Simkie, I’m so sorry for what you are dealing with. I hope you guys can figure out the best solution.
Thank you! I feel like I’m going through the stages of grief. I’m still angry. So angry. At all the surgeons who saw me leading up to my reconstruction, and all the surgeons who saw me post, who couldn’t figure this out.
Honestly, short of a magic wand, I feel like all the solutions suck a whole lot. And I probably need a crystal ball to know which direction I should take?
No one talks about this as a potential outcome. 
Funny that I stumbled across this thread. I’m 34-years-old and have been having issues with my left hip for at least 10 years. This year it has escalated to it “catching” where I get in a certain position and literally cannot get it to move without “releasing” it. Met with an orthopedic surgeon after an MRI and he diagnosed me with a bone spur and a labrel tear. In my state, he would not do the surgery but a different surgeon in the clinic could, who I will hopefully meet with in about a month after we try a steroid injection next week. Have already been doing physical therapy.
I myself work in the medical field so I understand all the stupid “hoops” you have to jump through for the insurance. So we’re getting all the ducks in a row so that surgery could be an option for me if I decide that’s what I want.
I’m just really not looking forward to being laid up but I am SO SICK of having problems with my left hip.
Had an interesting appt with the hip guys for a dynamic ultrasound. It’s how they evaluate how unstable your hip joint is. Basically a couple of MDs geeking out over how your bones move around. Can’t say I’ve ever had any sort of imaging when the docs are driving rather than the tech, much less had TWO of them there.
For one motion they said “wow, I don’t think we’ve ever seen it that bad” which is not really a prize I’d like to win, you know?
My regenerative medicine guy wants a shot at this to see if peppering the joint capsule itself with PRP will tighten things up, and hey–it’s only money, so we’re trying that first. Very much a hail mary. But such low risk, why would we not? PAO surgeon is booking out into the spring anyway, so we’re not losing any time.
But I’m getting pretty worried that PAO is going to be the path forward here, and it’s tough to sign up for that. Oh, and the labral graft looked non functional on the ultrasound, so we’d scope at the same time (and redo the reconstruction? Gah, I don’t even know.)
Hey @Risuena just curious–did White do a 3D CT prior to your reconstruction? That might have prevented all of this for me. They weren’t really very standard back then. Wondering if he’s now looking. How are you healing?
Hi fellow hip pain peeps:
I’ve had documented OA in my right hip since my late 20s. When I started limping on XC course walks, I started myself on Gloucosamine/Chrondroitin, and have been able to maintain pretty well on that over the years (I just turned 60). My current go-to is Purica Recovery.
Two years ago I started up with lower back pain and I thought it was my SI joint. Sure enough, using an SI support belt pretty much took away that pain. I also found that if I accidentally slept on my right hip and woke up sore, I could put on the belt and go back to sleep, then wake up pain free. Pretty cool.
My latest I wanted to share recently happened. I was not paying attention the other day, and my frisky TB clocked me in my right femur, HARD. I thought it might have been broken, but thankfully, it was not. I had jeans and wind pants over them, and it was hard enough to split the skin about 1" wide and 1/8" deep.
I immediately when in, laid down, took NSAIDs and started hitting it with Arnica. Within and hour, my right hip started aching, like 8-9/10. I assuming the force from the kick had torqued my hip joint, not good with OA in the joint. I pulled out my CBD cream and started rubbing it into the hip area. Now I will be the first to tell you that I would never believe that a cream like that could penetrate deep enough to help, but sure enough, within another hour the aching ceased. I kept up alternating Arnica for the bruising and CBD creme for the pain. Three days out I have minimal bruising and am virtually pain free unless pressure is put on the affected area.
That’s all, just wanted to share some non-invasive things that have helped me tremendously. My best to all of you!
@Simkie - I’m so sorry to hear how much trouble you’re having! It sounds like they are getting closer to figuring out the problem(s), I really hope they are able to fix you!
Nope, nobody did a 3D CT on me…I didn’t even get a MRA! I live in New Mexico, so I’m not sure if it would have been different if White did more of my workup. My local hip doctor just ordered a regular MRI (despite my questioning), and the local radiologist didn’t even read it as a labral tear, just a “questionable” area. But my local hip guy felt that clinically it was my labrum, and between that and my imaging he even said he thought that calling it a “tear” was overly simplistic, he thought my labrum was toast (and he was right). When they sent my imaging up to White, he thought there was definitely a tear and enough pathology to warrant a reconstruction (and they were right). I’m doing fantastic - I still have some soft tissue tightness and am working on my strength, but I’m back to full activity and the hip itself is pain free. I’m so sorry you’re still struggling with your hip - the chronic pain really does eat away at you.
Wow! Holy cow, I’m really really glad to hear you’re doing so well, but so little pre op imaging just seems a little negligent 
Talk about flying blind!
My labrum was also in terrible shape. There would not have been a way to repair it, from what I understand. But, based on what my docs here are telling me, White was aggressive on the acetabular rim trimming and removed too much bone there. He’s not a conservative surgeon. It’s incredibly frustrating to hear that this team has done these salvage PAOs on other patients of White’s, for this very same reason. And really disheartening to hear that White hasn’t changed to perhaps prevent cases like mine. 
I don’t know what the right answer is here. It’s tough to sign up for what they’re proposing–which is fracturing the pelvis in three places, detaching muscle from bone, and then screwing it all back together. And then just toss in another reconstruction at the same time? 
I thought I did everything right last time–asked the right questions, did the research, even got the best second opinion I could. I never considered this could be the outcome. Makes it even harder to try again.
Ha, my doctor offered this to me too. I saw him two days ago.
Not exactly going to volunteer to have my pelvis cut apart and put back together. I know he was presenting all options to me but no thank you!!
For me, he told me I had too much hip dysplasia and he won’t repair the labral tear I have. Because I could walk out of there and tear it instantly again. The “socket” of my hip is way, way, way too small in circumference than it should be. So he offered the referral to cut my pelvis apart, LOL, but I would personally rather wait until I’m ready for a total hip replacement and do that. Much more “sure” of a surgery, and much less recovery time than the alternative. IMO. The do hip replacements all the time. PAO? Not so much. The place he would have referred me to does 10-15 of them a year. Not common at all.
I was half relieved I didn’t have to have surgery to repair the labral tear, but also half disappointed he couldn’t do anything for me. I’m hanging in there; I just have to be careful with how I move.
But I guess it’s nice to know what’s going on and where I am at.
@beau159 I’m sorry they didn’t have better answers for you. It’s hard to hear they want to dismantle your pelvis, isn’t it?
Yeah, I wouldn’t go with a guy who does so few of them, either. PAO does have a longer history than labral repair/reconstruction, though.
I’ve heard that THR can be challenging on a dysplastic hip, and that PAO prepares the bone for THR down the road. Just something to consider :-/
Simkie, sorry you are having so much trouble. Why won’t they consider a hip replacement for you?
Well had my third surgery on Monday. My labrum was toast so the surgeon had to use graft. Also had the capsule repaired. Got to see it all on video which was cool and weird all at the same time. I guess I tore my glute too. Not sure how I did that. 
But this recovery by far has been the best out of the three surgeries. I had to get a new surgeon since mine moved out of state. This guy did a familial job.
Wow, so sorry to hear you’ve been through so much! Are you saying you were awake for your surgery? I’ve read of people just using locals/epidural anesthesia. How’d that go? I just can’t imagine not being knocked out for the distraction of the joint I hope you have speedy and easy healing!!
I don’t have enough arthritis for a THR, and I’m young enough that it’s unlikely one will last my lifetime. The under coverage of bone in the acetabulum also makes it more difficult. I CAN skip the PAO and opt for THR once the arthritis gets bad enough–likely within the next five ish years–but that’s signing up for worsening pain from where I am now until they deem the joint done.
I had surgery two years ago and I thought the pain was better, but the last year has been even worse than when I started.
I originally went in with FAI, but when I was under, in my surgeon’s words, the labrum was “shredded” and shoved between the femur and acetabulum. They just pulled all the debris out and just left bone as it was.
But I’ve had a major increase in pain and my hip flexors are so angry and just frozen. Even with PT, I could never regain ROM.
Anyone ever in a similar situation? I’m very curious because I see all of these repairs, but I keep putting off having appointments since well…COVID and I already work in healthcare and I can’t imagine trying to spend more time at work.
I’m sort of frustrated because now I’m wondering if the surgeon should have taken down some of the bone in the original surgery instead of just removing all the debris.
@starrunner Have you had any recent radiographs? You’re describing debridement of the labrum, I think, which is not advised. The labrum serves a purpose to help seal the femur head in the acetabulum, and provides some stability in the joint. Without it, the the joint is more unstable, and arthritis is likely to develop. Given the timing you describe, that would be my #1 concern.
With arthritis, your choices are limited. Steroid injections might provide some relief. HA or PRP might be worth a try. But nothing short of a total hip replacement is going to be curative.
The original surgeon should have done a labral reconstruction if the native tissue was too damaged to repair. Only a small % of arthroscopists are trained in that procedure, though. You could try seeing a reconstructionist now, to discuss if a reconstruction would be suitable, but arthritis is usually a hard stop there.
I’m sorry you didn’t have a better outcome.
Thanks for the thoughts. I have hEDS too, so I don’t know if that was a factor with that surgeon. Sort of frustrating because given that diagnosis, there was only one surgeon that would even look at my case.
I haven’t had recent radiographs. Thank you for that excellent suggestion. Easy to do and honestly, imaging is right down the hall from me, so not much excuse there.
Part of my slowness is my PCP retired in all of this, but my rheumatologist ordered my last set, so I think they probably would put in the orders until I set another PCP.
Simkie, no I had anesthesia, my surgeon does video for his patients. It was weird because he was talking to me while I’m under and it almost feels like an out of body experience watching it.
Question for you guys how long did you wait before you got back in the saddle. I haven’t gotten a definite answer but I remember being back in the saddle like two months after the first surgery.
That totally blows my mind!
White was pretty firm on 6 months out of the saddle, IIRC. I was barely off crutches two months out!
