CAM Impingement - know anyone in Melbourne?

MelHipster

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Hi there, fellow hipsters.
My friend Diane told me about this forum, she's had a successful THR in New Zealand.

I'm in Melbourne and finding it really difficult to get care! So if you know of anyone good in Melbourne, PLEASE post!!!

So the thumbnail story:
* pain in right hip for 7 years.
* totally fine prior to this - running, walking, stretching, cycling etc, with no issues.
* had baby #4 at age 43, three weeks later, took one step - ouch. Hip pain.
* rapid deterioration since then, with erratic grabbing pain in the hip - it's random, you never know when it's going to grab.
* GP said, "Oh it's because you gave birth. From being up in stirrups". (The fact that I gave birth kneeling at home in a birth pool wasn't sufficient to dislodge this fixed opinion).
* Tried physio - same
* Tried chiro - same
* Finally, the CHIRO (!! not the GP!) referred me for an Xray!
* Xray notes state: "There is a right femoral CAM deformity. The right acetabulum appears to be mildly dysplastic. Further workup would be appropriate particularly with the history of 5 years of hip pain"

Finally the GP deigned to refer me to an orthopaedic surgeon. Of him, I asked, "What are my option?" He decided that at the age of 48, I was TOO OLD to have the procedure to repair a CAM deformity (I believe this is the procedure where they use a powered burr to "trim" the CAM via arthroscopy?) His reply: "You'll just have to suffer until you are 'ready' for a hip replacement". This was 2 years ago.

He referred me for an MRI. I went to Box Hill for this (2 hours drive from my home). There, they let me fill out paperwork and wait for about an hour, then took me in to the Xray rooms where they informed me that "We don't do 'that kind' of MRI here." Neither could they inform me just where exactly, I could get 'that kind' of MRI done ...

So now, we are going to see a guy called John O'Donnell. Apparently he is an orthopaedic surgeon. However, the GP told me today that because he is a private surgeon, he will not see me because I do not have private health insurance (I have a Health Care Card).

At this point, after 7 years of being unable to walk or run or climb stairs without pain, even rolling over in bed is painful, I am concerned at my deteriorating condition and fitness. I am 51 years old and I feel like they are just fobbing me off as too old and female to be bothered with.

So if anyone out there has any clue at all about what to do for CAM deformity and dysplasia (note - I was born breech) - I would LOVE to hear from you.

I was a runner, hiker and outdoor adventurer, all my children are rock climbers, campers and hikers. I am really grieving my life-long fitness and the ability to do things with them.

(I should add what I *have* been doing: trying to reduce inflammation: cutting out sugar, coffee, dairy, wheat, taking turmeric, white willow, prickly ash, devil's claw, boswellia, celery seed, ginger, black pepper, brocolli sprout powder, fish oil, glucosamine etc.)

Thanks for listening - and bring on the pearls of wisdom!
 
Last edited:
Hi!
Welcome to BoneSmart!
I'm still stuck at Baby # 4 at age 43! Superwoman :wink:

Let's have the Nurse Director, @Josephine weigh in on your situation and questions.
She's seen it all through 50+ yrs experience in Orthopedics. She'd be best to direct you.
I've tagged her for you, so please check back.
Wishing you comfort as you make decisions and move forward.
@MelHipster
 
Xray notes state: "There is a right femoral CAM deformity. The right acetabulum appears to be mildly dysplastic.
Yep, that's what it sounds like! Read these articles
Femoro-Acetabular Impingement (FAI)
FIA - a review of diagnosis and management
FIA: Femoro-acetabular Impingement. Does Physiotherapy Improve Symptoms
He decided that at the age of 48, I was TOO OLD to have the procedure to repair a CAM deformity
That was very rude but I wouldn't recommend it anyway. The hip arthroscopy isn't exactly bathed with great outcomes and many end up having to have a hip replacement anyway. Only problem is, though you might still be in bad pain, no-one will see you until you're a year out from the scope!
I am concerned at my deteriorating condition and fitness
And so you should be.
I am 51 years old and I feel like they are just fobbing me off as too old and female to be bothered with.
I think it probably more that they don't know what to do with you! FAI is a fairly recent addition to the orthopaedic armamentorium and there are STILL hip surgeons who haven't a clue how to even diagnose them much less treat them.

But I think in your case, it sounds more like you should totally skip the arthroscopic treatment and pitch straight in for a hip replacement. So stop worrying about the FIA (or 'cam' deformity) and start talking about a replacement straight off.

Another thing you could do is to print off this form I've attached here. Then complete it and give it to the next surgeon you see. It will cut down on the interview about 60% because it will tell him pretty much all he needs to know about how this problem impacts your life. But do be honest in your answers. Don't under or overplay them as we can tell if you do! The results are just for you and your surgeon so don't post them on here.
 

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@Josephine is right about arthroscopic work for FAI vs THR. I can tell you in my experience, arthroscopic fixes for FAI was a short-term solution. Worked out for a little under a year - pain started returning after around 6 months. Felt OK for a while, but OA decided it wasn't going to go gently into that good night. It kept deteriorating, and even seemed to speed up based on my pain levels just before I had my first THR.

As for "You'll just have to suffer" - to heck with that. Good luck finding a surgeon that will listen to you and work with you to figure out a path, including THR.
 
Hi @MelHipster ....just dropping by to say welcome to the forum.....Mojo thought you were a fellow Kiwi and I could help with questions, but I see you're in Australia, so I can't help with anything local to you. I do hope you find a more clued-up surgeon who listens to you properly.......you need to have confidence that they know what they're talking about! You've made a great first move by joining BS....everyone is so friendly and supportive and I'm sure it won't be long before someone from your neck of the woods pops up to make suggestions. It's all a bit of a journey, but you'll get there in the end :)
 
:blush::blush:PS..
Close, but no cigar.
:shrug:
 
Hi Anny, thanks for posting! Well funny thing is, though I was born in Australia, I went to school in NZ, did RCompN at what was then "ATI" and nursed at Taumaranui during my first post-grad year - and there was a surgeon from South Africa who specialised in, guess what, THR and so at that time I nursed quite a few THR pre and post op! People would come from all over NZ for their THR because of the super short waiting lists and his skill as a surgeon and we took good care of them all. Small country hospital! I didn't get to see how they were going a few months down the track, though.
 
I just remembered another piece of the puzzle.

I was born BREECH (at Box Hill hospital in 1967).

I'm told I was removed from my mother immediately after birth - she was not permitted to see me, hold me or smell me until THREE DAYS after I was born - not even one tiny touch before they took me away. Apparently, the reason for this was they knew that my paternal Aunt (who was also born at Box Hill hospital) was crippled all her life with severe hip dysplasia from being born breech, which was not picked up at the newborn screening (I'm guessing they didn't know as much about checking for "clicky hips", symmetrical creases etc, back then.)

Anyone else out there born breech resulting in hip issues later on? I'm told it's A Thing?
 
I just went to the search feature and entered 'breech' in the keywords search box.
Indeed there alot of folks discussing this.
Check it out!
 
Hi Mel.....so you came across THR at quite an early age, and you possibly know more about NZ than me as I've only been here 12 years! Hope you unravel the breech thing....unanswered questions tend to hang around. Your poor mum....must have been very hard for her to be separated from her new baby like that :sad:
 
Hello bone smart people! An update.

I had an MRI finally, which showed that: "the right acetabular cup is perhaps a little shallower than the lieft. There is a large oblique tear involving the anterosuperior rim. No paralebral cyst. No other features of femoroacetabular impingement. No thinning of cartilage and the ligamentum flavum is in continuity. Minor joint effusion."

So a little bad news, a little good news.

One thing I was happy to see was "articular cartilage is preserved"

So the Dr I saw (John O'Donnell) has recommended a hip arthrotomy (basically to sew the labrum back in place) and a "stabilization of the joint". These two procedures cost $1500 each and with hospital fees the bill will be about $11,000.

(Or I could wait a couple of years on the public system - but as I've been in pain for 7 years now … I don't know if I can put up with this any longer!)

I am posting here because I would love more information about what exactly a hip arthrotomy is, and what the procedure called "stabilization of the joint" is about.

All advice and insights are most welcome!

Thank you so much, I am very grateful this site exists.
 

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