Femoro-acetabular Impingement and Labral tear recovery thread

[chewymix]

With knee to chest I can't really pull knee across body. Right locks up more than the left even though the left seems to have more damage. Worst pain is with sitting, some days it's agony in high hamstrings and groin.

Need to figure out how to confirm this is my pain generator after the issues the hernia surgery has caused me.

[Mazderati]

Injection is an option if you don't mind them. If the pain goes away, the problem is confirmed.

[chewymix]

The doc mentioned a shot into the hip of some steroid to see if that helped but he said he did it in the OR with sedation which seems a bit weird to me. I would have thought that he could just do it in the office?

There was also some questions around what if it does not help as apparently they can be ineffective but surgery still successful.

[Mazderati]

Not sure about the procedural options for injection. Several people I've spoken with had injections when symptoms started and I just assumed it was handled in an office visit. Knee-jerk reaction thinks OR and sedation overkill, but I suppose a short-lasting sedative is reasonable in certain situations, and some sedatives can be very short-lasting.

Steroid injections seem like a patch; they won't fix the root problem, especially when the problem is bony, but they can help get people through until surgery.

[chewymix]

Yes, I don't see how steroids would help if its just bony but I have tears too so perhaps a shot can help that pain.

Apart from scope does anyone have any experience of 'mini open' surgery as I have heard that recovery is actually easier than a scope and the doc can get to more if the joint. My current doc only does scope so I would need to shop around but I don't know if it makes that much difference.

[gibbssco]

Apart from scope does anyone have any experience of 'mini open' surgery as I have heard that recovery is actually easier than a scope and the doc can get to more if the joint. My current doc only does scope so I would need to shop around but I don't know if it makes that much difference.

I would think the more they open you up, the riskier the recovery. Three little portal holes was pretty nice, and my scabs have completely disinigrated in the last week, plus less chance of infection.

Went in on monday (5/12) to see Dr. Nho. Pretty standard checkup minus the day of travel hell i experienced trying to get out of chicago. His marching orders were to hit the bike/elliptical hard now and start swimming. I asked for a cortizone shot in my left hip, as it's been giving me issues lately (possibly from putting all my weight on it during crutch phase) but he said maybe next time. It's bike to work day tmrw here, so maybe i'll use that as a benchmark.

Maz, you get your surgery done?

[Mazderati]

I would think the more they open you up, the riskier the recovery. Three little portal holes was pretty nice, and my scabs have completely disinigrated in the last week, plus less chance of infection.

Went in on monday (5/12) to see Dr. Nho. Pretty standard checkup minus the day of travel hell i experienced trying to get out of chicago. His marching orders were to hit the bike/elliptical hard now and start swimming. I asked for a cortizone shot in my left hip, as it's been giving me issues lately (possibly from putting all my weight on it during crutch phase) but he said maybe next time. It's bike to work day tmrw here, so maybe i'll use that as a benchmark.

Maz, you get your surgery done?

Definitely seems like less opportunity for infection with arthroscopy and all the irrigation used, as compared to any type of open surgery. Would like to know more about it, though; might afford the option for ACI.

Glad to hear things are progressing in a positive direction, gibbs. Swimming seems good for sure. I had the works; six weeks out as of tomorrow. Mortality blows.

[BraddA]

4 days out and feeling great. Osteoplasty of femur+cup, new labrum by way of a cadaver's IT band, and a psoas release just for kicks. Best part: no microfracture!
Shocked at how good things felt the second day, and each has been better than the one before. 6 hours a day in a cpm+ice machine has been great, though a bit boring. First day off the oxy, hoping I can leave that stuff behind a few days early.
I start PT Tues. What can I expect?

[Mazderati]

The regimen depends on your surgeon; some like to get their patients on the bike and start PT immediately while others wait a few days. Most exercises focus on regaining mobility, muscle activation, and retaining as much strength as possible: bicycle without resistance, abduction, heel slides, etc. Spend time in the pool if you can.

[cdmdeepbreather]

yo fellas,

Looks like it's been a little while since you guys have posted, but came across this thread and wanted to say whats up.

The onset of my symptoms occurred in January 2012. I live in Southern California was doing a lot of highlining (slacklining high in the air) at the time, and was using a mounting style that required extreme flexion of the hip. I started noticing muscular soreness (not the good kind) radiating all around my right hip (flexors, lower abdominals, oblique, glutes). I ignored and pressed on. Over the next 6 months, I started training for a triathlon, and had taken a break off of work. Being between jobs, I was running, cycling, and surfing like 5 days a week. One day, after a long mountain bike ride, I had joint pain…different from muscle pain. Took 4 months, and seeing 6 doctors to nail it down as FAI with Labral tear. Had corrective surgery by Dr. Guanche in Los Angeles in November 2012. He did labral re-attachment, debridement of some shit cartilage, microfracture in that new bare spot, and shared CAM and Pincer lumps.

The next 6 months consisted of strict adherence to PT…didn’t do ANY surfing/running/biking during that time (only stationary bike). 7 months after surgery, I surfed for the first time. Had the flare-ups (hip would feel good, then I’d workout hard, and it’d get sore for a few days or a week) for about 18 months after surgery. Finally at about the 2 year mark, it was feeling pain free 90% of the time. Only problem was my muscles around the joint had become soooooo tight. I almost always had some type of muscle pain. After more PT to address that, with no luck, I started a 3 month regiment of foam rolling and stretching everything around the hip, 4 days a week, every week. It loosened up some. I still have lost ROM in that hip (cant pull it as close to my chest as I can my left), but it’s looser. Still never returned to running (tried it twice, hurt both times) or highlining (falls are too risky… uncontrolled and violent).

Fast forward to this past month (3 yrs & 2 months post op). El nino has been gracing us here in Cali with great waves for 2 months straight. I have been putting in about 2-3 sessions a week every week…surfing hard. Both hips are hurting me, but particularly my left (non-operated hip). Interestingly, at first, the pain in the left hip would just go from zero to 10 for a few seconds at a time, like I was being electrocuted in my hip joint. So bad that I’d have to stop talking/walking/whatever I was doing until it passed. After continuing to surf on it, it’s changed to a more consistent ache, without the spikes to level 10. Long story short; I suspect same problem in left hip, and even my operated (right) hip has been giving me shit from doing so much surfing. I’m convinced it’s my lack of flexibility that is causing this pain (along with the back/knee/ankle pain that I have experienced since surgery).

Am going to take up Yoga for a few weeks before doing any more intense activity, with the hope that it will improve my alignment and mechanics, and thus prevent further aggravation of these joint. Keep your heads up guys. People are skiing, snowboarding, surfing, etc… with hip replacements these days, so even if things go that direction, you don’t have to give up!

-Matt

[Mazderati]

I'm guessing they did, but did your PT work on capsular stretching?