2 Weeks post hip arthroscopy

[Gum168]

Hello everyone

I'm really glad to have found this place, I'm 2 weeks post hip arthroscopy today, and until now I hadn't had any contact with anyone else who's had the same op. It doesn't seem that common in the UK (I believe it's not available on the NHS, at least not yet).

I've had microfractures in the socket, and some impingement on the femur head cleaned up. It wasn't a large area, but I am still coming to terms with the prospect of the likelyhood of a THR at some undetermined time in the future. None of my family has or has had arthritis like this, it wasn't what I expected at 50.

Although I know my recovery will be a little different from those of you with THR, it is at least good to know there's somewhere I can go to reassure myself my continuing aches and pains are quite normal. My physio told me to be more patient and I notice there are others being told to slow down, so I'm beginning to realise it's all quite normal and nothing to worry about.

One question, what sort of age do most people discover they have hip arthritis (I know, piece of string, how long etc, but I feel too young for this)? I had problems starting with pain sitting down and standing up from about age 45. And initially no one seemed to listen, maybe because of my age. It took 4 different GP's before I was referred to hip specialist (and a physio missed it too).

TIA for any replies.

 

[Jaycey]

Welcome to BoneSmart! So glad you found us. I hope you find plenty of information and support from our great members.

As you are discovering every recovery is different. And yes the aches and pains are very normal.

You will find hippies of all ages on this site who suddenly discovered they had a problem. In my case the pain was diagnosed as a back problem for literally years. It was only when my hip partially dislocated that I finally had it xrayed.

My OS says I am actually young for THR. I only found out after my op that my grandmother had both hips replaced - but she was over 80 when they were done so I guess it could have been predicted.

If you do some reading in the Library (top bar) you will find other stories from hippies in their 20s and 30s. THR does not age discriminate.

Please do keep us updated on your progress. It does help others who are considering ops like yours.

 

[Josephine]

Hello, Gum. What did you surgeon do during the arthroscopy? Was it a cam impingement, labral tear, or just a look-see? Which hospital did you have your surgery done at?

Actually this is a growing procedure all over the UK and is readily available on the NHS. It's just not talked about very much yet.

 

[Gum168]

Hi Josephine and Jacey

I had this done at BMI Harrogate. I was told it's not available on NHS (from several sources locally), at least not in our area, and I had to travel a long way from East Yorkshire, just to find a surgeon who could do it. I've read the NICE patient guidance,and I'm guessing that the NHS primary trusts in Yorkshire aren't funding this yet, as the leaflet says its for the local NHS bodies to decide. (For non Brits, NICE is the National Institute for Health and Clinical Excellence, they review and recommend which treatments the NHS can spend money on or not). The NICE guidance for patients is here.

I had several xrays and also an MR athrogram, all of which came back showing no damage. However, the 1st surgeon I saw at a Spire hospital said despite the imaging tests he had a feeling there was impingement and/or labral tear, so he referred me on to the 2nd surgeon (BMI Harrogate) who does this procedure. Again, he seemed pretty sure he would find something, which he did. Cam impingement and some cartlidge damage from early arthritis. I don't know what I thought the problem was, but when impingement was explained to me, it all made perfect sense, based on my hip getting stuck sometimes and the episodes becoming more frequent and lasting longer over time. It often occured the day after I'd done a bit more bending, or I'd walked further than usual with my dog. I used to do 3-4 miles most days, but by the end of last year, I could only manage about a mile (flat ground), or I'd pay for it next day and uphill and upstairs was becoming gradually more painful. I'd had to stop yoga as well as I kept getting stuck in the hip in certain positions (I'm no expert, only someone who liked to keep flexible in her own living room with a DVD).

I gather the long term outcome of microfracture treatment is still in doubt (hence NICE and the NHS being cautious about recommending it), but I'm hopeful that at least the tidy up of the cam impingement should buy me time before a THR. I'm no where near needing that yet, but the longer the better. The arthritis I have is still early, so I'm hoping that it will help with the pain of uphill and stair walking. And who knows, maybe I'll be able to get my yoga dvd's out again.

If you think it could be helpful to others, I'll start a new thread to record my progress over the next few months. My case is at the mild end of the scale, but it might still be useful to some. I'll also look through the various links I saved and pick out some of the best to post. There's a lot - I was very hungry for info after I saw the 1st surgeon - so it might take a few days to go check them all.

Everyone is different, but hopefully I'll have a positive outcome long term that can reassure others facing the same op. I've had some real up and down days, especially in the 1st week and half, I wish I'd seen this site before then.

 

[Josephine]

That NICE report is dated 2007! I attended a conference in London a couple of weeks ago. One of the sessions dealt exclusively with cam impingement surgery. Several of the speakers said they had done in excess of 2/300 of these surgeries though over what time period I cannot remember. I very much doubt they were all done privately! In fact, having talk to two of them afterwards, I know there weren't! On a straw poll in the 900 strong audience, about 150+ surgeons said they were doing this procedure.

Anyway, fact is, it's a growth area of treatment and apparently showing results for two reasons:
1. the cam deformity can set up conditions which ultimately lead to arthritic changes in the joint
2. the cam can also cause labral tears which also leads to arthritic changes.

But please continue your progress in this thread - no need to start a new one.

 

[Gum168]

Hmm, interesting. The post code lottery strikes again then. I was told it's not available NHS in East or North Yorkshire. I'm very lucky in that we have insurance via my husband's job.

The NICE leaflet is the one currently available for patients on their website, that's all I have access to as a patient. I'm really glad to hear it's starting to be more widely available though. Obviously I don't know how things will be 2, 5, 10 years or more from now, but I'm really hoping that aside from stopping the totally imobilising hip sticking episodes, it'll slow down the progress of the arthritis considerably (now the cam impingement is sorted out). I still can't quite believe I'm standing up out of a chair now without that scream of pain in my hip every time. Brilliant.

 

[Josephine]

Oh that's terrific, Gum. Long may it continue.

 

[Gum168]

OK, sorry, I had intended to keep this updated a bit more than this, but we've had a bit of a family crisis to deal with that's had me spend more time researching dementia than hips this last week.

Anyway, info for anyone facing hip arthroscopy, I'll recap on weeks 1-2 first.

Week one, pretty much as you'd expect, it was pretty uncomfortable, and my thigh seemed to be throwing a tantrum and refusing to work. The exercises, depsite being very gentle, took an enormous effort, but I did them every day, 3 times, as directed. I was allowed to weight bear from day one, with 2 crutches, it was painful the first few days, but started to ease after that. I did need painkillers most of the week though.

Day 4 was very odd, I had strange pains all over the place, my knee developed a severe clickiness and I had shooting pains through my knee all evening. But that settled and by week 3 the clicky knee isn't really obvious. I'm guessing that was all due to the swelling from the traction receding and things slipping back into place gradually, perhaps catching on nerves as it did so.

By the end of the week I could move short distances in the house with one crutch.

Week two, started to feel great. Range of movement was returning, slowly, but getting there, I could also manage the odd few steps without the crutch from one side of kitchen to the other. I could sit and stand without pain inside the hip and I'd been able to straighten it without sticking at all. However, I wasn't really bending it that much, not beyond 90 degrees.

Week three, a few ups and downs. I was distracted by a family problem, so maybe wasn't paying as much attention to being careful and the last 7 or 8 days have been a bit variable. Physio said I still had to use 1 crutch, even at home, and needed to practice walking without leaning into the crutch as much. I think most of last week the aches and pains were more to do with getting my muscles working again, and also loosening up the tightness that had developed. On the whole I felt things were moving in the right direction.

My last physio was 5 days ago, she said I could walk around the house on my own, so long as I could do it properly upright, and without limping. Had to still use a crutch away from the house. So far so good. Then I got to Sunday :th_sigh:

The last few days have been difficult. The weekend was my youngest daughter's birthday, so Sunday we went out for a family meal. Unfortunately it involved a longer walk than I'd done up to then, as we couldn't find parking very close to the restaurant. I say there was no parking, there was a free disabled space outside, but of course we don't get a temporary pass here. I thought it was fine at the time, I wasn't in pain or anything, I used the crutch and I took it slowly. That evening, I bent down for something, quite forgetting myself (which at the time seemed a good thing, I obviously wasn't in pain), and then the pain hit me, right in the hip! It was OK, I got up very slowly, went and sat down and rested.

Early hours of Monday morming I turned over in bed, and pow, my hip got stuck. Very bad news. That used to happen a fair amount, and it used to be up to 12-14 hours before it was possible to free it up, leaving me totally immobilised for that time. I was told that was most likely due to impingment. However, this time, I rolled over a bit and with a bit of wriggling, I could straighten my leg/hip within a minute. Very painful, but I did manage it. Then last night (monday night, less than 24 hours later) I got into bed, rolled over and it did it again! It came unstuck quickly again, less than a minute, so that is a huge improvement. but I have to say I burst into tears at the thought that the op hasn't worked. I've been in pain deep in the hip when I walk ever since then.

I'm trying my best not to be disappointed and to keep some perspective, but it's hard. It's only 3½ weeks, early days. I was warned we won't know if it's worked until maybe 12 weeks or more.

I was so sure I'd be able to give everyone a postive week by week run down of my recovery, but it seems the path isn't as smooth as I thought. I'm resting as much as possible today, and I've pulled back a bit on the exercises, made them super gentle today. I'll take it easy until the pain settles. As I sit here at the computer, I can feel discomfort inside the hip, sort of to the front (as it was pre-op). It's low level, but when I walk it hurts much more. I might use both crutches in fact, take the strain off as much as poss.

Up to yesterday I felt it had been mostly 2 or 3 steps forward and 1 back. This feels like 3 or 4 back. I know I need to be patient, I know I do. I keep telling myself to be patient. It's a bit hard today though.

Hopefully I'll be able to come back with more postitive news in a day or two. Goodness, I wish I could fast forward to 8 weeks, to see how it'll turn out, so I can see these are just blips and it'll be OK. Never mind. It is what it is.

And I'm sorry I haven't sorted out those weblinks I promised, as I said, last week was tricky, what with an elderly relative having problems. I will do it, I just need to sort through my bookmarks as some are better than others.

I'm going to read some other people's experiences now, to remind me that it's not all necessarily a straight line to the finishing post. And sorry this got so long.

 

[Jaycey]

Sorry you are having ups and downs - but that is exactly what recovery is all about. 2 steps forward, 1 step back and then start again.

Be sure to ice and elevate when you can. It does help through the bad days. And yes - if there is discomfort do not hesitate to use your crutches.

Please do keep us updated!

 

[Josephine]

Oh bless you! This phase is dreadful, isn't it - not knowing if you have been through all this for good or less? Really praying it's for the good.

 

[Jamie]

Hang in there, Gum.....you are still very early in recovery and muscles must gain strength to hold everything in place. It takes time and patience....more for some than for others. Hopefully this will all resolve itself as you get farther into recovery. Take care of yourself!!!

 

[Gum168]

Aagghhh, I just spent ages typing a reply with loads of links in it, then managed to navigate away before posting. Ah well, here goes again.

First of all, thanks to everyone for your encouragement. The pain is easing now, and I'm back to one crutch in the house. I've just been resting more and doing the exercises extremely gently. I've gone for fewer repetitions, but more often and not pushing as hard.

I'm not quite sure what went wrong last weekend, but I'll slow down and stop trying to fight back too hard. I'm not a very good patient I've decided. Impatient is more appropriate for me I think. But as my family have been telling me the last few days, if I don't slow down, I'll end up making the recovery take longer. I'm not great at accepting help, I always want to do it myself, but I'm trying say, yes, thank you, more often now.

So sat back on my backside again with a laptop, I've had time to check through my bookmarks for the better websites on hip arthroscopy and impingement (FAI). There are quite a few and a number of blogs, but these are the ones I found most useful. Blogs can be useful, but I'm aware that most of us will be thinking about our hips when we hurt, so most blog postings are when it's not going so well. We don't want to think about it when it's all good, so unfortunately a lot of online experiences can look a bit negative which may not be representative of the experience for most people.

If anyone has any other sites to add, please, please do.

This first one is a good all round site for hip arthroscopy, lots of quite detailed info on here about everything from the reasons for the procedure, through to an example recovery programme.
http://www.hiparthroscopy-ireland.com/index.html

Another site with quite good info on various hip and knee procedures. Follow the links on the left hand menu.
http://hipandkneepain.org/Procedures.aspx

More on hip arthroscopy prodedures. I had numbers 1 and 3.
http://www.hipcenter.org/Hip-Education/hip-arthroscopy-1/surgicalprocedure

This blog is quite good
http://www.understandingfai.com/

There's also an easy to understand video on the same blog here
http://www.understandingfai.com/2009/08/great-video-for-friends-family.html

This is also quite clear and easy to understand.
http://www.hss.edu/conditions_Hip-M...ent's-Guide-Femoro-Acetabular-Impingement.asp

I hope that helps anyone facing or recovering from hip arthroscopy. Since as Josephine says this is a growing area of orthopaedics, I'm sure there'll be lots of people searching for info about it.

 

[Gum168]

Forgot to add this one for anyone trying to persuade the NHS to provide hip arthroscopy.

http://www.nice.org.uk/IPG213

This is the most up to date info from NICE. It's not that up to date (it was reviewed 29 Jan 2011, but info still dated 2007), but that's what there is so far.

It is available if you have private health insurance (you might have to travel), although after the xrays and MR arthrogram we've now used up this year's out patient budget, so we're having to pay for my physio ourselves. Incidentally, the xrays and MR arthrogram were a total waste of money, since neither showed any problems, but sure enough, there was physical damage once they had a proper look inside. It wasn't large, but I have photos to prove it was there. It shows the value of a good surgeon who knows how to listen to his patients and not just rely on image results. Mind you, when he did the impingment test, I shouted at him "No!", and almost shot off the couch. I didn't mean to shout; but boy, did he hit the right spot!

 

[michelle44]

Hi Gum, ive been through Arthroscopy and can understand the frustration with the recovery(very painfull). Have you tried the support site Hipchicksunite its full of FAI storys and recoverys. Take care and remember to rest that poor sore hip. Michelle x

 

[Josephine]

Neat forum! I joined myself as I spotted someone in trouble!
But they don't seem to have any 'informed' mods on there, do they?

 

[Gum168]

Hey thank you for that, that looks like a good forum, thank you.

Pain update - it's good today, looks like my rest has helped. Still got some pain but it's much reduced and not scary. It's half term hol next week, so I'll have to be a bit careful, I promised my 13 yr old a shopping trip with her birthday money, but I'll make use of seats and coffee shops and let her loose a bit more than usual. She is after all a teenager now (Whatever!). She's been wonderful about helping me, so she deserves the trip.

 

[michelle44]

Hi Jo and Gum, so glad you liked Hipchicks and no Jo there is no informed mods to help and advise,you will be a godsend to some of the ladies that seem to pop up every now and then at wits end. You might have already seen but have you tried understanding FAI on facebook,lots of people post op there Gum may be helpful. Take care ladies. x

 

[Josephine]

Don't understand FB, Gum. I have a page and so does BoneSmart but I've never been able to figure it out.

 

[Gum168]

Don't understand FB, Gum. I have a page and so does BoneSmart but I've never been able to figure it out.

Ha, ha, Josephine, we (hubby and I) have a FB page for only 2 reasons.

1, to keep an eye one youngest daughter's activities on there (she's only 13), she reckons we're stalking her, but I agreed to allow her laptop time and to never actually post on her wall, in return to for us being allowed "friend" status so we can monitor things. Her older siblings (3 sisters and a brother) all also monitor, they're all 10 yrs+ older, so old enough to understand the dangers better.

And 2, because some companies are now making special offers only available or notified via FB, which I find irritating, but that's modern life.

Oh, and 3, when our daughters have gone overseas , e.g. Kenya and South Africa over last 2 summers, they posted some pictures on FB for friends and family to see. They were both gone 2 months so it was good see what they were up to and where they were.

However, as for how it all works, I only know what the kids tell us. We observe more than participate.:smile: It's like a whole new web in itself these days. Have you noticed how in advertising some companies are now giving a facebook page web address instead of a dedicated website address of their own? In the end the FB wall becomes too cluttered to be able to sort the wheat from the chaff. I don't like it myself. Hmm, old fuddy duddy alert, methinks I am getting old aren't I.

I will look out for FAI on there though. Thanks for the tip Michelle

Back on topic though, 4 weeks 1 day on, so far so good today, although I haven't braved the icky rain outside for a walk yet. Still got some pain inside the hip though. Not sure how normal that is or if it'll settle. It's all a waiting game isn't it.

Josephine, do you know how many athroscopy patients get monitored long term in the UK? You said you'd been to that conference/gathering, and I wonder how NICE is going to make informed decisions if there are limited long term stats. The more I read, the more I realise the outcomes can be variable, up to several years later even.

 

[Josephine]

How many? Wish I did. Don't think it's reached that level quite yet. There's been an article or two about it in the Journal of Bone and Joint Surgery but nothing of note yet.

I agree with you about FB. And Twitter is the same - a definite no-go area! :th_heehee: