called back in and he had conferred with some other associates and wanted to perform an exploratory Arthroscopy to see what was going on.
19th of December 2002 I had this procedure and learnt I had a labral tear and that he had debrided it during the operation. ( Yay, at this stage whats a labral tear) I was put on a passive motion machine shortly after the op to prevent my hip stiffening up. Crutches for half a day and was walking on my own shortly after with minimal pain. All up 2 days in Hospital with key hole surgery from the Arthroscope. Progressed over next 2 weeks to have no pain at all. Beginning of February 2003 I started a new job pain free.
6 Months down the track I twisted around one day doing something and the pain was excruciating. Back to the specialist and 23rd of October went in for another Arthroscopy which didn't work this time and he said he had trouble with scar tissues. He then referred me to a hospital with better equipment to try again. The waiting list was quite long and in 2 weeks time I go for a contrasted MRI of the hip to shed some light on my problem and where we go to from here its now 6th of June 2006 and I just want a life back.

[Paul Romain]

What a great forum! Wish I had found it years ago!

Well I thought I would share my story with you all and I will post updates on my recovery if it is useful to anyone.

As with many of you I have done the rounds of many doctors and surgeons over the years before good diagnosis and surgery recently. My pain actually manifested mainly in my right knee as long ago as 1990 when playing soccer used to cause deep throbbing and shooting pains in knee for several days after. X-rays and scans showed little and various suggestions of early arthritis, tight hamstrings, back problems were made with no progress on pain.

For many years I coped by just avoiding any strenuous exercise, thereby not aggravating what I thought was a knee problem. However two years ago several other lighter activities such as golf, and even long walks were causing flare ups. To cut a long story short, another knee specialist sent me to a physiotherapist who trumped all the doctors by identifying the underlying problem as coming from my right hip. A hip specialiast identified a tear and thought arthroscopy would help - I was referred on to an expert in this who immediately said my hip was a "timebomb waiting to go off" - not just a tear but much more requiring open surgery

OPERATION REPORT

I quote from report (this is technical - some may understand it all more than others!)...

Indications were - chronic anterior internal impingement and early degenerative changes

Approach - Lateral with Trochanteric flip and anterior exposure of the hip. Joint disarticulated

Surgical findings were - large Ganz lesion/anterior epiphyseal tongue and anterior acetabular osteophytes. peripheral damage of acetabular articualr cartilage from 11 o'clock to 2 o'clock.

Procedure carried out - Epipheseal tongue/Ganz lesion excised. Lateral retinacular vessels preserved. Anterior acetabular osteophyte removed. Excellent joint movement with no residual impingement

I had an epidural anaesthetic which was kept topped up for two days, left hospital after four days and am supposed to be on crutches for 6 weeks. I have a scar about 8 inches long and there are two surgical screws in the bone apparently

I have now been home for 1 week and am managing on crutches quite well. Can stand on both legs with no crutches OK and am relatively pain free unless I accidentally set off across the room without picking up my crutches first (more easily done than you might think ha ha!)

Sleeping is harder cos I keep rolling onto operated hip in my sleep! Also am having trouble with my right knee which feels as if I have strained it somehow. I suspect this is because my knee is trying to do to much work shifting my leg sideways off beds and sofas for example as my muscles down side of leg were obviously cut during surgery. Guessing at that though - hope it is not a new problem that surgery has caused!!

Anyway, surgeon (Mr Field, St Anthonys Hospital, Cheam, UK) thinks may have extended life of natural joint by at least 10 years - if op continues to show no ill effects I will have to repeat on left hip at some stage.

If anyone would like to know anything else about my experiences please feel free to post or contact me direct.

I will update on recovery

[Surfchick]

Hi fellow hip sufferers!

I am 29, female, surfer in the UK and also work in an NHS Cardiology dept - for my sins!

I also have a horrible story - occuring over the last 16 mths - I will try and keep it brief!

Sudden loss of use of left leg - following 2 mths lower back pain - Feb 2005.
A+E ->ambulance to royal orthopaedic hospital - T + L Spine MRI - Normal.
Brain MRI - normal.
In 5 days - under spinal surgeon whilst awaiting transfer to my own hospital where I worked, to rule out a neurological cause.

No neurological cause found - ? psychological - see psychiatrist - whilst an in patient.
I kept telling them my hip kept clicking, leg locked, knee hurt and knee gave way but it felt like it was my hip making knee unstable!! 2 neurologists and 1 psychiatrist - said no way could it be mechanical - it was stress!!!

I begged to be seen by a trauma surgeon who had seen me a few mths previously for back pain. With very bad grace they agreed.
MRI - Hips, thigh and knee - normal - March 2005. The trauma surgeon referred me back to orthopaedic hosp to an orthopaedic surgeon - to exclude a labral lesion in my hip with a view to arthroscopy! I was given a steroid injection - 2 mths relief, after initial agony for 10 days after!

The hip surgeon said it was coincidence I got better - psychological - discharged - told toget on and surf and skydive again and if my hip fell apart he would do an arthroscopy!

After 2 mths - acute hip, groin and knee pain! Trauma surgeon phoned hip surgeon to ask him to see me - he declined - told him to send me to a musculoskeletal physician.

This new doctor - ? SI joint ligament laxity - 4 mths of prolotherapy injections - to not much effect. We then had a "breakdown in patient/doctor relationship" and he refused to treat me - said I was beyond help. Nothing medically to be done - sent home. I was so upset!

Mean while - ongoing physio - muscle imbalance and trigger points - given stretches and joined a gym - got worse!

My GP agreed to send me for a second oppinion to Coventry which I paid for. Told not my back - ? hip! My anger levels raised!

He referred me to Professor Damien Griffin at BMI Meriden Hospital, Walsgrave site, Coventry, UK. Classsic mechanical history, slinical exam - strong suspicion of labral tear.
I paid £968 on credit card for an MR arthrogram (MRI with contrast injection) and 3 plain x-rays - 1 was a lateral view never done on me before!

X-rays = slight bulge in the supero-lateral acetabular rim.
MRa = extensive degeneration of the antero-superior labrum with a degenerative tear.

Paying £3700 for arthroscopy on 22nd June. Plan = debride acetabular labrum and treat any adjacent damage to articular surface, and reshape the area of excess bone in order to relieve impingement! There is also a cyst on head of femur - visible on the plain x-ray.
I AM SO SO ANGRY - AS ARE THE REST OF YOU I GUESS?! I asked why the hip sugeon would not have detected the abnormal shaped head of femur - unless they are specialised in this field it will be reported as normal

I am dreading surgery - but hoping for my life back!!!

After reading most of the messages - I gather that these labral tears are difficult to diagnose and you must have a contrast MRI (arthrogram) - routine MRI likely normal!
I REALLY FEEL MOVED TO DO SOMETHING TO HELP OTHER PATIENTS. My notes are a mess with reference that I may have a psychological problem, etc. I am going to complain and try and get my money back from both of these hospitals - including the one I work in - even if it takes years and I prepared for more debt for a solicitor if I have to - medical negligence I think!

I think there should be labral tear awarness education meeting in every hopital to the orthopaedic and trauma teams, physios, neurologists and psychiatrists! WHAT DO YOU ALL THINK? I also wonder about a patient support group - FOR WHEN YOU DO GET THE DIAGNOSIS - TO TALK ABOUT THESE BAD EXPERIENCES - AGAIN - IS THAT POSSIBLE?

WHO WOULD DO THESE TALKS TO THE CLUELESS DOCTORS AND SURGEONS? WOULD IT BE US - PATIENT LEAD - WITH INPUT FROM THE EXPERIENCED AND RARE SURGEONS?

DOES ANYONE THINK THIS WOULD BE POSSIBLE - MAYBE WITH HELP FROM THIS SITE? OR AM I LIVING IN FAIRY LAND?!

I am keen to here from anyone that feels like I do - email:
surfchick@totalise.co.uk

Take care

Amanda
xx:)

[DiverDan]

Paul,

I recommend the Philippon hip brace. See my previous posts for link. I have been wearing one at night for a couple of months and the catching pain has stopped while sleeping. Sleep can still be interrupted as it takes some time getting used to wearing the brace. Other symptoms now include numbness around the knee. Currently doing iliotibial stretches to assist.


dan

[Unregistered]

Hi - I'm am new to this, but finding a lot of interest in what you have going on. I'm starting to feel like a hypochondriac, but I know the pain is real. I have had knee pain for about 20 years - 3 ortho surgeries and IB problems for years. I have noticed over the past few years that I have been having a lot of hip & back pain. Thought was that it just radiated from the knee to the back and hip and if I could get my knee fixed, then everything else would start to feel better. Almost a year after the last knee surgery, I am not doing any better in fact everything (except the knee) are worse. I have gone back to my orthoped and he didn't want to do anything (the cartilage in my knee is 50% of the way cracked to the base of where it attaches in a few different places) I then tried to find a PT that could help with both the back & the knee & the hip. His conclusion was that I do have a possible tear in my knee, but that there were other things that are wrong, in my hip and back. He thought at one of the 1st visits that I may have a labral tear and a bulging disk in my back. Had an MRI done - negative on the hip, positive on the bulging disc& stenosis of the back and degenerative knee. Had an epidural for the back - some relief, but the hip/groin pain wasn't better. Went to another orthoped (tried the one that did surgery on my knee last July - and he didn't even look at my hip during the visit). This orthoped took an x-ray - believes there to be a possible labral tear and a growth on the femur bone- recommended I try a floral guided cortisone shot in the hip - didn't do much. He also gave me a cortisone shot in the IB area - that helped a lot with the knee pain I believe, but not with much else. I sent my pictures, MRI etc. to Dr. Philippon in Colorado - he believes that arthoscopy of the hip may help my condition. I know he is the best in the country, but he isn't in my health plan and is quite a long ways away. Has anyone heard of or Dr. John Clohisy in St. Louis or had any experiences with him. I would appreciate some feedback. Good Luck! I am a firm believer that the hip, knee go hand in hand.
Steph


Thanks for the response Thihan. The problem I have at the moment is that the inflammation is so bad that I can't even ride short distances to experiment with bike position. I am looking at pedal float, saddle height and fore/aft position - have you had luck with any other adjustments?

If the knee pain is simply from overuse or bike position it seems fairly straightforward. The real nagging question in my mind however is that if the knee pain or say tight ITBs are as a result of the labrum tear, then will it recur as my training increases? For the moment I have to recover from the inflammation to do the required strengthening and then bike adjustments.

Still keen to hear from anyone who has had labrum tears with referred knee pain and in particular, lateral knee pain.

Thanks again!

[rkdjones]

I just found this forum and it is like someone turned on the light. 20 years ago, in my late 20s, I injured my right hip. At the time, I was an active recreational bicyclist, and ran a bit. After years of misdiagnosis, no diagnosis, physical therapy, I finally all but gave up bicycling and sports of all sorts. I eventually got pain-free after about 8 years, but did not regain function. The only strenuous activity left to me was hiking. Any other strenuous activity resulted in right hip pain. For 20 years, I thought it was due to ilio-psoas tendinosis.

Recently, 2 things happened: I was diagnosed with anterior femoroacetabular impingement and started reading about it. And, 2 months ago I injured my left hip. Initial exam by my orthopedic surgeon reveals a calcified labrum on right side. I am awaiting an MRI which should clarify nature of injury on left side and extent of hip damage and possible early arthritic changes.

I am so relieved to know what is wrong with my hips and immensely joyful to find other folks who have similar problems. And I am also terrified and saddened at my loss of function and prognosis (a lot more pain and hip replacement is probably in the cards for me sooner or later). The recent injury to my left hip is really disturbing.

Here are my questions for you:
Are there other forums dealing with femoroacetabular impingement and secondary injuries, like torn labrum?
What should I be doing, or not doing, over the next few weeks till my MRI is done?

If you haven't yet torn your labrum, I think it might be possible to live with FAI by adapting activities and gear. Here is my experience that might help others with FAI: limit activities that involve extreme hip flexion. You can buy bicycle cranks (bmx) with crank arms as short as 145mm and change bicycle geometry so hip angle in as open as possible (comfort bikes, and some recumbents have this feature). Carefully, use orthotics or insoles to cant your feet to the outside: it puts a slight external rotation on the hip.


Robert

[Unregistered]

Good Luck with your MRI. Just an FYI....The doctors that looked at my MRI did not see the labrum tear and didn't see the FAI on my X-Ray although they did see a calcification or growth of some kind on the hip (neither the labrum tear or FAI are very recognized in the midwest region of the country). I sent my x-ray & MRI to Dr. Philippon in Vail and he diagnosed me with both based on the same MRI and X-ray that the Drs. in Omaha looked at. My PT was the original one that thought I had a labrum tear - they are somewhat rare and he had only seen one other one in the last 7 years. I knew my pain was real and that it was getting worse. I guess just a word of advice, that even if your MRI is negative for a labrum tear is negative by the initial Dr. that looks at it, you can send it to Philippon and have him look at it. He knows what he is looking for - Save yourself some money and don't have the MRA (if your MRI is negative) done until after you have Philippon look at the MRI. I'm so excited that someone looked at the symptoms and pictures and realizes that I do have a problem. I am scheduled for surgery in August.

Steph

[Surfchick]

Hi Damian,

Have you had any useful relpies yet? I have had hip/groin/ knee pain for 16 months. Just paid for hip arthroscopy - labral tear debridement and partially torn ligament repaired (the 1 that holds ball into socket!). Small extra bone left insitu - hope to recover without having to go back for more surgery later! My knee pain is still present. Physio says all muscles are rubish, hence knee cap not in correct alignment - they call this a "tracking" problem. I had my knee taped for 2 days - 1 week post op and I could go on ex bike without feeling grinding in my knee and without knee pain. Got loads of new exerices to do now to rehab my muscles and told eventually with my hard work - the muscles will improve and hold knee cap in correct place. Without having the tear sorted out I think exercise will be painful! Let me know how you get on.

Manda

[Surfchick]

Sorry - my last post was in response to this message!



Hi everyone,
I live in Victoria. I have been reading through the thread with much interest. I am a cyclist and skier. My main interest here is whether or not anyone has had chronic lateral knee pain associated with a labrum tear. If interested, please read on.

I had hip and groin pain for about 12 months. Confirmed labrum tear (by MRI) with a small cyst. I had a cortisone injection which did very little. I had two surgical opinions - one surgeon wanted to do an arthroscope whilst the second recommended waiting/rest/reduced activity. Interestingly the doctor who came recommended to me as more 'aggressive' took the more conservative approach. I opted for conservative management - ie reduced cycling. Hip and groin pain reduced dramatically but started getting knee pain when I resumed training. I now have lateral knee pain on both knees (side with confirmed labrum tear is much worse). The forced rest with knee pain has further improved my hip - now little symptoms at all.

My knee symptoms are very similar to ITB Friction Syndrome or Patellofemoral Syndrome (classic cycling overuse) but wondering if anyone with labrum tears has had accompanying knee pain?? My physio hasn't excluded that hip pathology could refer pain to the knee.

Thanks!!
Damian

[Keren]

Hi Paul,

I was wondering what the name of your surgery was, do you know? I couldn't quite follow all of the technical terms and since I have been told by one group of ortho's that I need an osteotomy instead of just arthoscopy for my labral tear I am trying to sort through this and since you mention screws in your hip it sounds similar. I just think that I am too old (48) for that and would rather just move on to a new hip, than re-aligning my bones. Please share your thoughts. Thank you.

Keren

PS For those of you chronic hip pain, labral tear sufferers as myself-I have found that daily swimming, glucosamine chondroitin and naproxen helps quite a bit.

[djw]

Whew! So I'm not crazy after all? My sympathies to all those sharing this painful ailment. I am thankful to all of you for sharing your stories. Having been in pain for the last two years, I am just starting down the road to a valid diagnosis. I am a 35yr old active female - doing normal stuff required of a single mom and Navy Sailor. After initial x-ray last year showed nothing, I was referred to PT with minimal relief. A year later and new set of doctors, my latest x-ray showed ossification at the lateral margin of the acetabulum. Follow up MRI indicated possible detachment of the anterior labrum and small exostosis of the superior lateral head and neck of the femur. So now I am waiting for my MR Arthrogram next week. My pain is only manageble with percocet so far - and I'm not sure I want to be on it for very long.
My questions to those in the know...1) At any point has it been clear whether non-treatment or continued activity will make the problem worse over time? 2) For those that had the surgery 6+ months ago - do you consider the surgery (arthroscopic or otherwise) worth it? 3) can anyone translate that mouthful of medical jumbo in the above paragraph? My primary care PA doesn't speak English well and I don't think she really knew. I've yet to see an ortho - appointment is pending.

[HDHR]

I thikn I have a hip problem like what you guys are describing. Anyone know a doctor in melbourne, aus who specialises in this type of stuff?

Hi Dr David Young is based in Melb, Aus and specialise in treating hips, and in particular does both arthroscopy and open to treat impingement. He was recommended as the only dr in Aus to do this type of work, he is recommended by hip specialists in Sydney and people travel to Melbourne from all over Australia to see him.

[Surfchick]

Whew! So I'm not crazy after all? My sympathies to all those sharing this painful ailment. I am thankful to all of you for sharing your stories. Having been in pain for the last two years, I am just starting down the road to a valid diagnosis. I am a 35yr old active female - doing normal stuff required of a single mom and Navy Sailor. After initial x-ray last year showed nothing, I was referred to PT with minimal relief. A year later and new set of doctors, my latest x-ray showed ossification at the lateral margin of the acetabulum. Follow up MRI indicated possible detachment of the anterior labrum and small exostosis of the superior lateral head and neck of the femur. So now I am waiting for my MR Arthrogram next week. My pain is only manageble with percocet so far - and I'm not sure I want to be on it for very long.
My questions to those in the know...1) At any point has it been clear whether non-treatment or continued activity will make the problem worse over time? 2) For those that had the surgery 6+ months ago - do you consider the surgery (arthroscopic or otherwise) worth it? 3) can anyone translate that mouthful of medical jumbo in the above paragraph? My primary care PA doesn't speak English well and I don't think she really knew. I've yet to see an ortho - appointment is pending.

Hi,

No - you're not crazy! I think most of us have been sent down that line too! It is a real mechanical problem! I am not sure which country you are from. I am in England, UK. I see Professor Damien Griffin at BMI Meriden Hospital, Coventry. I am now just 3 1/2 weeks post op (arthroscopy).

To try to translate the jargon;
detachment of the anterior labrum = labrum is a bit like cartilage in the knee, only in your hip, detachment - it's come away from the bone surface, anterior - front bit of your hip.
Small exostosis - not too sure what this means! Many people get cysts forming on the bone - head of femur - which can be removed. You can also have a slight irregular shape to the bone - head of femur - they can do bone shaving - called bone resection! I think you will have to ask your doctor or do a search on the web for exostosis!

I had my labral tear debrided - which means cut out and tidied up. Small tears can be repaired, extensive tears can't! I was told the labrum where my tear was had also completely detached, however, once the tear was removed, the labrum either side was intact and normal. Surgeon used radio frequency waves to stiffen up either side of the labrum to prevent this normal labrum tearing! My abnormal shaped head of femur turned out to be soft cartilage, not bone, so not bone shaving done!

Before I had my surgery I was told, nothing would help this problem, no amount of physio, steroid injections or anti inflammatory drugs would cure it - surgery would be the only thing to fix it!

All my back, buttock and leg muscles had become weak over 16 months prior to surgery, post op they are weaker! I have a really good physio package of exercises to follow. I am told it will take about 12 weeks to heal and then I should be able to go out on my surf board again! I was driving 2 weeks post op, only had crutches for 1 week!

I too would be keen to hear from someone 6 months post hip arthroscopy!

Let me know how you get on with you MR arthrogram - email =
surfchick@totalise.co.uk

Amanda

[charmccarty]

I was diagnosed via MRI of a 3-1/2 centimer cyst (possible tear) of the left hip. I had explained my groin and hip pain to my GP and he me do an MRI. I have yet to see an Orthopedic Surgeon as I want one that is familiar with this problem. Can anyone recommend a surgeon in the Houston, Woodlands, Conroe areas?

Thanks much...Charlotte

[New guy]

Wow. Great info here. My first time out. Been suffering for years with what I thought was simply bad knees. Whenever I ran, I could only do 10 minutes and then I would have to stop. I have also had many flare ups with what I thought was groin pain. Long story short, countless doctors and physiotherapists later, X-Rays on knee and hip normal, MRI on knees normal. Back to the gym, physio was great at strengthening glutes, inner quads, obliques, transverse abdominus to the point where I can now run 3k pain free, but all that work has really loosened up my hip and uncovered some further pains that I don't like.

Any golfers out there? My main activity now is golf, and as my internal rotation (on affected hip) is very limited, I get shooting pains with every swing. I also get dull pain and stiffness in the hip when I sit for long periods of time (unfortunate necessity of my profession). I also get sharp pains near the inner hip when I try and stretch. I have never had any lock-up or collapsing hips and I don't really have a "click" either, but I am really starting to wonder about this acetabular labrum tear...

Will be suggesting this to my doc on my next visit.

Thanks.

[Surfchick]

Hi,

Just read your plight! I am not sure if Labral tears are difficult to diagnose or there are just so many in-experienced orthopaedic surgeons etc?!

It wouldn't hurt to exclude a labral tear - I am told, and do believe, that the only way to confirm this is by an MR arthrogram. This is an MRI on your hip - but with a contrast (dye) injection into your hip first (they give you local anaesthetic, but I had diazepam and morphine too!). The contrast indicates if there is a labral tear.

Good luck - and try to pursuade your doctors to refer for this test!

Let me know how you get on!

Manda

[djw]

Not intending to scare anyone, but in the hopes you can be more prepared than I was...

I started by making the appointment with the MRI clinic. I was instructed to first report to radiology for my IV then to proceed to the MRI clinic for the test. Simple enough.
On the day of the exam, I went to Radiology as instructed where they showed me to a dressing room where I could change into a paper gown. Hmmm....for an IV? Upon asking the clerk why I was disrobing, he said it was much easier to insert the needle into my groin if I wasn't clothed. WHAT?? After much explanation, distress, and an overwhelming urge to just want answers to my pain, I changed into the paper gown.
Lidocaine was used to anesthesize the area on the front of my right hip/groin area, then the resident (under Doc's supervision) proceeded to insert the needle (similar to one used for Spinal Taps) that would deliver the contrast material. They used the x-ray equipment to insure the needle was going the right way. Unfortunately, the x-ray doesn't show nerves - which the resident managed to hit on four occassions. OUCH! Each time he'd hit one, he'd administer more lidocaine! Before he was done I couldn't feel anything from my belly button to my knee! They wheeled me to the MRI clinic where everything was as expected from there. I only wish I had been more informed of the process and that they had suggested for me to have someone to drive me home. It was a difficult drive not being able to lift my right leg!
Results indicate nothing out of the ordinary, however I expect to meet with an OD next month to review all my symptoms and exams.

[arbrador]

I'm a 57 yo female with mild arthritis, labral tear and femoral bone spur causing impingement. I had surgery on May 25th. Initially it felt good like my problem was solved but now I have pain when I walk without the crutches and I'm feeling discouraged. i'm packing myself in ice and resting a lot. Exercise seems to hurt it so I'm not doing any. The doctor said to rest and take anti inflammatory meds. I don't know when to assume it's a failure and go on to hip replacement or resurfacing. I will ask for another MRI soon.



:confused: Anyone interested in post-op recovery.

It is now 3 weeks, + 3 days since procedure. I've had a couple of physio sessions, including weight bearing exercises.

Still experiencing pain while sitting, with hip not taking any weight. Any change in direction, or sudden rotation of the hip causes it to "catch", resulting in sharp pain. Hopefully ongoing physio will strengthen muscles around joint, aiding recovery.

Anyone experienced similar symptoms?


Dan

[DiverDan]

I'm a 57 yo female with mild arthritis, labral tear and femoral bone spur causing impingement. I had surgery on May 25th. Initially it felt good like my problem was solved but now I have pain when I walk without the crutches and I'm feeling discouraged. i'm packing myself in ice and resting a lot. Exercise seems to hurt it so I'm not doing any. The doctor said to rest and take anti inflammatory meds. I don't know when to assume it's a failure and go on to hip replacement or resurfacing. I will ask for another MRI soon.

arbrador,

I'm a little younger, fast approaching 6 months post op, with hope fading fast. While using a cross-training machine at physio the other day I had a major "catch", which almost caused me to pass out. PT programmed machine on lowest setting for 5min's. Catch occurred 2-2.5mins into exercise while on upwards back stroke. I had been doing OK with strengthening/ load bearing exercises up until then. The majority of my pain has been on the outside of my hip. My PT & OS kept telling me they were not worried about this pain. Experts ( X marks the spot and spert is just a drip of water ). Finding "professionals" who are not just interested in the money has been the hardest thing to come to terms with. Iliotibial stretching is helping manage this pain. If you can, seek as many opinions as possible. I have only found one specialist who was at least honest about this injury and he diagnosed it!! I don't want to consider THR at this stage.:(

Dan

[beej]

Hi,

I'm curious to hear from people who have had multiple hip labral tears. I'm 35, am in very good health, and would like to find out why the heck I'm getting these darn tears (I'll admit, I have been a runner for years). I had surgery six months ago on my right hip to repair a tear (I was told the cause was degenerative), and just learned two weeks ago that I have a tear in my left hip. And, unfortunately, I think that my right hip (the one I just had surgery on) has another tear, given my current symptoms. Needless to say, I'm really frustrated, but still count my blessings b/c I know that things could be a whole lot worse.

When they did the surgery six months ago, they said that they found arthritis when they went in. It took 3 1/2 years to diagnose the tear so who knows whether the tear was a result of the arthritis or the arthritis was a result of the tear being left untreated. My doctor claims that many studies have been done on this topic and it's very difficult to determine if arthritis can cause a tear or vice-versa.

I have resorted to trying to find my own answers on the Web, and read that hip dysplasia can be the underlying problem. I saw my surgeon a couple weeks ago and asked him if I have hip dysplasia. He said that I have mild dysplasia and that it could be contributing to the tears, but he said that the dysplasia isn't so bad that it requires hip osteotomy. So, why the tears??? If anyone has any insight, I would greatly appreciate it.

[Hipster]

Dear Beej
I would love to say that I know the answers to your questions about why you're hips are damaged. Sadly this is impossible because know one really knows. The lumbo-pelvic-hip complex is exactly that... it's complex. In any complex system, causes and effects are intermingled to such an extent that it makes the chicken and egg discussion seem a walk in the park. I know you're frustrated and obviously the pain doesn't help but the most important thing is to keep searching for answers. There is no cure for this problem becuse there isn't actually anything to cure. All we can do is manage the symptoms and treat what we can see. This is where the surgery comes in, to remove the intra-artcular irritation from the labral pathology.

Right now, probably the most important thing for you to do, is to look at your activites and behaviours which may be exacerbating your condition (ie posture, running etc.). Then devise a program with a physio who is well versed in motor control and biomechanics to modify your technique so as to maximise your strengths and minimise your weaknesses when loading your hips. Pilates can be really good.

Good luck with it. Keep on keeping on.

The Hipster

[beej]

Thanks very much to the Hipster for your reply.

I am interested in learning more about people's experiences sending their films to Dr. Philippon in Vail, Colorado. Is this something that he normally does? Could you tell me more about the process? How long did it take to get a response? Sorry for all the ?s.

Has anyone tried getting an appt with him? I imagine it's not easy. I will be vacationing in Vail in Aug and would love to try to get in to see him.

Any insight would be greatly appreciated.

Thanks!

[BAC]

Hello Fellow Hip, Groin and Butt pain sufferers!!!!
I thought I was finally on the right track with my upcoming appointment with a "hip doc" for an initial consultation to have an arthroscopic procedure but now I wonder if it will do any good and even if it does, will it last???

I'm a 36 y.o. female in the military. While running bleachers for PT, I heard and felt a "snap" or "pop" in the front part of my left hip/groin/pelvis. Extremely painful but, the military being what it is, I was given massive doses of ibuprofen which helped. I continued to run (4 miles a couple times a week) and ruck (20k with 20lbs on my back, talk about a living hell!!!) After 3 months, Ibuprofen finally tore up my stomach and when I quit taking it I could barely walk. For the last 2 1/2 years I've had groin/hip/butt pain. I constantly felt like I was having mini tears in my groin (along the line where your bathing suit would be in that area); a "catching" sensation that often times made me suck wind because of the sharp pain it caused and a feeling as if there was a stick jabbed into the bottom of my left butt cheek (sorry for the visual image!). For months I had tingling and numbness down the outside of my left hip, down to my knee and prolonged sitting (as short as 20 mins) would "lock" up my hip and I'd walk around like Quasimoto until I could work it out. Several misdiagnosis to include exploratory surgery of my groin (which did discover bilateral hernias, much to my surprise) and no relief!

I've had physical therapy, steroid injection into the bursa, dry needling (Man, oh man, what pain!), TENS unit, ultra sound, massage, various types of meds other than ibuprofen (which didn't touch the pain), been put on a crutch and most frustrating of all been dismissed by so many doctors as being "broke" and unable to be fixed. ALL of my films (x-ray, CT, MRI, MRA, ultra sound, and I know I'm leaving something out) came back normal. Although my MRA from 2 years ago did show "a deficient labrum in the left hip but it is my opinion that this is normal for this patient." I'm wondering if I should have had someone else read that film!!

Finally a wise doctor prescribed a steroid injection into my hip capsule, with the help of an x-ray machine to make sue they hit the right spot, and I couldn't believe it!!!!! Within a day I was completely pain free!!!!!! Unfortunately, this lasted only 3 weeks but the pain that came back was bearable so I didn't fret. However, 6 weeks post injection I'm back to square one and even more frustrated! I have a wonderful physical therapist that is convinced it's a laberal tear and she's ordering another MRA and this one will just focus on my left hip socket (the last one, 2 years ago took pictures of my entire pelvis.)

I know the arthroscopic surgery of the hip is still relatively new and it sounds like there are contradicting entries here as to how helpful the surgery is for the long term. However, as I'm sure you all know, after close to 3 years of constant pain in a relatively young and formerly very active female....I'm willing to do just about anything to make the pain go away and be able to go out dancing again with my friends (or just sit at my desk for more than 30 minutes without hurting while I'm at work!!) I catch myself putting all my weight on my right butt cheek while driving (totally subconcious) and wonder if I'm aggravating my situation without realizing it???

I know I probably won't find a definitive answer in this thread but was just wondering if there's anyone that would definitely NOT recommed the arthroscopic surgery??? I think i'm just going to take my chances and hope for the best but after having my hopes squashed so many times before I don't know if I'm willing to put myself through that emotional rollercoaster, not to mention the pain of surgery, again just to get a couple months of relief.

Any advice, thoughts, guidance is greatly appreciated!!!! Again, although I hope everyone finds relief from their pain, I'm so thankful to see that I'm not alone and that searching the web to help self diagnose seems to be the norm for this situation. Thanks for taking the time to read my entry and I welcome your comments!!

BAC

[DiverDan]

Dear Beej
I would love to say that I know the answers to your questions about why you're hips are damaged. Sadly this is impossible because know one really knows. The lumbo-pelvic-hip complex is exactly that... it's complex. In any complex system, causes and effects are intermingled to such an extent that it makes the chicken and egg discussion seem a walk in the park. I know you're frustrated and obviously the pain doesn't help but the most important thing is to keep searching for answers. There is no cure for this problem becuse there isn't actually anything to cure. All we can do is manage the symptoms and treat what we can see. This is where the surgery comes in, to remove the intra-artcular irritation from the labral pathology.

Right now, probably the most important thing for you to do, is to look at your activites and behaviours which may be exacerbating your condition (ie posture, running etc.). Then devise a program with a physio who is well versed in motor control and biomechanics to modify your technique so as to maximise your strengths and minimise your weaknesses when loading your hips. Pilates can be really good.

Good luck with it. Keep on keeping on.

The Hipster

Hipster,

Read with interest your post that, "there isn't actually anything to cure", regarding labral tears. I was advised during diagnosis that an arthroscope would not fix the tear in my labrum. After almost 6 months post op physio, I am starting to lose hope. I have had 2 major "catches" during physio, with my hip now making a "cracking" noise. Rather than just treating the symptoms, would the global medical community be not better suited to finding a way to make cartilage grow in a Petri dish? Other body parts are able to be grown, why not cartilage? Failing this, what about a type of superglue to join the torn labrum?

DiverDan

[Surfchick]

Not intending to scare anyone, but in the hopes you can be more prepared than I was...

I started by making the appointment with the MRI clinic. I was instructed to first report to radiology for my IV then to proceed to the MRI clinic for the test. Simple enough.
On the day of the exam, I went to Radiology as instructed where they showed me to a dressing room where I could change into a paper gown. Hmmm....for an IV? Upon asking the clerk why I was disrobing, he said it was much easier to insert the needle into my groin if I wasn't clothed. WHAT?? After much explanation, distress, and an overwhelming urge to just want answers to my pain, I changed into the paper gown.
Lidocaine was used to anesthesize the area on the front of my right hip/groin area, then the resident (under Doc's supervision) proceeded to insert the needle (similar to one used for Spinal Taps) that would deliver the contrast material. They used the x-ray equipment to insure the needle was going the right way. Unfortunately, the x-ray doesn't show nerves - which the resident managed to hit on four occassions. OUCH! Each time he'd hit one, he'd administer more lidocaine! Before he was done I couldn't feel anything from my belly button to my knee! They wheeled me to the MRI clinic where everything was as expected from there. I only wish I had been more informed of the process and that they had suggested for me to have someone to drive me home. It was a difficult drive not being able to lift my right leg!
Results indicate nothing out of the ordinary, however I expect to meet with an OD next month to review all my symptoms and exams.

Hi again,

I can't believe you weren't fully informed of the procedure and made arrangements for someone to drive you. Insurance doesn't cover you to drive after an arthrogram -glad you made it home safe.

It is equally as important to have a competent orthopedic radiologist reporting your scan. Is it a specialist centre that did it for you? Given your ordeal - doesn't sound like it.
I paid to see a Proffessor for a second opinion. I asked him if icould get my scan done at the hospital where I work ( they had said they could do it in 3 weeks for me). He told me he had seen many young patients that had already had arthrograms done in Birmingham. He had to repeat some of these studies. These patients had been told there hips were normal but on him repeating the study and obtaining more images from different views - he found clear labral tears. In England in the UK he tells me there are only 2 surgeons that are "specialised" in this field of MR arthrogram and hip arthroscopy. Given the fact that you have been told it's all ok - I would be cautious in believing that if they are not that specialised.

Surf chick

[Surfchick]

Hello Fellow Hip, Groin and Butt pain sufferers!!!!
I thought I was finally on the right track with my upcoming appointment with a "hip doc" for an initial consultation to have an arthroscopic procedure but now I wonder if it will do any good and even if it does, will it last???

I'm a 36 y.o. female in the military. While running bleachers for PT, I heard and felt a "snap" or "pop" in the front part of my left hip/groin/pelvis. Extremely painful but, the military being what it is, I was given massive doses of ibuprofen which helped. I continued to run (4 miles a couple times a week) and ruck (20k with 20lbs on my back, talk about a living hell!!!) After 3 months, Ibuprofen finally tore up my stomach and when I quit taking it I could barely walk. For the last 2 1/2 years I've had groin/hip/butt pain. I constantly felt like I was having mini tears in my groin (along the line where your bathing suit would be in that area); a "catching" sensation that often times made me suck wind because of the sharp pain it caused and a feeling as if there was a stick jabbed into the bottom of my left butt cheek (sorry for the visual image!). For months I had tingling and numbness down the outside of my left hip, down to my knee and prolonged sitting (as short as 20 mins) would "lock" up my hip and I'd walk around like Quasimoto until I could work it out. Several misdiagnosis to include exploratory surgery of my groin (which did discover bilateral hernias, much to my surprise) and no relief!

I've had physical therapy, steroid injection into the bursa, dry needling (Man, oh man, what pain!), TENS unit, ultra sound, massage, various types of meds other than ibuprofen (which didn't touch the pain), been put on a crutch and most frustrating of all been dismissed by so many doctors as being "broke" and unable to be fixed. ALL of my films (x-ray, CT, MRI, MRA, ultra sound, and I know I'm leaving something out) came back normal. Although my MRA from 2 years ago did show "a deficient labrum in the left hip but it is my opinion that this is normal for this patient." I'm wondering if I should have had someone else read that film!!

Finally a wise doctor prescribed a steroid injection into my hip capsule, with the help of an x-ray machine to make sue they hit the right spot, and I couldn't believe it!!!!! Within a day I was completely pain free!!!!!! Unfortunately, this lasted only 3 weeks but the pain that came back was bearable so I didn't fret. However, 6 weeks post injection I'm back to square one and even more frustrated! I have a wonderful physical therapist that is convinced it's a laberal tear and she's ordering another MRA and this one will just focus on my left hip socket (the last one, 2 years ago took pictures of my entire pelvis.)

I know the arthroscopic surgery of the hip is still relatively new and it sounds like there are contradicting entries here as to how helpful the surgery is for the long term. However, as I'm sure you all know, after close to 3 years of constant pain in a relatively young and formerly very active female....I'm willing to do just about anything to make the pain go away and be able to go out dancing again with my friends (or just sit at my desk for more than 30 minutes without hurting while I'm at work!!) I catch myself putting all my weight on my right butt cheek while driving (totally subconcious) and wonder if I'm aggravating my situation without realizing it???

I know I probably won't find a definitive answer in this thread but was just wondering if there's anyone that would definitely NOT recommed the arthroscopic surgery??? I think i'm just going to take my chances and hope for the best but after having my hopes squashed so many times before I don't know if I'm willing to put myself through that emotional rollercoaster, not to mention the pain of surgery, again just to get a couple months of relief.

Any advice, thoughts, guidance is greatly appreciated!!!! Again, although I hope everyone finds relief from their pain, I'm so thankful to see that I'm not alone and that searching the web to help self diagnose seems to be the norm for this situation. Thanks for taking the time to read my entry and I welcome your comments!!

BAC

Hi BAC,

I have had shivers down my spine reading your history. I am so angry there are so many of us that are dismissed and told our hips are normal then a long time later get the correct diagnosis. I have posted quite a few replies - as I am very keen to start some kind of awareness/education group for orthopaedic surgeons etc!

Proffessor Damien Griffin whom I have great faith in told me that it is classic for a patient with a labral tear to get relief from a steroid injection but only for a short time. It gets rid of some inflammation - but then it comes back. The comments from your MRa 2 years ago are very suspicious. I think you need to find a competent centre to have another MRa and a competent surgeon to do the arthroscopy!

Prof Griffin told me there are only 2 surgeons in th UK and only about 7 or 8 world wide.
He also said arthroscopy is the only way to sort it - it won't get better on it's own.
There may be other surgeons that have a go at arthroscopy. I know I saw a Mr Marcus Green in April 2005, he did my steroid injection. Told me it was coincidence I got better and probably a psychological problem! He too has been known to do arthroscopy of the hip, but his main speciality are knees and shoulders! I am glad I didn't let him loose on my hip!

If you want - I can try and find out from my Professor the names of the good surgeons? think he is on holiday at the moment! Let me know if you want me to enquire - I know this is one big nightmare! There is light at the end of the tunnel, i'm sure.

Take it easy in the mean time

Surf chick

[steph1]

Philippon is scheduled to do my surgery in August. Still waiting for insurance to all be approved. I have been going through this process with my hip since May/June with him. I have not seen him personally yet, but sent my x-rays and MRI's out to him (my doctors did not see anything on the MRI). Philippon saw the tear on the MRI and sees an FAI on my x-rays. It takes a while to get responses back from them after you leave messages, but they are suppose to be the best in the country. Good Luck!

Steph

[steph1]

Hi again,

I can't believe you weren't fully informed of the procedure and made arrangements for someone to drive you. Insurance doesn't cover you to drive after an arthrogram -glad you made it home safe.

It is equally as important to have a competent orthopedic radiologist reporting your scan. Is it a specialist centre that did it for you? Given your ordeal - doesn't sound like it.
I paid to see a Proffessor for a second opinion. I asked him if icould get my scan done at the hospital where I work ( they had said they could do it in 3 weeks for me). He told me he had seen many young patients that had already had arthrograms done in Birmingham. He had to repeat some of these studies. These patients had been told there hips were normal but on him repeating the study and obtaining more images from different views - he found clear labral tears. In England in the UK he tells me there are only 2 surgeons that are "specialised" in this field of MR arthrogram and hip arthroscopy. Given the fact that you have been told it's all ok - I would be cautious in believing that if they are not that specialised.

Surf chick

I had the MRI & MRA done also, and the doctors here couldn't see anything on either one. I sent the MRI out to Philippon's office and he was able to see it right away. I supposedly had one of the best radiologist in the country read my MRA and he didn't see anything out of the ordinary wrong with my hip. I sent the MRI out to Philippon and he saw it right away. He specializes in hips only and is suppose to be one of the best in the country. He has developed the braces, and help develop some of the surgical equipment to perform the surgeries. He has also done over 2,650 of these surgeries and does about 12 a week. Good Luck, this is a very frustrating process. Philippon's office is slow at responding and that is very frustrating also. I'm scheduled to for surgery in August.

Steph

[Hipster]

Dear DD

To clarify my "nothing to cure" statement I probably should have said that there is no cure at the moment with the technology available. We are still in the early days of cartilage regeneration and growth (they have been doing chondrocyte implanation in knees for some time with mixed results). The problem is that the body's natural system is normally so well designed that when there are underlying physiological, biomechanical or pathological problems like labral tears, cartilage damage or impingement our rudimentary human solutions are not advanced enough. Basically it's like asking a carpenter to fix the gear box in your car. He may have a general idea of how it all works, so he an pull it apart but his knowlegdge is not good enough to allow him to fix it with the available tools (ie hammer and nails) nor put it back together again in its original condition.

In Australia we are still educating the medical establishment about the reality of hip pathology as a cause of lumbo-pelvic symptoms in the non-elderly population. Let alone being able to get funding for further research into an area which is high risk and low return for government. At the end of the day the systems says, wait till the hip is rooted then rip it out and wack in a joint replacement (which have a finite life span so you can't get them until you're old). In the mean time deal with the pain and change your lifestyle. That's what a lot of people end up doing.

This same process happened many years ago with knee pathology and arthroscopy (and it is still going on today). We are in the infancy of medical awareness about hip problems and many years away from any sort of solution. Until then we need to address each case individually and treat the problem from a number of angles including - physiotherapy, behaviour modification, surgery, injections, massage, supplements (ie glucosamine, chondroitin) , acupuncture - whatever works. There is currently no answer.

In your specific case obviously your hip is pretty stuffed (to put it lightly). Hopefully you can find a path to managing your symptoms with help from the right people. Other ideas you may want to investigate are endogenous cytokine injections into the hip joint (synvisc- orthokine) which may reduce inflammation and joint symptoms - these have been trialled on knees but are bloody expensive to produce. May be you need another surgical or pain management opinion.

Hopefully we'll come up with some better options before you need a metal hip.
Take care,
Hipster
PS sorry about the long post - had to get a few hings off my chest

[DiverDan]

Hipster,

Can you please contact me via private message.

DD

[gina]

I have been experiencing extreme pain in my hip and groin for four years. I have been thru many diagnoses until I finally was diagnosed with femoral acetabular impingement, the X-ray showed the cam affect in the femoral and acetabular, also cysts, pits and a spur behind the femoral about 2.5 inches long. I have been living off a cocktail of vicodin, neurontin, advil, and darvocet for approximately six months. Tomorrow I am going to have my second blasted MRI with arthrogram. Really excited about that. My doctor wants to take the very conservative treatment. He first wants to rule out a labral tear. My question is if there is no tear but I still have the femoral acetabular impingement will cortisone injections help the impingement or do I need a more invasive treatment like surgery to correct this problem? If I do have a labral tear do I need surgery? I was also wondering if people are experiencing the same symptons that I have? My symptoms are as follows: pain inthe groin, pain in the back of my hip, cannot sit long, cannot do household chores such as ironing, vacumning, sweeping, bending forward, shifting weight from side to side,standing still for more than an hour or less, cannot sleep on affected hip, and having trouble being able to start my urine, and staying asleep. Please help me to understand this awlful and painful condition?:confused:

[DiverDan]

Dear DD

To clarify my "nothing to cure" statement I probably should have said that there is no cure at the moment with the technology available. We are still in the early days of cartilage regeneration and growth (they have been doing chondrocyte implanation in knees for some time with mixed results). The problem is that the body's natural system is normally so well designed that when there are underlying physiological, biomechanical or pathological problems like labral tears, cartilage damage or impingement our rudimentary human solutions are not advanced enough. Basically it's like asking a carpenter to fix the gear box in your car. He may have a general idea of how it all works, so he an pull it apart but his knowlegdge is not good enough to allow him to fix it with the available tools (ie hammer and nails) nor put it back together again in its original condition.

In Australia we are still educating the medical establishment about the reality of hip pathology as a cause of lumbo-pelvic symptoms in the non-elderly population. Let alone being able to get funding for further research into an area which is high risk and low return for government. At the end of the day the systems says, wait till the hip is rooted then rip it out and wack in a joint replacement (which have a finite life span so you can't get them until you're old). In the mean time deal with the pain and change your lifestyle. That's what a lot of people end up doing.

This same process happened many years ago with knee pathology and arthroscopy (and it is still going on today). We are in the infancy of medical awareness about hip problems and many years away from any sort of solution. Until then we need to address each case individually and treat the problem from a number of angles including - physiotherapy, behaviour modification, surgery, injections, massage, supplements (ie glucosamine, chondroitin) , acupuncture - whatever works. There is currently no answer.

In your specific case obviously your hip is pretty stuffed (to put it lightly). Hopefully you can find a path to managing your symptoms with help from the right people. Other ideas you may want to investigate are endogenous cytokine injections into the hip joint (synvisc- orthokine) which may reduce inflammation and joint symptoms - these have been trialled on knees but are bloody expensive to produce. May be you need another surgical or pain management opinion.

Hopefully we'll come up with some better options before you need a metal hip.
Take care,
Hipster
PS sorry about the long post - had to get a few hings off my chest

Hipster

If you are located in Sydney and see patients, I would like to arrange a referral.

Prior to surgery I spent time at physiotherapy, hydrotherapy, massage & acupuncture.
Following surgery I have attended physiotherapy ( including massage ) with a couple of months of hydrotherapy. I have taken Glucosamine ( including high doses in a product called ChondroCare ). My injury is aggravated by sitting. I have been sitting since July 2005, which is a catch 22 as this is the only light duties work my employer has. How can I change this behaviour, get a doctor to put me off work. I tried this as well following surgery!!

I'm still sitting 9 - 10 hours a day, with pain increasing as each hour passes. Apart from pain killers ( Endone or ********, which make me sick ), iliotibial stretches are the only pain management options currently being used.

If I sound desperate, I am. Can you assist?:confused:

DiverDan

[Surfchick]

I had the MRI & MRA done also, and the doctors here couldn't see anything on either one. I sent the MRI out to Philippon's office and he was able to see it right away. I supposedly had one of the best radiologist in the country read my MRA and he didn't see anything out of the ordinary wrong with my hip. I sent the MRI out to Philippon and he saw it right away. He specializes in hips only and is suppose to be one of the best in the country. He has developed the braces, and help develop some of the surgical equipment to perform the surgeries. He has also done over 2,650 of these surgeries and does about 12 a week. Good Luck, this is a very frustrating process. Philippon's office is slow at responding and that is very frustrating also. I'm scheduled to for surgery in August.

Steph

Hi Steph,

Thanks for detailing your experiences with regards to reporting of these important diagnostic MRI and MRa scans!

It just proves again the struggle and fight that people within this "patient group" that are wanting a diagnosis to there severe hip pain and all the other symptoms associated with FAI and labral tears - have had and will continue to have - unless there are some orthopaedic awareness/education seminars on this subject. It's clearly a world wide issue. Where does it leave the patient? The more posts I read from different people, the more angry I get that people are suffering for a long time through misdiagnosis.

I was one of these patients that was dismissed and told my hip was normal, sent to see a psychiatrist and told it was psychological pain and stress related. Fortunately something inside me told me this wasn't right and I am glad I did pay for a second opinion.

WHAT CAN WE DO AS PATIENTS TO RAISE AWARENESS TO THESE SURGEONS/RADIOLOGISTS THAT SO FREQUENTLY MISINTERPRET MRI/MRa SCANS?

I sent my complaint letter to The Royal Orthopaedic Hospital, Birmingham last Sunday. I should have had an acknowledgement letter in 3 days - guess what, I have had nothing! Cause for further complaint!

Steph, I hope your surgery goes well and your rehab is not too bad - do what the surgeon and physio tells you!

I am now 5 weeks post op, just went to the coast for a 4 day holiday. I was told not to surf - gutted, but I could body board and swim front crawl only! My mates told me it would ruin the image to go and hire a body board, but the sun was shining and I wanted to be in the sea - so had to! It was fun, bit painful as the waves bashed against my hip but no long lasting effect - sure it must have helped! I didn't have chance to do my physio exercises whilst I was away, feeble excuse I know, I can sure feel the difference, I feel more seized up and stiff - must start againg with avengence!

Anyway, take care and take it easy,

Manda

[Surfchick]

I have been experiencing extreme pain in my hip and groin for four years. I have been thru many diagnoses until I finally was diagnosed with femoral acetabular impingement, the X-ray showed the cam affect in the femoral and acetabular, also cysts, pits and a spur behind the femoral about 2.5 inches long. I have been living off a cocktail of vicodin, neurontin, advil, and darvocet for approximately six months. Tomorrow I am going to have my second blasted MRI with arthrogram. Really excited about that. My doctor wants to take the very conservative treatment. He first wants to rule out a labral tear. My question is if there is no tear but I still have the femoral acetabular impingement will cortisone injections help the impingement or do I need a more invasive treatment like surgery to correct this problem? If I do have a labral tear do I need surgery? I was also wondering if people are experiencing the same symptons that I have? My symptoms are as follows: pain inthe groin, pain in the back of my hip, cannot sit long, cannot do household chores such as ironing, vacumning, sweeping, bending forward, shifting weight from side to side,standing still for more than an hour or less, cannot sleep on affected hip, and having trouble being able to start my urine, and staying asleep. Please help me to understand this awlful and painful condition?:confused:

Hi Gina,

Have you read my post to BAC on 22-07-06? That may help with some of your questions. You must ask your surgeon too!

As for your symptoms and problems with daily activities etc, I had all those problems too!

5 weeks post op - I can vacuum using an upright cleaner pain free. On holiday last week I had to lift a heavy cylinder vacuum out of a cupboard and that really hurt! Sudden movements, twisting etc still hurt - but it takes 12 weeks to heal, so I guess I am doing quite well! Also pushing nephem's pushchair up steep hill was hard and my mom who is on chemo for liver cancer, had to take over! It's the blind leading the blind!

Have you had your results yet?

Manda

[Surfchick]

Forgot to say -

I never had problems starting urination! I don't know if that's to do with hip pathology - does anyone else know? I think that should be addressed with your doctor. Just a thought - is it a side effect of any of the strong pain killing medication? Get it checked out!

Manda

[gina]

Hi Manda,
I just got my results from my mri and arthrogram, I have now been told that I have no labrum tear, but I have a synovial herniated pit. What the heck? I heard the results from
a nurse at the ortho's office. I will go see him on Tuesday morning. I guess I will find then what is the next step. I think you are right about the pain killers and urinating. I would just like to be able to sit, lay and do all the the things they call life again without pain just for one day. i hope you get relief from your pain also. Thanks for responding. Nice to talk with someone that is going through the same thing. Gina

[Surfchick]

Hope they sort you out soon. Pain of any cause can be stressful and debilitatiing.

Take care
Manda

[gina]

hi Manda, I saw the doc today and he is starting me on cortisone next Monday, he also told me he can not really help me as well as a doc at Duke. he is referring me to him and I am hoping for a appt. as soon as possible. He said I definitely have an impingement and I have develop more bone in my joint and on my femor. He said this guy does these kind of surgeries everyday and he would be the best choice for me. He said maybe the cortisone will give me relief and I may not need surgery. I can only hope. I wish I knew if cortisone has erver helped someone to the point they do not need surgery. Thanks for your reply and your kind words. Gina in N. C.

[Auzzie]

Hi, What so many of us have been through with miss diagnosis and non responsive doctors. I have just today been diagnosed with acetabular labrum tear, not by my specialist but by the report being faxed to me, so I have done my own research and thankfully found this site, what I would like help with if at all possible, I live in New Zealand does anyone know of a surfeon, ecperienced in the surgery required for this condition. Living with this pain for much longer is not an option so I want to move forward as soon as possible. Anyone can email me on auzzie@xnet.co.nz. Many thanks in advance

[Alex]

Hello! Wow, there are others out there.

I was just diagnosed with a labral tear in June. I have an appointment with an ortho doc in 8 days. I was wondering if anyone could share what the timeframe was from the day surgery was elected to when it was done? I have had this pain for 11 long years and I am in a big hurry to get it fixed. PT did nothing for the pain, pain killers barely work.

I am in a rush because my job requires me to be on my feet frequently and sometimes some lifting. When my hip starts to hurt it is very painful and difficult. I can work from home, though so recovery time doesn't matter.

Alex

[Surfchick]

Hi Alex

I am from the UK. My experience is - if you want anything done quickly - pay for it!
I had a loan and am paying it back over 5 years. Had to wait 4 weeks - that was allowing time for pre op assessment and arranging loan and paying the hospital etc!

Good luck, hope you get sorted soon. I am told it is 12 weeks for the recovery - I am 7 weeks post op and still off work!

See my next message to everyone!

Manda

[Surfchick]

ATTENTION ALL PATIENTS WITH FAI AND LABRAL TEARS AND ALSO POST OP, RECOVERING PATIENTS!

As you know, I am in the UK, England. My surgeon is Professor Damien Griffin. He is developing a website on FAI and labral lesions. I have been asked to think of questions that patients would want answering. I am meeting another patient in the UK tomorrow who is scheduled for possible surgery next week. I am sure we will discuss this in great length!

I would really appreciate it if you could all email me:
1) Questions you would ask before you get a diagnosis, when FAI and labral tear is suspected.
2) When you have a diagnosis - what you want to know from the surgeon?
3) If you are scheduled for surgery - what questions pre op would you ask?
4) What post op questions regarding rehab, exercise, work, sport, implications for your future, etc.

email = Surfchick@totalise.co.uk

Thank you in anticipation!
I will keep you updated on the website etc.

Manda
:)

[Surfchick]

Hi again!

Just thought you might all be interested in the following;

Prof Griffin has organised a conference for hip surgeons on 30th October 2006 to include FAI and labral tears. From the website I see there is a list of invited surgeons from across the world - including Australia and the USA! and many more. So, there is hope that the clueless orthopaedic surgeons might learn about this painful, debilitating hip problem!

I'll include the website - if any of you have a good "patient/doctor" relationship - maybe you could ask your surgeons if they are going to attend???!!!

www.warwickorthopaedics.com


Let me know if any of your surgeons will be attending!

Manda

[Surfchick]

hi Manda, I saw the doc today and he is starting me on cortisone next Monday, he also told me he can not really help me as well as a doc at Duke. he is referring me to him and I am hoping for a appt. as soon as possible. He said I definitely have an impingement and I have develop more bone in my joint and on my femor. He said this guy does these kind of surgeries everyday and he would be the best choice for me. He said maybe the cortisone will give me relief and I may not need surgery. I can only hope. I wish I knew if cortisone has erver helped someone to the point they do not need surgery. Thanks for your reply and your kind words. Gina in N. C.

I bet you feel like you have been on an emotional roller coaster? Glad you have a diagnosis.

My steroid injection into my hip - helped for 2 months! However, it got worse for a few days after - had 1 night in hospital. Had inj on Thurs, leg weak on Fri, bit better on Sat - stupidly went to a ball and danced! Sun - really bad pain - had to go to hospital for pain relief! On day 10 - it was like a miracle - symptoms went. Another week on - I went surfing - was fine. After 2 months I kicked a heavy box at work - then that was the start of my pain again!

I think maybe? - if you take it easy for 10 days after and then lived the life of a couch potato with no physical activity - it may last longer! However, there are some patients that get no benefit from the injection at all! We are all individual so I guess you will have to see how you go.

Feel free to email any questions for my surgeons new website! See previous messages!

Manda

[Alex]

Thanks for the reply. I have been out of the military for 10 years now. That's been part of the reason it took so long for a diag- VA doctors and the whole system. There is no way in the world I will let the VA operate on me, though. I just needed the diag for my records. I could request that they pay for the operation (should I be a good candidate) but I don't have time for all that red tape. I have health insurance with my employer and will be using that.

I am hopeful that the ortho doc supports surgery and that I can get it done soon. I have plenty of sick and vacation time but I can also work from home, so work and recovery should not be a problem.

Can anyone share what physical therapy has been like? Is it daily? Due to neck and back problems I can only swim. I am pretty good at not using my legs since it's painful on my hip. Is swimming post-surgery an option?

Alex

[June Bug]

Hi - I'm am new to this, but finding a lot of interest in what you have going on. I'm starting to feel like a hypochondriac, but I know the pain is real. I have had knee pain for about 20 years - 3 ortho surgeries and IB problems for years. I have noticed over the past few years that I have been having a lot of hip & back pain. Thought was that it just radiated from the knee to the back and hip and if I could get my knee fixed, then everything else would start to feel better. Almost a year after the last knee surgery, I am not doing any better in fact everything (except the knee) are worse. I have gone back to my orthoped and he didn't want to do anything (the cartilage in my knee is 50% of the way cracked to the base of where it attaches in a few different places) I then tried to find a PT that could help with both the back & the knee & the hip. His conclusion was that I do have a possible tear in my knee, but that there were other things that are wrong, in my hip and back. He thought at one of the 1st visits that I may have a labral tear and a bulging disk in my back. Had an MRI done - negative on the hip, positive on the bulging disc& stenosis of the back and degenerative knee. Had an epidural for the back - some relief, but the hip/groin pain wasn't better. Went to another orthoped (tried the one that did surgery on my knee last July - and he didn't even look at my hip during the visit). This orthoped took an x-ray - believes there to be a possible labral tear and a growth on the femur bone- recommended I try a floral guided cortisone shot in the hip - didn't do much. He also gave me a cortisone shot in the IB area - that helped a lot with the knee pain I believe, but not with much else. I sent my pictures, MRI etc. to Dr. Philippon in Colorado - he believes that arthoscopy of the hip may help my condition. I know he is the best in the country, but he isn't in my health plan and is quite a long ways away. Has anyone heard of or Dr. John Clohisy in St. Louis or had any experiences with him. I would appreciate some feedback. Good Luck! I am a firm believer that the hip, knee go hand in hand.
Steph

Hi, Steph,
It was nearly 7 years from my injury until I was finally diagnosed with a labral tear. At the time of injury, I had pain in both the groin and buttock. I had numerous x-rays, MRI, bone scan, all of which were essentially normal. Finally, it was the third orthopedic physician I consulted who ordered a MRI arthrogram (MRI with contrast). Bingo! The MR arthrogram was suspicious for a labral tear. I was then referred to Dr. John Clohisy, St. Louis, who specializes in disorders of the hip and knee. By this time, my pain was primarily located in the buttock area. I also have 3 bulging lumbar discs and at first, Dr. Clohisy thought my pain might originate from my back. Dr. Clohisy sent me to a Physical Medicine physician at the Center for Advanced Medicine (Washington University/Barnes), who injected my hip with cortisone under flouroscopy. The injection only helped for a couple of days.

Dr. Clohisy performed a surgical arthroscopy on my left hip on 2/8/2006 and shaved off a piece of detached labrum (see earlier Post #53 on this website).

Over the years, my body “learned” to do a lot of dysfunctional stuff to compensate for pain. I was rotating my hip inward & twisting my torso towards the affected hip. Since surgery, it has become more evident that the chronic buttock pain was probably from misuse/disuse of muscles to compensate for the injured labrum. After almost 7 years of pain, I had considerable muscle atrophy (wasting). Three months post-op, I still could not stand up from a low sitting position without using my hand to push up. I also had to use my hand to lift my leg in and out of the car. Dr. Clohisy referred me to a Physical Therapist (PT) at Washington University School of Medicine, who specializes in working with people with muscle dysfunction from chronic pain. My PT possesses a Doctorate Degree in Physical Therapy. Thank goodness, I have improved considerably since I started therapy at Wash U. I am grateful to Dr. Clohisy for sticking with me and not giving up until we got the problems figured out.

I'd like to hear about your outcome, Steph.
Best wishes,
June Bug

[cjcc67]

I has surgery in December, and although the pain is different, i can't say whether i feel better. I guess the problem was compounded as it was undiagnosed for a long time and i continued a high training load whilst injured for nearly 2 years.
Can others who have had this surgery indicate how long 80 % recovery took after their operation.
I would also be interested to hear of positive rehab experiences in Melbourne.

[June Bug]

Thanks for the reply. I have been out of the military for 10 years now. That's been part of the reason it took so long for a diag- VA doctors and the whole system. There is no way in the world I will let the VA operate on me, though. I just needed the diag for my records. I could request that they pay for the operation (should I be a good candidate) but I don't have time for all that red tape. I have health insurance with my employer and will be using that.

I am hopeful that the ortho doc supports surgery and that I can get it done soon. I have plenty of sick and vacation time but I can also work from home, so work and recovery should not be a problem.

Can anyone share what physical therapy has been like? Is it daily? Due to neck and back problems I can only swim. I am pretty good at not using my legs since it's painful on my hip. Is swimming post-surgery an option?

Alex

Hi, Alex,
My understanding is yes, you can swim as soon as the surgical skin wounds are healed. Swimming should enhance your recovery. One of my friends had a total hip replacement and recovered much faster than I have following my hip arthroscopy (for labral tear)!!! I attribute my friend's rapid recovery to her having exercised in a pool at the YMCA, before and after her hip replacement. I wish I had known to exercise in a pool before surgery! Like you, I was unable to walk/exercise (due to hip pain). Consequently, I had considerable muscle atrophy and my post-op recovery has been somewhat protracted. I don’t know what resources you have in your area . . . some Physical Therapy centers have pools. If your PT doesn’t have an exercise pool, perhaps the YMCA is an option.

Best wishes,
June Bug

[Alex]

I belong to a gym with a pool, so I'm all set. I have other neck and back problems that make any other type of excersize painful.

How long does it take to heal enough to swim? A week to 2?

I am so excited that my appointment is on Thursday- it's just such a relief to know that the end may be near. It does concern me slightly to read that some people don't feel much different. Does anyone know the success rate of surgery for a labral tear?

[June Bug]

Hi, Alex,
I had three small incisions, each only about 1/4 inch long (I submitted Post #53 on this thread after my surgery). My surgeon closed the skin incisions with steri-stips (paper tape strips). If there were any stitches, they were beneath the skin. My surgeon told me I could shower after 3 days & not to disturb the steri-strips, but to let them come off on their own. When the steri-strips came off between 10 days to 2 weeks after surgery, the incisions were completely healed!

As for success rates, the scholarly literature reports a 67%-91% success rate for arthroscopic treatment of labral tears: See, "A Review Of Hip Arthroscopy And Its Role In The Treatment Of Adult Hip Pain", (under the bold heading, "Labral Pathology") http://www.uihealthcare.com/depts/me...eviewofhip.pdf.

Good luck at your Thursday appointment! All of us "hipsters" are eager to hear about your outcome! Wishing you the best!
June Bug

[injuryupdate]

Received on contact us:

Hi, 3 years ago I realized that the pain in my hips wouldn't subside. I went for physical therapy a year later for my left hip and it gave me temporary relief. However, 1 month later I had an MRI performed and it revealed an anterior labral tear. The radiologist then suggested I receive an MRI arthrogram to confirm it. I couldn't afford it financially and I had to take care of my shoulder first. Just 2 months ago I received my 3rd right shoulder operation and this time it was cut and had alot of work done. I'm recovering pretty good and hoping to return back to delivering mail by december. But my hips bother me almost as much as the shoulder. Tomorrow I'll see a hip orthopaedist but I think he does more than just hips. I was obsessive with running and weight-training in highschool to be more competitive in HS athletics. I never took any oral supplements harmful to the body. I always stretched more than others cuz I pulled muscles easy especially the groin. I'm now 31 and have also seen a pain-manage-specialist 3-4 months ago and he diagnosed both hips with laxity and as having a little instability on one side. My job aggravates both on a daily basis but I half to feed my family and pay bills. I think maybe the right hip may be a posterior labral tear. They both click and pop w/ lots of movement and sometimes very little. I struggle to keep fit anymore due to pain but I take a few meds and try to endure the more challenging days. I generally walk 4-6 miles a day as a mailman. Sometimes I feel my body wobbling from place to place. Will a specialized surgeon scope both hips the same day? I don't have enough sick leave to cover me for 2 separate procedures. Can anyone recommend an excellent specialist? I want to get back to biking, light weight-training and possibly running but most of all to feel better while at work. I would appreciate any advice, Chad in UT

[Alex]

Well, it's much worse than just correcting the tear. I am scheduled for a periacetabular osteotomy.

This should allow the tear to heal itself. If the tear alone was fixed it would just happen again. I have dysplasia and that's what's causing everything else.

[RareErr]

Greetings all,

I just stumbled onto this forum after enduring 4 years of increasingly painful hips, after reading about Mr Manilow's upcoming surgery. What an epiphany, so glad to have found such a wealth of information and empathy. Never thought I'd be thankful for Barry Manilow, but there you are . . .

My story: An athlete all my life, grew up playing ice hockey, baseball, football (both US and real), basketball, golf, you name it, I played it with gusto. Clock forward to 4 years ago, 40 years old, still active, and playing ice hockey 2-3 times a week. I sustained an injury playing ice hockey that I didn't think much of at the time, but in retrospect it has had a huge impact on my life. Hard to describe how injury was sustained, suffice it to say I plowed into the end boards at near full speed (which I estimate to be around 20 mph), hitting the end boards with knees and jamming both femurs into hip joints. Painful to be sure, but I walked (hobbled) away, feeling lucky nothing broken or otherwise serious (Ha!). Hip pain for some weeks, but it got better, to the point where I dismissed/forgot the event as insignificant.

Approx year later, a different kind of hip pain started to emerge, accompanied by the start of range of motion limitations. With many aches and pains a part of the game (hockey), easy to write it off as normal wear and tear. Pain gets progressively worse and range of motion starts to be an issue, getting socks on, clipping toenails, getting golf ball out of the cup all become troublesome (but not yet impossible, that comes later!). Still not linking previous injury to my condition, chalking it up to getting older. Rationalization combined with an abnormal fear/aversion to Dr's, lead me to just carry on.

One year after that, pain and limited range of motion progressively getting worse, finally to the point where I enter self-imposed restriction on activities (quit hockey, temporarily I thought) to see if time off will allow me to heal fully, or at least show some improvement. No improvement, OK finally time to get out of denial, I am NOT invulnerable, I speak to my GP about issue (have not seen him since before original injury). After tests for rheumatoid arthritis, x-rays, and a few other things, declares that its osteoarthriitis, a degenerative condition, can only get worse over time. He arranges a referral to Orthopedic Surgeon, who is unfortunately out of town when my first appointment is made, and I only see his assistant. After more x-rays, and some prefunctory range of motion tests, he corroborates GP diagnosis, declares me a joint replacement candidate, really a depressing and scary thought for me. He recommends I re-schedule to speak with real doc, and discuss my treatment options, which in his 'expert' opinion is a short list, i.e. joint replacement. At this stage, I still haven't linked my original injury with my problems, I just think I'm suddenly striken by arthritis, bummer. Resign myelf to never playing Hockey again, ditto most other sports (still golf, but its painful to say the least)

This was one year ago, and I've not yet pursued a followup appointment, as I'd rather live with pain than go through getting my femurs sawed off and artificial joints installed. At least thats what I thought then. This pain is pure hell, dealing with it has taken a toll on my mental and physical health thats hard to see from the inside (i.e. I have a hard time seeing it), but manifests in so many ways (others have seen marked difference in me, but afraid to mention).

I've finally scheduled that appointment (OK, go ahead and give it to me, I deserve some criticism for being so cavalier with my health), after seeing that Manilow story, googling "Hip Labrum Tears", and finding this site. Along with finding this site, I have found some hope that there is something that can be done instead of total joint replacement, to give me not only my life back, but (dare I hope it??) even to play hockey and other sports once again pain-free. I feel like the sun has just come out after years of being in the dark, I have hope! (OK, I'm realistic, joint replacement may still be my only option, but now I'm ready to do it to get past this chronic pain!)

My question for all of you is, what questions should I be asking the Orthopedic surgeon, and what responses should I be wary of? My fear is that he will steer me to what he wants (joint replacement, just a guess here), as opposed to exploring all the treatment possibilities. I have a hard time accepting that at 44 its OK to consider hip replacement without exploring all treatment options, but I need to try and understand what those options are.

I'm ever so sorry for such a long initial post, you can't (or probably you can) imagine how good it feels to discuss (or at least post! that in itself has proven cathartic!) with a group who I'm sure will understand my situation.

[kjwilkin]

Hi there,

Sounds like you've had a rough time of it.

If I was you I'd also seek out the opinion of a good sports physician. They often have a lot of good ideas apart from surgery.

I've got a problem with loose ligaments and was having quite a few problems with my hip. My sports physician in Melbourne recommended pilates and has helped to no end. It turned out that my psoas was also quite tight so he's been doing some massage on that and has helped heaps. Amazing how everything is inter-connected.

Unfortunately GP's often have limited knowledge of orthopaedics. So, is worth while getting an opinion from a Sports Physician as they specialise in this area. GPs also often do scans that are not really appropriate.

No harm in seeing what the orthopod has to say. Keep in mind that it's only one person's opinion.

Good luck !

[injuryupdate]

Good full text review on acetabular labral tears at:

http://www.ptjournal.org/cgi/content/full/86/1/110

[DiverDan]

Good full text review on acetabular labral tears at:

http://www.ptjournal.org/cgi/content/full/86/1/110

:mad: What a shame my physiotherapist never found this article.

Just an update to any interested parties. Last week I managed to pass an operational assessment, resulting in my return to full duties. Wearing the standard issue ( 6-7kg ) appointments belt is now causing both groin and butt pain, but considering the alternate duties I have just spent the last 12 months performing, pain is just a state of mind. For me it will now be a case of, "How Much Can a Koala Bear"? I have no doubt the wearing of this equipment will expedite the need for a metal hip, but tomorrow is another day.

Suitable alternatives to the standard issue appointment belt are being looked at by various law enforcement agencies. Hopefully forums like these will bring about a change in thinking/ treatment.

DiverDan

[barb217]

I just had surgery on Friday (8/25) for a labral debridement. The surgery took about 45 minutes to an hour. The setup for the surgery took about an hour also. So total 2 hours. This was my second surgery on my hip. The first surgeon did not get everything. The first surgery the doc went in through the front of the thigh/groin area. The second surgery the doc (different doctor) went through the side. His name is Dr. Frank Ebert. He perfected the MRI Arthrogram. The second surgery went so much smoother and I had less pain than the first. He said I should be on crutches about 7-10 days and then get the stiches removed. If I have any arthritis he will give me shots to help lubricate the joint. He feels like he fixed the problem. I will know in a couple of weeks if everything is fixed. But compared to the first surgery...this one was a breeze.

[BAC]

Hi All,
I apologize to Surf Chick, I couldn't figure out how to reply to you on this website. :confused: Well, I finally got referred to a hip/pelvic speciliast. Oh my goodness, this man seems like the answer to my prayers!! From a simple x-ray he noticed that the head of my femur (the ball of the ball and socket) has a dent in it (pretty freaky!)due to hip impingement which, in turn, has caused not one but possibly two labral tears!!!!! (Why the half dozen other doctors never picked up on this, really ticks me off, but from what I understand it is difficult to diagnose with the untrained eye....... hmmm.)

He ordered another MRA and a steroid injection to help with the pain (3 injections into my hip socket wtihin 8 days, my poor hip is pretty sore) to get pictures to his specifications and I go back this week to find out our game plan. I asked if surgery would be the next step and he was hesitant to answer until he saw the pictures from the MRA he ordered, but he suggested I google Dr. Rheinold Ganz. I was thinking arthroscopic surgery would be the answer but, and I hope I'm wrong, it looks like PAO (Periactabular Osteotomy) may be the answer. I'm on pins and needles waiting to see what he has to say this week. Have any of y'all had the PAO (Done by a surgeon trained under Ganz and does it truly give relief??? If so, how long have any of y'all been pain free after this procedure and what type of activities are you able to do?) I fit the demographics (36 yrs old, wrongly diagnosed hip and groin pain for almost 3 years now, and wish to return to an active lifestyle. Swim, snow ski, dance, jog, golf, etc....)

From reading some of the other entries, it seems like more orthos are getting better information on how to help those of us with "mysterious hip/groin/butt pain" I just hope we all can help them to help others so they that don't have to go through the frustration of misdiagnosis and lengthy painful symptoms like we have!!

Hearing all of y'all's stories really does help and although I pray that y'all receive relief from your symptoms I thank you all for sharing your stories!!
BAC

[BAC]

Hi Gina,
I'm in NC and am being seen at Duke too. I don't know if steroid injections will prevent surgery for you. I was told that everyone reacts differently to the injections. In my case, I had 3 weeks of utter relief, completely pain free. However, after 6 weeks, my pain quickly got back to being unbearable and I started oral pain medicine again. I had another steroid injection last week, but I had 2 MRAs within 8 days and so I think all of those injections led to an unfavorable result with this last steroid injection which was done during that 8 day period. (still having to use oral pain meds). One doc told me they really don't like giving steroid injections as a therapy and really only give them to a patient about to undergo total hip replacement. Mine was originally given as a diagnostic method. However, that doc also said some folks do very well with steroid injections and never have problems again, others have minimal pain returning while others, like me, get back to the point of needing some other sort of help. I wish you luck and if you would like to chat, please email me! I bet we're seeing the same doc and if we are, I've heard wonderful things about him. I'm seeing him this week to get a prognosis. He's tentatively diagnosed me with two laberal tears secondary to hip impingement.
BAC

[silverspirit7]

Hi all, everyones posts were very interesting. First off I am 20 years old and I have been having off and on, now constant groin pain for almost 2 years now. I was diagnosed as having a groin strain and PT just made things worse. I went to other doctors and over time came to the conclusion that I have a labrum tear, a femoral head impingement and the possibility that my synovial tissue has grown?? too much (possible synovectomy). I received a cortisone shot and felt great. I now have full flexibility of my groin and hardly any more groin pain. But now I have hip pain, feelings of a very stiff joint with pain sometimes over the area where I am supposed to have the surgery. I was told to build up my muscle and fitness again to test my legs to see if the pain worsens (have to make sure I require surgery), so I have been doing that for almost a week, and it seems that one day I'll be in pain, and the next I'll be fine. I do not feel confident at all, high speeds and agility are unheard of so far, but I am nervous..what if I dont need the surgery? Can anyone please relay a similar expierence or their thoughts, thank you so much for your time

-Ben

[philip whelan]

Hey guys, like most of you its great to hear other people know the pain I'm going through.

13 months ago I was playing a soccer match in Sydney. I was twisted in the air while jumping up to head the ball and landed with a lot of force directly on my right hip. I felt everything shift up but after getting my breath back after being winded I was thankfully ok, or so I thought.

Played soccer for the next 3 weeks but gradually my movement stiffened up. To make a very long story short, I have been mis diagnosed and spent thousands!! After having deep tissue massage, chiro, Pilates, core exercises, glute exercises my recovery has been minimum. I still feel tight, get pain when I sneeze and generally still in the dark.

I recently went to Dr Tom Cross who seems to know his stuff and he has referred my to Dr O Sullivan about a possible torn labrum in my hip. After googling it, and finding this site I think its a match, which im happy about but very worried.

My question is, has anyone gone back to there old normal life, and if so how long did it take?

Guys I'm 26 and a very keen sportsman. I play, sorry I played soccer at a semi pro level and used to run 15km every day. I even planned to run the marathon this year!! I haven't ran or kicked a ball in 13 months.....The thought of having this pain for the rest of my life is depressing. Please tell me there is light at the end of the tunnel??

[silverspirit7]

Hey, I haven't had the surgery yet, but I was also injured playing soccer, a fellow teamate during practice barreled through my outstretched leg and I went flying, thought I would be fine with a couple days rest...I was also baffeled by the pain I got when I sneezed, none of the doctors could explain it but I'm sure its a pretty tell-tale symptom..I heard that a cortisone shot can be a cure all for the pain for some, you may want to try that before you undergo surgery..good luck

[philip whelan]

Well I'm off to Dr O sullivan on Tuesday, so I'll keep you posted.

[Kris10]

I am an 18 year old female. I was diagnosed with snapping hip disorder and after physical therapy twice and prolotherapy before I underwent an iliopsoas legthening. I popped ont he the first day of my surgery. After that at 17 i had an athroscopy of my hip and a labral tear and buckling cartilage was found. I have had pain for four years now and have tried yoga, and accupuncture, and physical therapy once again. I have buttock pain whenever i sit, stand for more then five minutes, or lie on my back. I was wondering if anyone had any suggestions for pain relief of any other suggestions. I am young and not ready to have chronic pain.

[gina]

Hi BAC,
I am sorry I did'nt respond more quickly to your reply. I have had four years of hades
with this condition and have been misdiagnosed by several doctors. I have have also been to the point of thinking life isn't worth it I have to live like this anymore. But I don't go there often because I think of my three kids who need me and that keeps me going. I am in constant pain even thru percocet. I have been diagnosed with cam and pincer impingement and a synovial herniated pit. I am going to see Dr. Steven Olson at Duke on September 13. I guess then I will know what my future holds. Are you going to see him
also. What is your diagnosis? I don't know why but I am extremely scared to go thru this surgery. Please write me back and tell me about your circumstance?
Gina

[Tracy R]

Hi,
I just found this site and have found all of the info very interesting. I have had hip pain on the left side for about four years. I had an MRI and had a labral tear diagnosed. I had an arthroscopy in Sept 2004 and found that the pain did not improve a great deal afterwards. After worsening of the left hip pain especially in the upper buttock area, (Im told that hip pain often refers there) and lots of clicking in the joint, I had a repeat MRI and have another labral tear in the same place! The other hip has started clicking also and giving me similar pain symptoms. My orthopaedic surgeon has said that I may have acetabular/femoral impingement on both sides which may result in another arthroscopy or open procedure to correct this impingement which results in torn labrums. I intend to get two opinions before I opt for surgery. Does anyone know much about what this particular surgery involves. I have read the article from the link above and found it quite helpful.

Regards,

Tracy R

[Surfchick]

Hello again to all you hip sufferers!

I haven't posted any messages for a while as I didn't think I had any words of encouragement and didn't want to scare anyone!

I had my hip arthroscopy on 22nd June 2006. Recovery went well for 7 weeks, then I was given "bike pedalling" exercises to do (which I haven't done since I was age 5!). I had grinding in my hip, then pain - I haven't been right since. All my pre op symptoms returned - I have to admit I was scared and panicked! I paid £3700 and have a loan over 5 years. I get 6 months full pay then drop to half pay from work and can't afford half pay!Physio found I had a tight and infalmed iliopsoas muscle and pain in the groin - ? bursitis. For 3 weeks I was put on rest - ie no physio exercises, heat and trigger point massage. This did not help - I really hoped it would. Last Thurs I saw my physio again who thought it was a problem with the hip joint!(My fear for the previous 4 weeks). I then saw Prof Griffin. My operation report was finally given to me as it had been left in the back of my notes! Prof was not happy to hear of my problems. He said he had debrided the labral tear, fixed the partially torn ligamentum teres and left an osteophyte in place - which normally doesn't cause a problem. He had noted a "strangely lax capsule" at the time of surgery! Most peoples hip capsules are normal, but mine wasn't.
So, the hip is unstable within the capsule.

Question now - my muscles are tight, weak and poor core stability etc! Have these muscles pulled on the hip capsule to make it lax?

or - did the lax capsule come first and make the muscles tight etc?

Plan - physio programme changed. Went yesterday. Doing 3 pilates exercises to try and stabilise all the muscles and hopefully the joint. Should improve each week and have different ex each week. Take 6 weeks until they know if it has helped my hip.

? More surgery - still arthroscopy - to tighten the hip capsule if physio fails. This is a rare operation as not many need it. There is this big Sports Hip Conference on 30th October in England, UK, with many top world wide surgeons invited. Prof Griffin is holding a one off clinic with a top surgeon from USA and one from AUS. If I am no better I will be seen in this clinic start on November for 3 top opinions in 1 room! He won't operate until he has all the opinions - guess I am very lucky to get this much attention?! If I do have more surgery the osteophyte will be removed - but to do this the normal labrum will have to be detached then re attached - 10 times more serious operation!

After doing my pilates ex- hip circles - I have grinding in my hip, like when I did the bike pedalling ex and my leg feels weak and knee buckles more. I think my knee buckling/giving way comes from my hip?! I hope the physio works - but not holding too much hope at the moment - go again next Monday!

I also go for spiritual healing and Reiki - and hope I get a miracle recovery!

More surgery means longer off work - and if I drop to half pay - will have to find a rich man I think!

Has anyone else had or heard of a lax hip capsule? Quite disheartened but I still think there is hope of me getting back on my surfboard - maybe not this year?! I will be 30 on New Years Day - I would love to be surfing then - will have to wait and see.

BAC - what were your results?

Manda - AKA surf chick!

[DiverDan]

Dear DD

To clarify my "nothing to cure" statement I probably should have said that there is no cure at the moment with the technology available. We are still in the early days of cartilage regeneration and growth (they have been doing chondrocyte implanation in knees for some time with mixed results). The problem is that the body's natural system is normally so well designed that when there are underlying physiological, biomechanical or pathological problems like labral tears, cartilage damage or impingement our rudimentary human solutions are not advanced enough. Basically it's like asking a carpenter to fix the gear box in your car. He may have a general idea of how it all works, so he an pull it apart but his knowlegdge is not good enough to allow him to fix it with the available tools (ie hammer and nails) nor put it back together again in its original condition.

In Australia we are still educating the medical establishment about the reality of hip pathology as a cause of lumbo-pelvic symptoms in the non-elderly population. Let alone being able to get funding for further research into an area which is high risk and low return for government. At the end of the day the systems says, wait till the hip is rooted then rip it out and wack in a joint replacement (which have a finite life span so you can't get them until you're old). In the mean time deal with the pain and change your lifestyle. That's what a lot of people end up doing.

This same process happened many years ago with knee pathology and arthroscopy (and it is still going on today). We are in the infancy of medical awareness about hip problems and many years away from any sort of solution. Until then we need to address each case individually and treat the problem from a number of angles including - physiotherapy, behaviour modification, surgery, injections, massage, supplements (ie glucosamine, chondroitin) , acupuncture - whatever works. There is currently no answer.

In your specific case obviously your hip is pretty stuffed (to put it lightly). Hopefully you can find a path to managing your symptoms with help from the right people. Other ideas you may want to investigate are endogenous cytokine injections into the hip joint (synvisc- orthokine) which may reduce inflammation and joint symptoms - these have been trialled on knees but are bloody expensive to produce. May be you need another surgical or pain management opinion.

Hopefully we'll come up with some better options before you need a metal hip.
Take care,
Hipster
PS sorry about the long post - had to get a few hings off my chest

:confused:
Hipster,

Thankyou for taking the time to get a few things off your chest. Your response was appreciated. May I ask if you possess formal qualifications in this field?

Best regards
DiverDan

[Tbone]

My right hip has gotten stiffer over the last few years , but this last year i have notice it accelerating..ocassional pain, but nothing near the scope of what some of you folks have experienced. I went to a ortho to get an early diagnosis before it got worse and he suspected a labral tear right off the bat, he said they could test for it, but with my limited issues at the moment, I was best to wait and see how it progresses. He says there are cutting edge treatments going on with this problem now and if i can take care of it, non impact exercise and stretching, that maybe the procedures can be improved by the time I need it.

I just want to say i sure apreciate my only slight discomfort and know that by reading your stories I feel better prepared for what lies ahead.

take care all of you,
Troy

[Hipster]

Diver Dan,

Sorry, haven't been on the site for a while - things have been a bit busy what with AFL season finishing up. To answer your question, I am a physio in Melbourne with special interest in chronic hip and spinal pain - especially labral pathology. This is mainly due to the trials and tribulations of treating my own dysplastic hips as well as a growing number of patients pre and post hip scopes.

I am hoping to get into some further research next year. I am however, still trying to clarify the most pressing issues that currently need to be addressed in this area. I am just about to start my literature review, so if anyone has good resources or ideas about where my study should be targetted I would be most grateful.

Regards
Hipster ;)

[DiverDan]

Diver Dan,

Sorry, haven't been on the site for a while - things have been a bit busy what with AFL season finishing up. To answer your question, I am a physio in Melbourne with special interest in chronic hip and spinal pain - especially labral pathology. This is mainly due to the trials and tribulations of treating my own dysplastic hips as well as a growing number of patients pre and post hip scopes.

I am hoping to get into some further research next year. I am however, still trying to clarify the most pressing issues that currently need to be addressed in this area. I am just about to start my literature review, so if anyone has good resources or ideas about where my study should be targetted I would be most grateful.

Regards
Hipster ;)

Hipster,

You might want to consider law enforcement agencies as a source of information, starting in Vic who I believe are conducting a trial of a vest designed to take the weight off the hips of their members. Other States could flow on from there. Respective police unions may also assist your research.

Dan

[faichick]

Surfchick,

I sent you a private message, but not entirely sure how the private message feature works, so am posting this here also so you will know to go look for the private message.

Please let me know how you make out.

Good luck,
faichick

[damo]

Firstly thanks to those who replied to my earlier posts. I have not been on here for a while, so here's an update:
- my hip has been relatively pain free mostly due to me taking a prolonged period of rest due to knee pain. It's been 15 months since I had a cortisone which didn't do much. Rest has been the main factor. I hope this helps some of you guys. I do find I still have deep abdominal muscular tension/spasm on the right side. Does anyone else have this with labrum tear?
- my knee pain is definitely ITB Friction Syndrome. I'm not convinced this is related to the labrum tear but you never know.
Damian

[Surfchick]

Faichick,

I too have sent you a private message as I am having trouble sending emails!
Thanks so much for your email/message - very helpful.

Surfchick

[Hipster]

Damo,

Mostly likely cause of deep abdominal pain/spasm is psoas irritation caused by the hip joint. Need some deep soft tissue work to loosen it up. If this doesn't work then I've had some good results with a psoas sheath injection which is a cortisone injection into the muscle which can relax it.

Hipster

[damo]

Thaks Hipster,
So that would be quite a deep injection then? The point where I have spasm is almost hard up against the pelvis underneath my gut.
Damo

[worried29]

Hi all,
New to this so here it goes.
29yo male 7weeks post arthroscope labrum tear left hip. Feel like i never had surgery.
Went back to see surgeon today and was told there were complications getting into and aroung my hip. Cannot be operated on again so i get my first cortisone injection on monday. If theres no relief after a week then we talk hip replacement. If there is relief then i continue injections evetually needing a hip replacement. WTF so does anyone know the point of cortisone if it only prolongs.


Ben

[damo]

Hi Ben,
In my experience cortisone has been used for two things:
1. if you really need to get out on game day/race day - basically a quick cover up.
2. to give me a pain/inflammation-free period to get into rehab exercises. I have had some positive results with this one.

For the most part, I haven't had any miracles with it but if your alternative is hip replacement then maybe it's not so bad. I believe there is increasing evidence available to show that more frequent use of cortisone is not damaging as once was thought. Also, I have been told that there is a school of thought that in some instances cortisone can break down inflammatory tissue. You would be best to get someone with a medical/PT background to advise you on these last two points.

Hope this helps.
Damo

[worried29]

Hi Damo
Cheers for that information. Going to speak to my doctor and physio on monday before people start poking me. Will keep you all posted . If anyone is due to have an arthroscope i didnt have bad surgery i just fall into a minority. My hip was/is to tight to fully operate with success but its the perfect hip condition if you dont have an injury.

Ben

[JCannuck]

Hi all,
New to this so here it goes.
29yo male 7weeks post arthroscope labrum tear left hip. Feel like i never had surgery.
Went back to see surgeon today and was told there were complications getting into and aroung my hip. Cannot be operated on again so i get my first cortisone injection on monday. If theres no relief after a week then we talk hip replacement. If there is relief then i continue injections evetually needing a hip replacement. WTF so does anyone know the point of cortisone if it only prolongs.


Ben
Ben - I too had a labral tear and 2 yrs later was diagnosed with femeroacetabular impingement and had open surgery to correct the FAI 8 weeks ago. There are other options besides arthroscopy for labral tears. I strongly recommend you get a second opinion. I am 35 now and I know how frustrating it is to be in pain and limited at a young age. They know now that these conidtions lead to early arthritis in young people and that by fixing the mechanics of the hip this can be prevented or delayed. Find another OS who is a hip specialist who can review your imaging studies and figure out what's going on. You are too young to "do nothing" and wind up severly disabled and needing a THR before you are 40. email me if you have any other questions: jcannuck@hotmail.com

Also - check out the Yahoo forums on labral tears (labralicious) and on impingement. There is lots of info there.

JC

[may]

First time writing. A few months ago, I was diagnosed with labral tears in each hip. I also have mild hip dysplasia and was told hip arthroscopy to fix the tears may or may not help. The Ortho also told me that most likely they will tear again over time. I have severe groin pain and had to stop running. I do not want to have sugery with such an uncertain outcome. Has anyone had tears as well as hip dysplasia?

May

[Hipster]

Hi May

I have bilateral hip acteabular labrum tears and mild hip dysplasia. It's not uncommon. I have not had any surgery or injections as yet and am managing my condition with; (1) behaviour modification, (2) pilates and (3) more behaviour modification. This is working quite well and I only experience symptoms if I don't follow steps 1 and 3.

I treat a lot of people with acetabular dysplasia (or labradors as we like to call them). In Australia our current technology for treating latral tears in dysplastic hips is not yet at a level where we are getting good outcomes for everyone. I suppose this is because when we scope a dysplastic hip we are really only treating the symptom (which is the tear) rather than the underlying problem which is the dysplasia.

The surgery to correct dysplasia and FAI is pretty drastic and just for myself I would prefer to avoid these if I can manage my symptoms conservatively. There is of course a caviate - I can't do everything that I want to do. But at least I can walk, which I worry about losing if I let someone break my pelvis and reshape my hips.

If pain is still a problem despite behaviour modification and appropriate strengthening has been completed then, despite its limitations, hip scope by an experienced surgeon would be the next option.

Hope that helps
Hipster

[focus_911]

Hi guys
Havent been posting a lot but have been reading and want to thank everyone for posting.

I have also been having worsening groin pain. As of recently in my upper buttock as well. The pain is shar and always happens with twisting motion, getting in and out of my car, bending down etc, the pain was happening on both hips/groin area. I know all of you know what I'm talking about.
I always brushed it off thinking it was nothing but as of December it has gotten so bad it was affecting my work ( I work as an EMT/Paramedic).
Finally decided to see my GP. I was sent to a sport medicine specialist who right away mentioned the possiblity of labral tears. I was sent for x-rays and 2 hip arthrograms that came up positive. I was then sent to see one of the orthopedic surgeons in western Canada who does hip arthroscopies. He saw me agreed thats what the problem most likely was but wanted me to go thru physio before operating.
I came back 5 months later after finishing physio and told him after being referred twice from one physio to another (because they said they couldnt do much and it was without a doubt requiring surgical intervention ) I was now needing his help.He explained to me I also have hip dysplasia which made me more prone to that problem. I was scheduled for surgery that day.
I am getting my right hip scoped on Nov 21, in 4 weeks. Once the hip is healed I am going back to get the left one done. I was explained it might not take care of the problem and might have to consider the much more invasive hip reconstruction to make my hips deeper.
I have read everything on this post and come back every day but would like to know how many of you have found the scopes to be a success? How quickly did you know?

Thank you

[worried29]

Hello all
Still fighting the whole hip replacement thing. Getting my second cortisone injection in 3 weeks today, apparently the 1st missed as it had no effect at all. Pain worsening rapidly mobility lessoning and all i did was slip down 2 stairs.
Thanks for the info JC will look into it.
love to stay and chat but my groin and hip have a date with a big needle.

Get well all

Ben

[Hip62]

Hi
I'd love to hear some successful outcomes for surgical disclocation which I am soon to have. How long did it take to get back to 'normal'? I sustained an injury at the gym 7 months ago doing leg presses - so much for personal trainers and trying to improve fitness!. MRI arthrogram revealed 2 labral tears plus I have impingement. A 'bony irregularity' means that arthroscopic surgery isn't the answer. I'm 62 and have been fit but that's all changing. Pain is increasing so doing nothing isn't an option. Anyone else had this op?
Hip62

[focus_911]

Just a quick question for anyone to answer.

Does anyone know how long a scope of the hip arthroscopy takes? (from the time you are anesthetized to the time you wake up)

[focus_911]

sorry my sentence didnt mate sense...

Does anyone know how long a hip arthroscopy takes? ( much better english :D)

[lyn152]

Hi all
I've been reading this thread with great interest.
Just over 4 years ago I saw my GP regarding mild hip pain that I had been experiencing for quite some time. At the time it was decided not to go ahead & have it investigated as it was only mild (this year I found out that he had no idea what it could be & hoped that it would heal itself). Over the last 4 or so years I've had an ache deep in my hip. During the hockey season this year I started to experience increasing pain. While walking sometimes it felt that my hip was "dislocating" & would often "catch". My GP referred me to our local orthopaedic surgeon who sent me to have an MRI. It showed a labrum tear. He referred me to Sydney where I saw Dr Michael O'Sullivan. I not only have a labrum tear but also a femoral head deformity that has caused the labrum tear.
I'm having surgery in 2 weeks.
Looking forward to the surgery to rectify my problem but also feeling a tad apprehensive.
What I'm asking is for anyone who's had it done to tell me what I'm up for afterwards in regards to mobility... recovery... physio afterwards... anything
I'm 42.
Thanks heaps

Lyn

[deb9450]

I am a 32 yr old male that has had Terrible groin/hip and buttock pain for 5 or 6 yrs. I have been to different doctors and none can tell me what is wrong. I have had X-rays, a MRI and injections done. Anti Inflammatory pills seems to help at times. The pain comes and goes and is so terrible at times that I can not sit I must lay down. Any suggestions on what it may be, or how to find out what it is?

Thanks

[jlcartoon]

Hi everyone.
i have TWO questions for those of you who already had a clear diagnosis of labral tear.
I will be greatly appreciate it if you would be kind enough to either reply or email me with your response.

I am a 25 yr old male who started experiencing a dull aching pain in my hip and butt area about 1.5 year ago with no significant memory of serious injury. at first i thought it was lower back pain but as the condition gotten worse, i quickly realized that it was my left hip. while having difficulty sit down for a long time, my hip started to pop while moving it in different angle and soon led to catching sensation within the hip socket. first took an x-ray and it came out negative. even with stretching and exercise, the condition got worse to a point where i experienced the pain and discomfort lying down and had discomfort sleeping. few months later, i took a MRI and it was said that possible labral tear. (however, this was MRI and not MRA as i read labral tears are difficult to detect in both MRI and MRA but, especially MRI). took the MRI film to a surgeon, he doubted that it was a labral tear. during my first appointment, i got the cortosteroid injection into my hip for diagnostic test and saw that i didn't feel any difference. supposedly, i was told that people with labral tear find drastic ease of the pain and discomfort when injected with cortosteroids(Q1: did all of you guys see positive change after the cortoseroid injection?). he then put me in physical therapy for 5 weeks. it's been 5 weeks and i don't feel much difference. however, PT. told me that since i only feel significant discomfort when moving my leg on my own and not when during "passive" movement(meaning the PT will grab my leg and manipulate my hip joint), he guesses that most likely the problem isn't the hip joint it self but muscular problem.(Q2: was this true for you guys? did you experience pain and discomfort in your hip even when "passive" motions were performed on you guys?) i have been out of work for about a month. have been spending lots of $$ on this. I am supposed to go back to the surgeon in 2 weeks and let him know if i want to schedule an arthroscopic surgery.. It would be great to have somewhat of a clear sign of labral tear before i decide to receive the surgery. i would like to hear from any of you.

THANK YOU ALL and GOOD LUCK to you all on finding healing.

Sincerely, AARON

[Hip62]

Hi to other hip injured folks.
From all that I have read and heard it would seem there is only one positive solution when there is a labral tear - to have the torn peice(s) removed surgically or face probable osteoarthritis developing. None of the conservative treatments appear to work in the longer term. The orthopaedic surgeons say there is often underlying bony irregularity which predisposes us to tears. If that is the case, then the underlying problem must also be rectified - hence soon facing surgical dislocation of my hip and trimming the bone as well as removing 2 torn areas of labrum, rather than having the less invasive arthroscopic surgery. I've been told no weight bearing for 6 weeks then rehab. I have only heard of 2 others who have had this type of surgery and they faced a long haul back to full mobility after many months. Its a scary prospect but seems there is no other way. I am very keen to hear of others who have had this surgery. I note that most of those posting are much younger than me - age 62.
Hip62

[focus_911]

Hip 62,
I have heard the same thing mate. A labral is a labral tear but its a bit different if the cause is due to a chronic problem. I'm 21 and have bilateral dysplaisia and heard the same thing as what you posted above.

Its not just the labral tear that you have to take care but the underlying cause of them, otherwise you will continuously get more. I am going in just over 2 weeks (first of 2 scopes) to get my right hip scoped and cleaned out. I have been told though the fixing of the tears wont last and its up to me as to whether or not I want to go ahead and get the major fix.
Unusure either if I would want to go ahead yet. The operation is a major surgery and has a really long rehab attached to it.

Having said that its more of a question as to what you are willing to do to get your life back....I think I would get it done.

[lyn152]

hey all you fellow hip sufferers
it's great to know you're not alone out there with our hip problems. before i was diagnosed i had never even heard of a labrum let alone a labrum tear.
11 days to go before i go into surgery. fortunately my surgeon picked up the femoral deformity which my 1st surgeon didn't so that will be repaired as well as the labrum tear. an overnight stay in hospital because of this. have been told off work for 2 weeks, ongoing physio. glad we put that pool in now.
can anyone tell me what the physio entails?
good luck everyone with your diagnosis & treatment.

lyn

[mcmm]

Hi,

I am a 21 year old ballet dancer who has just been diagnosed with an acetabular labrum tear. I had an MRI arthogram done this past Monday and it showed a clear tear on the anterior portion of my labrum. My bones are fine minus some inflammation and a slight ridge on the neck of my trochanter. My doctor and physiotherapist are recommending surgery ( hip arthroscopy), but I first need to rest my hip and allow the surrounding muscles and tissue to calm down. I can't decide if I want to try a conservative method of treatment (rest and movement repatterning) and risk my symptoms flaring up again down the road, or if I want to go ahead with surgery. Any thoughts or suggestions would be great. It is awful to not be dancing right now.

[Hipster]

Wow, I don't know whether I should laugh because finally people are being accurately diagnosed with labral pathology or cry because our treatments are just so priimtve. To all you guys with hip pathology, I feel you're pain. I am currently putting together a database of good hip practitioners especially with regards to diagnosis. So, mcmm, lyn152 and focus_911 could you let us know who you're doc, surgeon, physio is?

[hokiecowgirl]

August 2006 I was diasnosed with 2 tears in the anterior labrum of my right hip. I have "clicking" or "popping" of the hip joint, anterior pain in the hip joint along with back and knee pain. Aside from this, I'm told I have shallow hip sockets and they are not "stable" and they are going to attempt to fix this as well. I am 20 years old... Does anyone know how intrusive this surgery or what my recovery time is going to be? I have 14 horses I ride and show.... and I havn't been on a horse since July.. this is literally making me insane. Someone please help!

[debbi70851]

[B]I was diagnosed with the same thing in my right hip as well. I don't know anyone who has gone through this. I'm getting surgery on the 20th of August to repair the tear. Can you discribe the pain that your having? I'm just wondering if I'm the only one who can't take the pain anymore. It hurts so bad to SIT I just feel like my butt and leg are on fire and I'm always in pain. I use to run between 5-10 miles a day and now I can't even walk for more than 20 minutes. Anyone else feel this way? Please respond if you do. Thanks Debbie

[doctorhl]

In July 06 I(55 year old) underwent a femoral neck debridement(femur is supposed to be concave at the head/neck junction but many people are born with it convex) to relieve a combination cam & pincer- type hip impingement. Impingement delaminated the labrum and it had to be reattached with labral screws. Impingement started a small lesion which started the arthritic process.The trochanter was cut off and reattached with screws to dislocate the leg to get to the labrum for reattachment and debride the femur. Surgeon said I waited too late to do a scope, because you just cannot access or see everything clearly with a scope. One week in the hospital. Was on a walker for 12 weeks. Will rehab for 6 months before resuming competitive tennis again. Surgery was extremely invasive and surgeon said total hip replacements are much easier to do and less invasive. However, he said that hip replacements only last longer than 10 years if your activity level is that of a 70 year old. Hip replacements do not last long if one is highly active. At 55, too young.Deep lunges which flexed the thigh and pivoting in the opposite direction to rotate femur internally probably caused the injury(tennis) Suffered for 2 years in the groin and buttocks and went through 3 orthopedists before I got proper diagnosis. Doctor said hip pain can be tolerated much better than knee pain and then one day it hits you bad. Then it is often to late to scope. Orthopedist who diagnosed(in Louisiana) said I needed to go to Denver/Vail or a friend of his in Houston who had many hours of hip trauma under his belt. Acetabulum was a little retroverted(posterior side of the socket is shallow) which is a common genetic abnormality and contributes to impingement. Pain is now greatly reduced, but difficulty with proper walking gait. Probably accumulated >30 hours of my own research about this injury, but necessary to communicate with doctors about cause of injury, types of surgeries etc. Now having to do my own rehab research because general physical therapists stop at minimum recovery level. To return to competitive tennis will require expensive biomechanists or physiotherapists with expensive computer diagnostics. I just will have to figure my own rehab. (Sorry--us older geezers get long-winded about health problems!!!)

[doctorhl]

My two cents ---Trauma physician who performed my surgery is Kyle Dickson, now at University of Texas Physicians in Houston. Studied with Bernard Ganz who is credited with Ganz procedure to dislocate for open hip surgeries. Dickson was early advocate of labral refixation rather than labral resection for tears. He said labrum was important for hydrostatic pressure and needed to be preserved if possible. Very down to earth and has the "hands on time" rather than the research name. e-MAIL: leis@lacollege.edu for further info.

[Hip62]

Helpful to read the last 2 posts. Daunting thought that I may be facing months of rehab after surgery but better to know ahead and prepare myself for a possible long haul back to fitness. Don't know anyone else who has had labral tears and other predisposing complications so have found this site invaluable - thank you fellow hip-injured!
Debbie - I can relate to your pain with sitting. UGH! My job is mainly office based and sitting means I need to take most weight on one buttock, hand under thigh on affected side, and moving often in my chair to try to relieve the pain. Walking limited - Christmas shopping will be done on-line this year. So frustrating as used to be so active.
Hip62

[lyn152]

hi all
my surgeon is Dr Michael O'Sullivan, based in sydney. i've elected to go through the public system (prince of wales hospital) as Dr O'Sullivan is the only 1 who does my type of surgery here so i know that i'll get him as a surgeon, not just anyone. was that or spend about $5000 for the op. i was scheduled for this coming tuesday but a more urgent case came in so have been rescheduled for 12 dec.

[Surfchick]

Hi all!

Just thought I'd post an update on my hip - interested if anyoone else has had the same/similar problems?!

Left hip arthroscopy for degenerative labral tear = 22nd June 2006.
7 weeks post op - pre op symptoms returned - panic!
11 weeks post op - told I had a "strangely lax hip capsule" at time of surgery, that coupled with an osteophythe left insitu - was likely causing impingement pain!
Plan - more physio to try to strengthen muscles around hip to see if that would stabilize joint!
1st Nov 2006 - my surgeon in UK, Professor Griffin, had just held a "Sports Hip Conference" and was holding a rare hip clinic with Mr John O'Donnell from Australia!
1 hour long consultation and clinical examination = outcome - need another arthroscopy.

Plan - Another MR arthrogram and a CT scan with 3D reconstrution to make sure they are not missing anything. If not, proceed with -
Remove osteophyte - done by removing labrum then re fixing after!!
Then thermal probe treatment to shrink/tighten the lax capsule by about 10%.

I am told this is a rare procedure - not done in the UK (yet) but done in USA and Australia with good results. My surgeon has done this thermal probe treatment (capsulorraphy) before in shoulders, but not in hips - scarey thought that I will be a guinea pig!

I am told I should get better, but worst case I won't improve but I won't get worse either!

I can't afford to pay for another operation as I have a loan to pay for the first one over the next 5 years. The NHS in UK has a long waiting list of 8 months but it's free of charge - I dread to think how I am going to cope during the next 8 months?

I went back to work Friday after 5 months off sick - still in pain but can't afford to drop to half pay. I now have 1 month full pay sick pay stored for when I have my next operation - so after 1 month will drop to half pay - scarey too, don't know how I will pay the bills!

Has anyone else had or heard of these problems?

Amanda - AKA Surfchick
xx :mad:

[hokiecowgirl]

Surfchick...

I was told during my first arthrogram that I have "lax hip capsules" as well. They are discussing doing the labral tear fix, and the joint reconstruction at the same time. I meet with my surgeon to discuss this and set a date for over christmas break. I am definatly scared about going through with this. I am 20 years old, and the thought of having to deal with the pain im in for the rest of my life is uncomprehensable. I have lower back pain that shoots up my back wen I lay down at night... I have constant pain in the hip, both to the outside and the inside, it never goes away, and I have pain in my gluts. I ride horses, surgery has to fix this, I can't ride with the pain im in now, and the thought of possibly not being able to ride for the rest of my life is not possible

[Hipster]

Hi Hokiecowgirl

Sorry to hear about your bugger of a diagnosis:( . Bilateral dysplastic hips with labral tears and loose capsules is definitely at the more extreme end of the scale with regard to congenital hip pathology. Probably the riding horses thing didn't help, but at the end of the day the problem is mainly predetermined (unless you have fallen off your horses a lot - then that might have had something to do with it:p ).

The main thing is not to give up hope. You have to be realistic about your choice of activites especially when your pain is bad, even without doing anything. Make sure you find a therapist or specialist who understands both you as a person and the problem in your hips. From my experience, surgery is not the full answer (though it can help). You will need to ahve extensive rehabliitation after any surgery and gradually decrease your pain and increase your function. Make sure you understand exactly what the problem is, and ask lots of questions if you don't understand. Slow and steady wins the race, listen to your body.

Good luck and keep posting
Hipster

[Surfchick]

Hokiecowgirl....

I am glad to know I am not unique with the lax capsule! I empathise with you fully not being able to ride horses. I don't ride horses - but I have a passion for surfing - it was my way of life, not just a sport. I torture myself watching surfing DVD's but then I try and think 1 day it will be me again back on the surf board! I long to get back to Costa Rica - tropical paradise - to ride some waves. Even if it kills me, I will get back on my board some time!

Had my scans today - will post results when I know them!

Let me know how you get on. Who is your surgeon?

Take care, stay cool,

Surf Chick
x:)

[npaton]

Thinking I need a fourth opinion.....

I was diag in May 2006 with a potential Labrum tear, form a local ortho doctor he based this on simple xray. If could see something on the xray that to him indicated damage to hip and felt if an MRI was taken a Labrum tear would be found. He told me if it still bothered me in six weeks call him back and he'll order the MRI.

Now, I hurt the hip in Feb. 2006 when I slipped on ice. I'm 45 old male, pretty active, play alot of golf little over weight (20lbs.) not to bad. When I slipped, I did a split, the legs just don't go that way, not now, never did. Anyways, I work at the biggest local hosptial in the area. Asked all the Operating Room people about who the best hip ortho doctor they all came back with the same name.

So, I booked an appointment with him for a second opinion. Brought a copy of the xrays, he took some of his own and order an MRI, Arthrogram with contrast. The results came back with a report that stated I did indeed had a tear of the superior labrum and also had a 4x9mm cryst.

To my suprise he needed to refer me to a Dr. Scott Martin of Brigram and Women's hosptial in Boston. I guess he one of only two doctors in the area that does the surgery. Anyways. met with Dr. Martin yesterday and I came away more confused than ever before. I'm hoping some of you can help me. The first two local ortho doctors both told me that joint and hip was in great shape no sign's of arthritis and I would be good candidate for the surgery. I brought, two set of xrays, MRI and the report from the MRI and all the doctors letters with me, everything he would need. Well he told me that, the MRI clarity wasn't good. Doesn't really know would they could report from them that I had a labrum tear. From the xray he felt, I have a little arthritis not only in my left hip but in both.

He wants to do the following Arthogram without an MRI, with an injection of a stediod and some other numming drug. If the numming drug works this suppose to tell him the pain is indeed from inside of the joint and not from the outside. The stediod will take two weeks to take. If the numming drug works and the stediod doesn't take then he'll order another MRI, arthogram with contrast that his people will perform. When based on the results he'll let me know if I'm a candidate of not....

Does anyone have any information about Dr. Scott Martin? I'm from the Boston area does anyone know of another Dr. that perform surgery to repair Labrum tears, in or around Boston? and does what they are putting me through sound right? I just feel confused and thinking he's wasting my time... and how can two others doctors not see the arthritis...

[Hip62]

Hi
I was told that without a contrast dye injection when MRI arthrogram is done it is hard to diagnose labral tears and that often there is an underlying bone condition which predisposes us to tears. If left untreated, labrals tears apparently lead to arthritis. I had no symptoms pre gym accident yet there were changes to my hip that showed on MRI arhrogram including chondral fissuring and a 'bony irregularity'. To clean up the bony bit requires open surgery in my case - scheduled 19 Dec.
If you have these tests as described you may be closer to finding out what treatment to pursue. It's a pain alright!!
Good luck

[DiverDan]

:cool:

For anyone considering a second arthroscope, obtain a second and even third opinion and ensure you have an MRI done. My OS suggested I had "stirred up my gluteal tendons", while at physiotherapy ( twice ). A new surgeon and a 2nd MRI showed a small chondral lesion, with femoroacetabular impingement.

I'm currently at day 5 post-op after having a second arthroscopy which included debridement of labrum & ostectomy of hip bone & femur to remove the impingement.

The moral of this story is; Don't believe everything you're being told, no matter who the source is ;) .

DiverDan

[focus_911]

What I would also add to what was just said NEVER rely strictly on the results of the MRI/ Arthrogram(s). When I was in the stages of getting diagnosed with labral tears I had 2 of them done, one for each hip. Both suggested of a labral tears.

I am now 47 hours after my first hip arthroscopy. As it turned out to be I had more than one tear along with the labrum being completely detached from the socket...

My moral of the story; Never rely only on a machine. A good doctor and/or surgeon along with results from such tests is the only way to hopefully diagnosed problems/injuries as such.

Cheers,

[lyn152]

hey Dan

Your OS for the 1st arthroscope was Dr O'Sullivan wasn't it???? I'm due for surgery 18 January (if it's not postponed again). Having debridement of femur & labrum tear cut out. Bit nervous after your comment... who was the 2nd OS that you went to???

Any comments would be most welcome

Lyn


:cool:

For anyone considering a second arthroscope, obtain a second and even third opinion and ensure you have an MRI done. My OS suggested I had "stirred up my gluteal tendons", while at physiotherapy ( twice ). A new surgeon and a 2nd MRI showed a small chondral lesion, with femoroacetabular impingement.

I'm currently at day 5 post-op after having a second arthroscopy which included debridement of labrum & ostectomy of hip bone & femur to remove the impingement.

The moral of this story is; Don't believe everything you're being told, no matter who the source is ;) .

DiverDan

[focus_911]

Lyn,
Im not sure if you have been following my thread about my scopes but here comes my opinion.

I had my first hip arthroscopy on my right hip a week ago (12/01/06). My surgeon found quite a few things that were damaged in my joint multiple labral tears being one of the issues. Having said that I have bilateral hip dysplasia which means that in my case I will require an arthroscopy to be done on the left side once the right side has healed.

Having said that here is what I was told. Now that I have had a scope done by surgeon who is considered the number 1 physician for hip arthroscopy in the country (I'm from Canada) has already told me that before HE considered another scope whether it may be on this hip which already had one done or my left hip, he needs to look as to whether or not the first scope was successful. Having said that he also informed me that if I was (or anyone else) were to require another scope on the same hip it, at this point its the underlying problem that needs to be taken care of. You need to look at what is causing those tears and take care of that, otherwise you will continuously require hip arthroscopy.
It would be a never ending problem.

Not sure if this helps, but keep in mind no matter what doc you talked to they will have different opinions and reasoning behind their treatment of choice.

Cheers.

[DiverDan]

hey Dan

Your OS for the 1st arthroscope was Dr O'Sullivan wasn't it???? I'm due for surgery 18 January (if it's not postponed again). Having debridement of femur & labrum tear cut out. Bit nervous after your comment... who was the 2nd OS that you went to???

Any comments would be most welcome

Lyn

Lyn,

Without sledging individual OS. Yes, my first arthroscope was performed by Dr O'Sullivan. My first MRI also picked up the femoroacetabular impingement, however there was no intervention for this pathogenic damage at the time. If you ( and others ) read all my comments starting from February, you may want to change your thoughts and any future RECOMMENDATIONS relating to rehab. Conservative, Conservative, Conservative and don't be pushed into anything, including returning to work. I was!!! Also, do NOT sit for long periods as this places the head of the femur up into the injury site. Standing for long periods is also not recommended. Current OS is Dr Ali Gursel.

I now base MY comments on hindsight, experience & personal knowledge. BLIND FAITH in others ceased some time ago. Starting hydro this week, with some light stationary bike work. This will continue for the next 4-5 weeks. Hope this helps.

Dan:cool:

[DiverDan]

hey Dan

Your OS for the 1st arthroscope was Dr O'Sullivan wasn't it???? I'm due for surgery 18 January (if it's not postponed again). Having debridement of femur & labrum tear cut out. Bit nervous after your comment... who was the 2nd OS that you went to???

Any comments would be most welcome

Lyn

Lyn,

Without sledging individual OS. Yes, my first arthroscope was performed by Dr O'Sullivan. My first MRI also picked up the femoroacetabular impingement, however there was no intervention for this pathogenic damage at the time. The second MRI also showed there was no re-tearing in the labrum. Based on the pain levels I experienced during the 2 previous incidents at physio, I believed I had re-torn it. Must be some other underlying cause eh!!!

If you ( and others ) read all my comments starting from February, you may want to change your thoughts and any future RECOMMENDATIONS relating to rehab. Conservative, Conservative, Conservative and don't be pushed into anything, including returning to work. I was!!! Also, do NOT sit for long periods as this places the head of the femur up into the injury site. Standing for long periods is also not recommended. Current OS is Dr Ali Gursel.

I now base MY comments on hindsight, experience & personal knowledge. My FAITH in others ceased some time ago. Starting hydro this week, with some light stationary bike work. This will continue for the next 4-5 weeks. Hope this helps.

Dan:cool:

[DiverDan]

Don't know how this double-up happened. Please see number 211 for complete post.:confused:

[focus_911]

DiverDan,
I read over all 20 pages of this thread and my eyes are getting a little crossy so I'm going to ask you because I mus thave missed your follow up. I read at the beginning of the year after you had a hip arthroscopy that about 3 weeks after your scope you could feel the catching sensation in your hip.

Did that ever go away with physio? Not sure if you have been following the thread I started about a week ago. I am having the same problem. I had my first scope a week ago a nd have felt that catching a few times already and a little concerned.

Thank you for any input :)

[Surfchick]

Hi all fellow hip sufferers!

I had another MRa 24-11-06 and CT scan. Had bleeding and bruising from the needles this time which I wasn't expecting as my pre op MRa I had no ill effect from! It made my hip symptoms worse and they haven't settled yet to the previous painful level!!

I managed to obtain both radiologists reports of pre op and recent MRa!!

I still have a antero-superior labral tear and the previous thinned superior labrum is now torn! I have an osteophyte and an "out pouch which may represent focal laxity in the capsule possibly secondary to previous surgery".

It is odd how the capsule problem shows up now and was normal on pre op MRa. The lax capsule was found at the time of arthroscopy - but I do wonder if it occured as a result of the surgery??? I have emailed my surgeon to ask many questions - awaiting reply, or letter or another clinic appt!!

I can't afford to pay again and the NHS list is 8 months wait. If I had loads of money I would choose to go to Marc Philippon in USA - but I don't, so will have to wait the long 8 months.

Has anyone else had anything like this happen to them?

I will let you all know when I get my official scan results.

Hope you all have a Happy Christmas and New Year and aren't in too much pain. I think whiskey will be my choice of remedy to make it a pain free one!! Hey and I am 30 New years day - maybe I am too old to be fixed?!

Surfchick
xx

[focus_911]

You are never to old to get something like this fixed! Unless you are 80 or 90 yrs old to which point I would think you would have more to worry about than a labral tear. Its to bad you have to wait that long. I dont even want to think about what you are going to have to go thru. Perhaps be able to go get some pain killers from your GP? You might want to get another opinion form another doc. Maybe you can get it sooner if you see someone else??

[lyn152]

Hey Dan

Thank you for your comments ... I've been reading bits & pieces of the thread since i found this site a few months ago.
I'm sure surgery is my only option unless I was to be a vegetable the rest of my life, even swimming causes me pain. I just hope I can eventually get back onto the hockey field. I guess if i can't there's always coaching.
in regards to rehab, I was told about 2 weeks off work with ongoing physio. Will be careful not to go back to work too soon now as my job entails a lot of movement/sitting/standing/walking etc. Will also be very careful with physio.

Hope all goes well with your recovery, that goes for everyone going under the knife.

Have a wonderful & safe Christmas everyone & may 2007 bring answers & healing

Lyn

[soccermom]

I've been paging through these posts and am trying to answer 1 question. I have had anterior groin pain for about 10 years now and was concerned that it was a labral tear. I had just a regular MRI and it did not show anything....no tear. I was told basically, so sorry too sad. How often do regular MRI's miss labral tears??? I am wondering if I should continue to look for the answer to my pain. I am 37 and play recreational soccer and run. My ortho (has put my ankle back together many times) is a lower extremity specialist, but I get the feeling ankles/feet are really his area. I am fortunate to work down by Wash U med school in St. Louis and made an appt with Dr. Clohisy....but earliest is 2 months. Anyone have any statistics on how often MRI's detect tears? I also have this horrible clunk in my hip that hurts with flexion/extention but am told this is no big deal (generally doesn't hurt but seems to hurt me).
--soccermom

[focus_911]

Hi Soccermom,
I check thru the posts every day to see if people lile yourself need assistance. You might want to also read the thread I have started as it may be helpful. Sometime in the next few days I will be posting a link to a news clip where they will be talking about my operation as well as show a clip of my actual surgery.

Having said that to answer your question, Im not sure what the statistics are for missed labral tears from MRIs but I know in my case it was. I had 2 MRIs done and both came out negative. I was fortunate enough to have a great surgeon(Im from Canada) who believed my story and symptoms and decided even tho a multi thousand dollar machine was suggesting nothing was wrong, that I the patient might be right and went ahead with arthroscopy.
He was shocked with the amount of damage that was found within my hip. I had a multiple labral tears, hald the labrum was detached, stretched and damage ligament(which holds the hip in place) as well as frayed labrum.

How could the MRI equipment miss all that?? who knows, but I wouldnt rule it out because the machine said so. It takes a good surgeon/physician along with the assessments, tests and the patient's Hx to diagnose and treat the problem at hand.

There are loads of wonderful people on this site whom are willing to help out if you have any more questions. Welcome to the hipsters family

[soccermom]

thanks, 911...gee, didn't know you were a celeb! :) so what tests should be done to detect tears...just have it scoped or discuss an mri arthrogram? and....this hip has troubled me for 10 years (swear it happened delivering one of my kids) but it tends to come and go--can go weeks without too much trouble and then weeks with it aggrevated. the last year has been the worst since i messed up my ankle and was on/off crutches so much as well as missing out on my regular exercise regimen (which i cannot get back into because either my ankle or my hip hurts). it hurts when i sit more than a few minutes, when i run, when i sleep, with internal rotation (which i don't have a lot of), and sometimes it catches when i walk....what else could it be??? it is disheartening to go to the dr. and hear there is nothing wrong...maybe i should see a psych instead!!!
any other thoughts from anyone?
soccermom

[focus_911]

Hi SM,
lol, yes I guess I am famous. I wont even charge you for an autograph;)

A lot of the questions you have should be discuess with your doctor. I cannot speak for him nor can anyone else as we are not trained to do so (even tho from I have read on this forum a lot of you guys probably know more than most physicians out there).

To help you all I can is share what I have gone thru. Please read my post which can be found on the main page, here is a direct link

http://www.injuryupdate.com.au/forum/showthread.php?t=3011

Cheers

[Surfchick]

Hello!

Just a brief message - I need some sleep!

Your history sounds so like many others. I am from England, UK - my surgeon is Prof Damien Griffin. He is the best in the UK. I believe the best in the world is Marc Philippon from Vail, Colorado. Another top surgeon is John O'Donnell from Australia.

Having learnt so much through my own experiences - your symptoms sound classic of a labral tear. MRI is most likely to miss a labral tear - you do need an arthrogram, this is contrast/dye injected into the hip. If there is a tear - the contrast is seen, as I understand, to come through the tear.

A lot of surgeons repair/debride labral tears but fail to diagnose and treat the cause of the tear - such as FAI - femoro acetabular impingement. Usually an abnormal shaped head of femur/"ball" rubs/impinges causing the labrum to tear. No point having surgery on a tear without addressing under lying cause - will mean more surgery at some point.

Go with your gut feeling. Find a competent surgeon who can treat FAI, labral tears and hip instability etc. Have an MR arthrogram - don't just go straight for arthroscopy. Also a CT scan with 3D reconstruction will look further at the bone for abnormalities if any bone resection/shaving needs to be done.

I hope I haven't scared you - just get angry when I hear another person is suffering and most likely being told the wrong information.

Don't see a psychiatrist - they sent me to one - but I proved it was my hip!

Ihave a meeting this Friday to discuss my complaint with an Orthopaedic surgeon that told me my hip was normal in June 2005. May 2006 I had a 2nd opinion and proved my hip was the problem.

I have lots of messages on here - if I can be of any more help you can email me at

croydesurfchick@yahoo.co.uk

Take it easy

Surfchick
x:)

[soccermom]

hi surfchick and 911:
so it is all in who you know....got into the dr. today (the one that does hip scopes) and he ordered the mri arthrogram. i never knew my hip could creak, pop, and click so much after he was done with it. now it's really aggrevated and hurting. so maybe i will at least know what it wrong. so the arthrogram sounds kinda yucky...needle in my groin, ouch! is it all that bad?
soccermom

[focus_911]

Not really no. They will put a local anesthetic first before they do anything. You might feel a discomfort but nothing else. I had more problems with the lying down into the MRi machine than anything else. Had to be sedated. By that afternoon I was out horseback riding:cool:

[Kiwi]

Hi everyone. Like many of you out there I finally have a diagnosis and thought I'd share my story up to now.
I'm 22 years old, female and physically fit. I was a martial artist for about 5 years and very outdoorsy throughout my school years. Recently I have completed a Duathlon and have been training for a mountain bike race (which i now cannot compete in due to the injury)
After 4 years of intermittant pain, clicking, catching and limited range of motion, 2 doctors, a physiotherapist and a sports doctor later, I finally had an MRI arthrogram. Didn't have local injected into the skin but it wasn't too bad. The doc did some flexion tests (yup still painful) before injecting contrast and local anaesthetic into the joint space. After the MRI he performed the same tests and the pain was completely gone as the local must have been working. (A fair sign that labral tear is the culprit). I had some sort of reaction to the contrast and was very stiff and sore the next day, could barely move my leg more than 20cm in any direction, but that came right after a day of rest. Today i got the results. I have one small tear at 9 o'clock and probably another larger tear from 11-12 o'clock (not that i know what that means yet). Unsure at this stage what has caused the tears but hope to find that out as well as the next step to take at my next appointment with the sports doc which is in 2 weeks.
This thread has been so helpful and i had pretty much self diagnosed myself from reading it! I will keep popping in to read your progresses and post how i'm getting on :o)

[DiverDan]

Hey Dan

Thank you for your comments ... I've been reading bits & pieces of the thread since i found this site a few months ago.
I'm sure surgery is my only option unless I was to be a vegetable the rest of my life, even swimming causes me pain. I just hope I can eventually get back onto the hockey field. I guess if i can't there's always coaching.
in regards to rehab, I was told about 2 weeks off work with ongoing physio. Will be careful not to go back to work too soon now as my job entails a lot of movement/sitting/standing/walking etc. Will also be very careful with physio.

Hope all goes well with your recovery, that goes for everyone going under the knife.

Have a wonderful & safe Christmas everyone & may 2007 bring answers & healing

Lyn

Lyn,

On average it takes about 8 weeks for the surgery to heal. I appreciate you may need to return to work, but if you don't want to go through another arthroscope down the track, personally I would extend the 2 weeks you were told. Last time I was sent back to work about a month post op and look where I ended up. This time around I'm looking at 2 months and possibly more, with me driving the RTW. Do not leave your future wellbeing in someone else's hands. If it doesn't feel OK, take over the wheel.

take care

DD

[Surfchick]

Hi again,

It's so good to hear you have a request orderded for an arthrogram.

In answer to you question, how bad is it - I think that depends on the individual to a point also. I really didn't like the sound of a needle into my hip. yes - they inject local into it first but I presumed it would hurt?! I had diazepam and morphine of my family doctor to take 1 hour before the arthrogram. In May 2006 I had my pre op done and felt no pain/sensation. I was fine after - no ill effects.

Nov 2006 I had another arthrogram - I had diazepam and morphine 1 hour before, was really relaxed. I did flinch at 1 point but it wasn't too bad. My leg did feel weak after but the test is really important in the diagnosis of labral tears so it's worth suffering any effect.

They put a plaster on me - I checked it 6 hours later and it had bled and bruised where the needles went in - that's quite a normal reaction but as it didn't happen in May I wasn't expecting it in November!! The same radiologist did the injection- it's just one of those things I think. Took a few days to recover - was told to rest - but I couldn't as had to go to work, so it took longer to settle down!! It has settled now though and bruising wnet after 3 weeks!

It really is worth getting it done, you may not have any effect from it - we are all different and out pain threshold is different. I didn't mind going inside the scanner for nearly 1 hour - but alot of people get clorstraphobic.

Let me know your results!

Amanda

[Surfchick]

Hello!

Read your message - you seem quite informed of what's going on with your hip?

Interesting that you had limited movement after your MRa. The first one I had, I was fine, the one 6 months later, my leg felt weak and painful hip too. They said they had never had anyone have problems after! Told to rest but I didn't have time to so took loads of pain killers and carried on working which meant it took about 3 weeks to settle!

After I had a steroid injection in my hip in April 2005 my leg felt weak after - the surgeon that did it said it wasn't a usual response which didn't suggest I had a hip problem! After 10 days I got better and he still wasn't convinced - still said normal hip. After paying for 2nd opinion and found I had a labral tear I was angry. I had a meeting with this surgeon last Friday complaining he misdiagnosed me and was wrong not to order an MRa scan on me. Eventually, he did admit with hind sight he was wrong and wished he had done a n MRa!! I am waiting for minutes and letters now to this effect. Through his failings I am in debt now but still need more surgery.

He said that the leg weakness after the injection confused him which is why he didn't think I had a labral tear. It sounds like you had a similar reaction after your MRa?

Has anyone else had this kind of effect after injection into the joint?

I hope they tell you the cause of the labral tear. There are too many people having labral tear repairs or debridement without the underlying cause being treated too. This may be FAI, lax capsule or some anatomical/congenital defect. If the cause isn't addressed then there is a high chance that the labrum will re tear post op as the physio and hip flexion etc is increased! There are some people that can have traumatic labral tears as a result of sport etc - and can just have the tear fixed but often there is a cause for the tear.

Let me know your results!

Amanda
AKA Surfchick

[Kiwi]

Hi Amanda, thanks for your reply :)
I had my scan done last week and being the xmas period couldn't get a doc appt until early January, so i called them up and requested my results coz i was itching to know lol They only mentioned the small tear and something else bigger that is probably another tear but they are unsure (something i'm sure we'll discuss at the next appointment) other than that NAD. Would the FAI show up on MRI? I would have thought that would have shown up on plain x-rays aswell? (which i had done back in April this year).
Regarding the arthrogram injections, it wasn't really a weakness i had the day after, I just physically couldn't move my leg past certain angles, it just stopped, wouldn't go any further and was very painful (the same pain as the sharp catching pain). I called the doc who did the injections and he said it could have either aggravated the tear causing a flare up in symptoms or caused Synovitis? It only lasted a couple of days though and I'm now back to how i was, which isn't perfect but at least i can walk lol.
I haven't had a steroid injection yet. That was the plan back when my GP thought I had Bursitis which was ruled out by an ultrasound, so I thought I was back at square one. Just glad I now have a diagnosis I can work with :-)
Sounds like you've had a terribly expensive experience. I'm lucky because when I first went to the doc for this prob he filled out an ACC form (accident compensation corporation) and the case was accepted. They are an organisation here in New Zealand that will pay for medical treatment arising from an accident or injury. So all though x-rays and other tests have small surcharges on them, my MRA was completely paid for by them (after me having to prove that the problems i am having now were related to those I had when the form was filled out). And if surgery is required, they will pay for that as well. As this was a preexisting condition when i took out my medical insurance, it is not covered by that.
From what I've read online it seems that not many medical professionals are aware of this injury? I guess I was lucky when I found a physio (of all people) who knew exactly what it was and a sports doctor who was very clued up. I've been told right from the word go that surgery is the most likely outcome so I guess we have clued up surgeons as well lol maybe you all should come to NZ lol :-)

[Hip62]

Hi (from another Kiwi)
Now 9 days post op following surgical dislocation and debridement. Surgeon resurfaced head of femur, trimmed off 2 areas of torn labrum, and ground off a bony projection in socket which probably caused tears. Like 'Kiwi" I was initially covered by ACC but when it came to meeting costs for surgery was declined on the basis that I had a pre-existing condition (the bony bump) before my gym accident. Thankfully my private insurance has picked up costs. Took ACC 7 weeks to decide they wouldn't pay.

Hopefully on road to recovery. Post op painful but good control with morphine and now paracetamol and codeine, incision about 25 cms long, only partial weight bearing for first 6weeks with 2 crutches then reducing down to one over next few weeks. Needing to rest with foot up most of day but independent for showering and dressing with aid of speciall stools. Best news of all was Dr saying no sign of arthritis in hip joint and it's 'the hip of a 25 yr old' - and I'm 62!!!!

My surgeon said that this couldn't be treated arthroscopically so am pleased that from the start I had good advice, MRa and option of surgery.
Good luck to those still seeking diagnosis and treatment.
Hip62 :)

[Kiwi]

Argh, that's a bit of a worry Hip62, I never thought about that, how stingy of ACC! I totally believe when you say they took 7 weeks to make a decision...I had to make about 20 phone calls in 3 weeks for them to agree to reimburse me $140 for the ultrasound!
As far as I know I don't have any bony bits to be shaved off so hopefully it stays that way or i'll be financially and subsequently physically in the poop!
Glad to hear you're managing your pain ok, I wish you a speedy recovery!

Jess

[bird33]

Hi Heather, I just found this web-site and just underwent surgery for a torn labram as well as FAI repair (day post op). I also live in NYC and went to New York Presby. Experiencing some pain but want to know your experience post op.

thanx,
Joe

[lyn152]

Hi all
My heart goes out to all of you. Compared to what some of you are going through my condition seems insignificant. I pray that all of you receive a correct diagnosis, the very best surgeons & a perfect recovery. May 2007 bring this about for all of you...oh & me :).
Thanks Dan, looks like I'll be having another look at when I go back to work thanks to your comments. My biggest problem is that the relief that'll be working for me is to put it bluntly hopeless but we have no one else. Am considering maybe working part days after having some time off. I WILL let my body be the judge of what I do, I sure don't want to face surgery again like yourself. When I'm searching for a physio to work with me what should I looks for? Not that I have much choice where I live. I have been told of 1 guy locally who actually works with you, just doesn't put you on a machine & leave you to it like another place I've heard about. Any suggestions?
In answer to the question posted earlier.... I had a bit of discomfort during the injection when it went right into the hip joint.. I did enjoy watching the xray while he located the spot to inject the dye. Was a bit sore around the hip area for about a day I think, but then exercise does that anyway so it was nothing unusual.

Take care all
Lyn

[doctorhl]

Open Surgery Update - Had 6 month visit for labral reattachment and femoral neck debridement which caused hip impingement(see detailed posts #196,197). No pain, some tenderness in gluteus medius because of posterior dislocation for the surgery.Gait is 90% correct when I concentrate. Feel a slight "clunk" during abduction. Haven't tried running. Physician said there were no 6 month post op issues on the x-ray and that the healing process will continue up to a year. The arthritis had already thinned my cartilage prior to surgery and this surgery will hopefully delay a total hip replacement anywhere from 2 years to infinity. His only guarantee was that high impact activities would "speed" up the arthritic process. So high impact activities(my tennis, racketball,etc.) can be continued if I am willing to undergo the inevitable hip replacement, sooner rather than later. I guess the escalation of the arthritic process is highly individualized, but the level of arthritis never really "stays the same" or certainly never reverses(short of the experimental cartilage grafts I read about at about $5,000 a pop). This surgeon is convinced that scopes just don't give enough access to the hip joint to deal with labral tears and impingements in many cases, especially if there is underlying arthritis.

Any 1 year, 2 year, etc. post op updates out there with a similar surgery?

[DiverDan]

Hi all
My heart goes out to all of you. Compared to what some of you are going through my condition seems insignificant. I pray that all of you receive a correct diagnosis, the very best surgeons & a perfect recovery. May 2007 bring this about for all of you...oh & me :).
Thanks Dan, looks like I'll be having another look at when I go back to work thanks to your comments. My biggest problem is that the relief that'll be working for me is to put it bluntly hopeless but we have no one else. Am considering maybe working part days after having some time off. I WILL let my body be the judge of what I do, I sure don't want to face surgery again like yourself. When I'm searching for a physio to work with me what should I looks for? Not that I have much choice where I live. I have been told of 1 guy locally who actually works with you, just doesn't put you on a machine & leave you to it like another place I've heard about. Any suggestions?
In answer to the question posted earlier.... I had a bit of discomfort during the injection when it went right into the hip joint.. I did enjoy watching the xray while he located the spot to inject the dye. Was a bit sore around the hip area for about a day I think, but then exercise does that anyway so it was nothing unusual.

Take care all
Lyn

Lyn,

You could start at the Australian Physiotherapy Association. Their website is www.apa.advsol.com.au.
Finding a physiotherapist with knowledge of this injury will depend on your general location in NSW. There is one I will not be visiting again!! See post 153 for recommended reading on this injury, including physio rehab and other recommendations on what you should and should not do. Take care one and all.:)

DD

[Hip62]

Good to have the encouraging words from Doctorhi -thank you! I will look foward to being pain free. Every day post-op sees an improvement.
Happy, and healthy New Year to all :)

[lyn152]

Lyn,

You could start at the Australian Physiotherapy Association. Their website is www.apa.advsol.com.au.
Finding a physiotherapist with knowledge of this injury will depend on your general location in NSW. There is one I will not be visiting again!! See post 153 for recommended reading on this injury, including physio rehab and other recommendations on what you should and should not do. Take care one and all.:)

DD

Thanks Dan:)
I have found all of 3 physio's in my area... 2 in Taree & 1 in Forster, yay... guess I need to make some phone calls & check them out before surgery.
Thanks heaps for the post referral... I've printed it out & intend to read it in bed tonight.. nothing like a bit of light reading ;)

How is everything going post op for you??

Lyn

[Kiwi]

I was wondering if anybody has had any luck with trying conservative treatment? If so, what was the treatment and did it work completely or did it only initially dull the symptoms and they came back when you returned to normal activities?

Thanks
Jess

[fishfriendz]

Hello -

I have been following this thread since I was recently (October) diagnosed with a small tear and "minor" impingement following about a year of nagging hip pain. I had been training for my 2nd marathon when the hip pain sidelined me 2 weeks before the race. I was able to control the pain for a year by basically cutting out all physical exercise. When I started back up with working out in September, the pain flared up. This lead to my sports med dr supsecting and then diagnosing the tear through an MRA.

Had a cortisone shot about 2 1/2 weeks ago but have had no relief. Anyone else that had a cortisone shot that didn't work? I have heard conflicting thoughts on this. Someone said her dr. told her the cortisone would determine if the problem was in the hip or not. I thought it was only the marcaine or other numbing agent that helped determine whether it was a joint issue. The marcaine (or whatever it was) numbed me up for a few hours but the actual cortisone shot has done nothing. I go back to my hip dr. on Friday. He initially told me that he wanted to try the cortisone shot because I would need the open dislocation with debridement (I don't think he fixes impingements arthoscopically). I am anxious to hear what he says on Friday. I plan to get a 2nd opinion from a dr. that fixes FAI arthoscopically. Here is my question: how are drs able to completely see and then fix the problem arthoscopically? That may seen like an odd question but I want to make sure that I choose the best option for me. Obviously I would like to avoid the open surgery option if I can BUT I do want this fixed right the first time. Dr. Phillipon in Vail is not an option for me. I looked into Dr. Olson in Winston-Salem NC but he is not covered by my insurance.

Thanks for your input.
Jenny

[Kiwi]

Where abouts in NZ are you/did you have your surgery?? I am in CHCH and am wondering if i'd have to travel for surgery?

Jess

[Kiwi]

Hi Hip62 :) Thanks for that! I have my appt with my sportsmed doc on Tues to go over the results of the MRA and depending on what the outcome is I may give you a call :-) Hope you have a good weekend!

[Happygirl]

Hi I am yet another kiwi also from Christchurch! I'm 21 by the way. I was diagnosed with a labral tear, I also had FAI (the cause of the tear)! It took almost 3 years for a diagnosis, so I guess you could call that conservative treatment but all it did was get worse to the point where I couldn't walk anymore, so I would recommend finding out what can be done to fix it. I also have to thank my physio, it was his persistance that got me a MRA and diagnosis in the end. I had x-rays done more than a year ago that were read as normal, even had frog leg views done but still read as normal but when I took them to show the surgeon a year later (after I finally got someone to order an MRA) the first thing he saw was the extra bony bump that shouldn't have been there so even if your x-ray report says they are fine it pays to get them looked at just in case. I had open surgery exactly 6 weeks ago (and love my surgeon by the way) and am so pleased I went through with it, I cant believe there is no pain like before anymore, just gets painful when I do too much as I am still on the recovery road. And it was covered by ACC so don't give up on them, they do cover this surgery even if you do have more than a tear-they did for me. I got to go to Saint Georges hospital and it was really lovely.
Let me know if you have any questions at all, I am more that happy to answer any you may have, I know what its like being on the beginning of this road and not knowing where it is going to take you.
I wont say ring me as I am off to Dunedn for summer school at otago tomorrow but certainly email me, I'd be more than happy to help and be in contact with someone else who's not in america with this as so far I haven't found anybody who has even heard of this before!

Happygirl

[Kiwi]

It's quite neat knowing there are others out there that are so close to home. Its a bit freaky trawling the net when all you can find is minimal information from a foreign country! It seems this injury is quite common regardless of what articles say huh. I'm surprised there are three of us from little old Christchurch on this forum! I guess it's where we all turn to to get answers :)
I'm hoping I haven't got FAI, so far nothing says I have but I didn't have a traumatic event causing this, so who knows...it may take a surgeon to pick it up.
I have had my pain for about 4 years on and off and only recently put two and two together (clicking, catching and aching etc). Recently the pain has gradually been worsening and now have a constant ache in the groin and a LOT more clicking, my catching seems to have subsided a wee bit but still have trouble rolling over in bed. I can walk ok with a bit of a limp due to limited movement, nothing too serious but on a bad day i do have pain on weight bearing but its at the side and back of my hip, not in the front. I'm a bit worried because recently I've had some similar pain on my right side :confused: i'm hoping its just from compensation but will have to have it checked out i think.
Hope you have a great time at summer school! What are you studying?

Cheers
Jess

[soccermom]

ok, so i had the mra yesterday. not bad, a little tightness but pain was fine--until i got home. i had so much weakness and pain i was pretty miserable last night. better today, but it just seemed to aggrevate everything. i went by and got the radiologist report today..."no definate tear" but looks like tendonitis and bursitis. hard to believe that i've had inflammed tendons and bursitis for 10 years, but i guess i get to live with it many more since there isn't much to do with that (besides all that stretching stuff...which by the way i am sick of and doesn't work for my pain). so i guess my journey ends here....glad i don't have a tear, but would have been nice to know what really is wrong with me. thanks for your help and good luck to you all.
--soccermom

[Kiwi]

Hey Soccermom, sorry to hear that you had a bad experience with the MRA and the news wasn't what you were hoping for, I wish you all the best and hope you get some relief of your pain soon! Also it pays to keep in mind that these tests aren't 100% sensitive, and different doctors also read the results differently :-)

Jess

[soccermom]

thanks kiwi...i am certainly not disappointed that my hip is not torn, but i did wish to have an answer. tendonitis and bursitis seem kinda like non-answers to me for pain that has been ongoing for so many years. maybe i should just admit that 37 year old moms shouldn't be playing soccer (just cheering their kids on from the stands) and running races.
toodles! soccermom

[lyn152]

Hi Soccermom
There's no way 37 is too old to play soccer, I'm almost 43 & still play hockey. Hopefully after my surgery in just under 2 weeks I'll continue to do so after having this season off.
As Jess (Kiwi) said, not every doctor read results the same. I went to my surgeon believing i had dysplasia, (yes i read the radiologists report, as we do) I don't have dysplasia. Go with your gut feeling as to your symptoms. if you read through this thread you can check other people's symptoms to your own. I'm sure you can compare the symptoms of what you are experiencing, labrum tear or tendonitis & bursitis. Check the symptoms for both & go with what you're experiencing. If you believe it's a tear then keep pushing... 2nd opinions etc. Good luck.

Lyn

[Happygirl]

Hiya Kiwi

I sent you a private message (it was too long for a post!)

;)

Happygirl

[focus_911]

Hi guys,
I have been searching desperately for answers. Been posting on the thread I started as well as posted a new thread a few days ago but it doesnt look like what I'm going thru might have happend to others. Im going to post this question here in case some of you havent had the chance to read the other one I posted. I'm honestly now thinking on giving up. I really dont know that there is anything else that can be done and I'm pretty depressed about it.
I was just starting my career, enjoying my horses but there is nothing I can do at this point. What I wanted to know is. Are there any options for hip arthroscopy that just havent been successful?
I'm 21 and undergone my first one on my right hip. Was in physio for about 3 weeks when the surgeon decided to stop because there was just to much catching and audible poping. Unless I sit down without doing anything I'm pain. I just want to cry. I can't believe that at the age of 21 you can be in so much pain.

Please help

[soccermom]

uhhhhh! went to the ortho with my "normal mra" results and now he wants to do an intra-articular hip injection. i agreed, but it's another trip back to hospital for that one. i am beginning to think either he thinks i am crazy or i really am crazy (which may not be a bad alternative at this point) :)

911: is the continual catching/popping still from the surgery and swelling from that possibly??? sounds like they did a lot of work on you and would seem fair to say your recovery may be longer. i can't speak of hips, but since the hip the joint is such a load bearing joint and almost impossible to immobilize.....may take a bit. i am only saying this as i had my ankle done in oct and i am still having some trouble with it--literature suggests that 6 mos for my ankle to feel good. if your therapy was too aggressive, it may have really stirred things up in that joint. after my initial ankle injury, i had a pretty aggressive pt who tore up my peroneal tendon--leading to surgery #1 in april and an ankle scope for debridement (surgery #2) in oct. all of which (i suspect) lead to my screwed up gait making my hip much worse and putting me here!

lyn: i don't think i am too old to play soccer, either...but my body sure tells me differently these days. pretty sad when i am "just hoping" to be able to run a spring 5K.

soccermom

[focus_911]

*NEWS*
The news clip that was done about my procedure will be passing on the news on monday. The reporter called this morning to let me know. I will post the links in the morning once they are posted.