Hip dysplasia with labral tear

[Lambda]

Hi everyone!
I'm so glad to have finally found a site like this filled with 'experts'
Anyways, I was born with hip dysplasia and had it corrected (as much as possible) as a baby. I grew up super active and played on many sports teams. My hip didn't give me any more trouble until I turned 21. At first it was aches and pains that would come and go, but back in 2007 it decided to become constant and I started losing hip stability (started dislocating, giving way, etc.) Eventually, I had an arthrogram/MRI and they found a labral tear along with a nice case of bursitis. I did everything possible to avoid surgery (physio, acupuncture, anti-inflammatories, painkillers, ignoring it) but nothing has worked. I got a steroid shot today (I feel like I got hit by a truck!) to tie me over until I get surgery, but have a few questions I hope you guys can answer.
1. Has anyone with hip dysplasia had hip arthroscopy/debridement? Did it work or is it a cycle where your bum hip just keeps causing problems, putting you back to square one?
2. Did steroid injections work? If so, for how long?
Thanks!

[oscarsmum]

Hiya,

Your story is exactly the same as mine, more or less to the year.
I am now 39, had an Arthroscopy in September.I was on partial weight bearing for 6 weeks, then had physio and hydro but sorry to say this I haven't really recovered from the scope at all. I am now 61/2 months post-op, but am in a lot more pain than I was pre-op. I can't walk more than a few minutes without using a stick or crutches, and take presciption strength codeine tablets like sweets. I believe I retore at about ten days post-op, probably due to doing too much.I am due to have a PAO (reconstruction surgery) in 7 weeks, and am literally counting the days until I can begin to get on with my life again. I am sorry if this is not the answer you were looking for. I was warned pre-op that the scope might not help ( tho not told it could make things worse), but I was in a fair amount of pain anyway so happy to try anything. If I had the time again, I would still try the Arthroscopy first, because it is a relatively easy and painless procedure and if it doesn't help at least you know you have tried everything before having a major reconstructive surgery.
On a good note, I have had a steriod injection in the past and after a few days of being a bit sore I got about 4-6 weeks of relief from it.
Sorry this wasn't the answer that you were looking for, but just because it didn't work for me doesn't mean it won't for you.
I hope this helps a bit, and ask if there is anything else you would like to know.
Do you have a date for your surgery? Also who is doing it, and were is it being done?
Take care, and keep in touch,
Kate x

[Lambda]

Hi Kate,
thanks for the reply. My surgery will be anywhere from June to August. The hospital is waiting to see how many OR hours they can book for this summer and then will make appointments. I am in Canada and am having surgery in Edmonton, Alberta. I did a bit of research on my surgeon and feel comfortable with him. He did explain that the surgery may help, do nothing or make things worse. However, in my case, that's a chance I'm willing to take. He also said that it could take up to a year to see improvement, so we'll see.
You mentioned partial-weight bearing.....was this on crutches? Does this mean you're not totally dependent on crutches but need them just to help out? My surgeon said after the surgery I'll be able to put weight on it right away, but that's probably with the help of crutches I assume.
Sad to hear that you're still having problems. I did a 'Google' of PAO, and pardon my ignorance, but it's used to disassemble and then reassemble the pelvic bone/joint into a better configuration? It sounds pretty major. Hopefully your upcoming surgery helps.
Pam

[Dee34]

Hi Pam,

snap- like you and Kate I have a very similar history. I have dysplasia which was corrected as a baby and didn't cause any problems until my early twenties. I had surgery last year to remove my inflamed trochanteric bursa and tendon release, then tore the labrum in the same hip when I was recovering (not my best move !). I did have a couple of cortisone injections for bursitis last year and did get some relief for 4-6 weeks but think it can be hit or miss depending on where the pain actually is and whether the surgeon gets it bang on. Worth a try would be my advice and I hope it works - can take a couple of days.

I've also just had an arthroscopy (nearly 2 weeks ago) and due to having dysplasia, my surgeon has me on crutches with no weight bearing for 2 weeks, followed by another 2 weeks partial weight bearing - but it's very dependent on your individual hip and surgeon's approach. Is too early to tell whether it was a total success or not, but my surgeon has warned me it could make things worse and he did find some evidence of wear and tear to the cartilage. He has also said it will take up to a year for the hip to fully recover.

I hope you get a confirmed date soon and glad you've found this community.

Dee

[oscarsmum]

Hi Pam,

Partial weight bearing is using two crutches to help take some of the weight from your hip. I was allowed to put my foot flat on the floor( as oppose to just toe-touching, which is almost no weight at all) and put some weight through the leg, but also take some through the crutches. ( Hope I have explained that ok). All surgeons have their own protocol, mine was quite conservative, some have you walking almost straight away, so it varies a lot depending on your individual issues with yout hip and the OS preferences.
Also Focus, who posts on here has a thread you might be interested in , as she had similar issues and is also from Canada so you might find that helpful ( hope you don't mind me jumping in there Kelly).You always feel better if you have a great surgeon that you trust.
Hope it all goes well for you, and it does help.
Keep in touch, and let us know when you get a date,
Kate

[focus_911]

Hi Pam,

Partial weight bearing is using two crutches to help take some of the weight from your hip. I was allowed to put my foot flat on the floor( as oppose to just toe-touching, which is almost no weight at all) and put some weight through the leg, but also take some through the crutches. ( Hope I have explained that ok). All surgeons have their own protocol, mine was quite conservative, some have you walking almost straight away, so it varies a lot depending on your individual issues with yout hip and the OS preferences.
Also Focus, who posts on here has a thread you might be interested in , as she had similar issues and is also from Canada so you might find that helpful ( hope you don't mind me jumping in there Kelly).You always feel better if you have a great surgeon that you trust.
Hope it all goes well for you, and it does help.
Keep in touch, and let us know when you get a date,
Kate

Not at all Kate I swear this thread was started for me I sounds EXACTLY like what I went thru.

Most regulars on this forum I have actually talked to in person. If you're confortable with it, I would be more than happy to give you a shout. If you want to fire out your number thru a pm, we can go from there. Take a look at the link in my signature. There is a news clip of my hip story when all this first started.
Take care
Kelly

[sue13]

Hi everyone,

I am new to this site and like most of you I am experiencing the same thing. I am 29 yrs old and feel like 80. I was diagnosed 2 yrs ago with a labral tear in my right hip. After seeing the specialist at Rothman Institute in Philadelphia I was also diagnosed with moderate to severe hip dysplasia. I am at the point where I can't exercise, be on the back of our harley or even stand for long periods of time. My hip pops all the time, tried pt, injections and nothing worked. I never had any pain as a child, played every sport possible. I now have to decide whether to have the labral tear fixed arthroscopicly or have the osteotomy sx to correct the dysplasia which really scares me. Is anyone is a similar situation. I would love some answers or thoughts. I am looking at sx in January and was told I would be non weight bearing for 4 weeks since the labral tear will be sewn in and not removed since I have hip dysplagia. Then therapy for atleast 6 months. I was told it is a long recovery.

[Dee34]

Hi Sue,

Welcome - you've come across a great resource. Yes the arthroscopy is a long recovery - up to 12 months or longer in some cases. I am 7 months out and had physio for 5 1/2 months, and only recently have begun to be able to walk without a limp although I did get a lot of pain relief from having a labral tear repaired and the joint space cleaned out. Pre op, I was like you unable to stand for any amount of time, or walk any distance without crutches and severe pain.

When you have an underlying condition like dyplasia, arthroscopic surgery will only ever address the symptons in your hip, not the underlying cause of the damage. Unfortunately the damage already in my hip has almost ruled out a pelvic osteotomy and my likely next step will be a hip replacement (THR) in the next couple of years. If you still have the option of an osteotomy (which will fix the underlying problem) my advice would be to explore that option. You can read some of the other posts here about people who have had PAO's.

My OS was very clear that hip arthroscopy was a short term, pain relieving measure for me but that I would be very unlikely to get permanent relief due to the dysplasia. Personally, I have been very frustrated by the time it's taken to recover whilst knowing I've still got further deterioration and a THR ahead of me.

Hope this helps.

Dee

[dreamwalker]

Sounds like I'm in the same boat as Oscarsmum - I had arthroscopy at the end of July, so I'm nearly three months out and had to go back to using a crutch last week. It feels like I've retorn the labrum, and I also have more pain than before surgery. I was doing well on my physical therapy and then had to back way off. Oh, and I have dysplasia that was never diagnosed until I was about 39 or 40. I wanted to avoid a PAO, but it looks like I will have to do that after all. Since I teach, though, I probably can't do it until next summer. I also live by myself, so my brother may come next summer to help me (he is working at a ski area for the winter).

Other symptoms I am having now are popping (loud enough for other people to hear), catching if I try to ride a bike, and the hip giving out after I've been sitting for more than 15 or so minutes. My physical therapist told me that the hip itself may not be giving out but that the muscles around it aren't engaging to hold me up, probably because they are so stressed!

My surgeon also warned me that the arthroscopy would not help. I don't think he mentioned anything about making it worse, but so far, everyone I've heard from online who has had arthroscopy for a hip with dysplasia has had to have a PAO or is planning to have one. I guess I've joined that club.

Good luck!

[oscarsmum]

Hi Sue,

My advice would be to get the underlying dysplasia fixed. I had the Arthroscopy and struggled for 8 months before having the PAO. I could barely walk for 5mins without a stick by the time I had my surgery because the hip gave out at almost every step. I am now 5months post PAO, the recovery is frustrating at times, but not as bad or as painful as I thought it would be. My hip is not perfect (yet) and I have lingering inflammation but it is heaps better than it was pre-op and I am so glad I had the surgery. I already have a much better quality of life and although still sore my hip doesn't stop me doing anything now (except running, and my OS has even given me the go ahead to do that).
Hope this helps.

Liz, it sounds as if you have made your mind up. I think you will be very glad if you go ahead with the PAO. Welcome to the club!

Good luck both of you,
Kate xx