@Josephine ,
@Harryn1 ,
@SaraK Went to Chicago to interview Dr. Benjamin Domb at American Hip Institute. He wants to to do a "lengthening" Psoas release at the Lesser Trochanter.
He has done over 2000 "native hips" tenotomies and over 200 tenotomies after THA.
He gave me the choice of either having the cut done at the central compartment or the lesser trochanter. He has done many at both places . He does not "cut" all the way (total release ) at the lesser trochanter he just cuts the tendon and repairs the muscle.
He agrees with me that doing the cut at the lesser trochanter has less risk of infection and less risk of dislocation (because you are not going in or near capsule (even though he admits both the left and central compartment cuts have minimal risk of either infection or dislocation).
He wants me in a brace for two weeks after surgery so I don't flex the psoas while its healing.
He says the main risks are the regular suspects (PE, Infection,etc ) and cutting the femoral nerve, and (which he has never done) etc.
He said I will not be worse off than before the surgery, it is relatively easy 30 minute procedure. He did mention the things that are not under his control that could make the surgery unsuccessful:
1. Rotational problem of implant that he can not see in CT or when he goes in (anteversion ,etc) rotation of stem causing problem (i.e .anteversion.)
2. Excessive scar tissue
3. Loosening of implant not seen on xray therefore unlikely
4. not the right diagnosis
5. extremely prone to scar tissue buildup, scars build back up and tighten area again.
6. weakness in leg that makes me unhappy . (has never seen it that significant..slight weakness)
He says he does not agree that if you have groin pain that you necessarily have to go into the "central compartment" because it is NEAR the groin pain, a significant release at the left tendon should loosen all the way up to the central compartment and relieve the groin pain as well.
However, the one caveat is before he releases the lesser trochanter (tendon only - not muscle part) that he will (Lysix ) look with the arthroscope all the way from the lesser trochanter up to the central compartment and REMOVE any and all scar tissue that may be impinging the tendon from the central compartment to the left and make sure its mobile before releasing at left.
6. Weakness in leg that makes me unhappy .(has never seen it that significant..slight weakness)
He looked at the CT and confirmed that the cup is well seated and there is bone coverage at the rim.
Please all comments would be appreciated. Especially from psoas release and tenotomy patients or anyone.
In addition if anyone knows of Dr. Benjamin Domb, please give me your thoughts bad or good. Or any other psoas release arthroscopic surgeons that you know of anywhere that are good?
You guys are the best Thank you Jeffrey