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Hello. I’m newly diagnosed protusio acetabuli

Franqui62

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Hello everyone. I was recently diagnosed with bilateral protusio. The specialist says it’s “longstanding “, but I landed on the left one when I fell in June 2018, breaking my right ankle at same time. I’m nearly 59 and also have osteopenia, diagnosed when I had breast cancer in 2016.

I have had a bit of physio pre-diagnosis, but wasn’t getting on very well with it. The specialist seems to think that physio is the way ahead and I just need to stretch the muscles around, which have become tight after using crutches. I am seeing a new physio tomorrow to that end.

I drive trams, which involves quite a lot of climbing up and down, swinging points, not just driving. As it’s safety critical, and pain meds have to be run past the Occupational Health Doctor. I’m currently cleared to have four 30/500 co-codamol on work days. However, I am starting to find these inadequate. I need to continue working, although I have cut my hours.

MRI and X-rays have shown I have mild to moderate osteoarthritis in both hips and knees, in addition to the protusios.

I’m feeling I should get a second opinion as the pain is near constant, and worsening. I’m getting insomnia as I can’t get comfortable despite a fab mattress. And I’m worried if it suddenly worsens and I can’t work. Should I be pushing for replacement? I am pushing 60 after all! The protusio X-ray shows both sockets well into the pelvis.

Thanks for reading.
 
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Pumpkln

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@Franqui62
Welcome to BoneSmart, glad you joined us! :welome:
Sorry you are having to go through so much with your hips and require opioids to work.
I’m currently cleared to have four 30/500 co-codamol on work days.
MRI and X-rays have shown I have mild to moderate osteoarthritis in both hips and knees, in addition to the protusios.
Given that you need opioids for work, have mild to moderate arthritis, and protusio acetabuli,it sounds like you are ready for hip replacements so you can have your life back once healed.
Should I be pushing for replacement?
IMO, yes!
The arthritis and protusio acetabuli are only going to get worse, resulting a more difficult surgery as your hips continue to deteriorate.

In the reading I am leaving you there is a score chart for hips, score the chart for your hips so you and your surgeon can see just how much your life has become. Age is not a the determinate for having a THR, it is how are your functioning in your daily life.

New BoneSmart members like you are in various stages of their journey to joint replacement. Making the decision whether or not to have surgery and preparing for surgery can be easier once you have done your research and know what lies ahead. Here are some tools that can help you decide what is best for you.

If you are at the stage where you have joint pain but don't know for sure if you are ready to have surgery, these links may help:
Score Chart: How bad is my arthritic hip?
Choosing a surgeon and a prosthesis
BMI Calculator - What to do if your surgeon says you're too heavy for joint replacement surgery
Longevity of implants and revisions: How long will my new joint last?

If you are at the stage where you are planning to have surgery but are looking for information so you can be better prepared for what is to come, take a look at these links:
Recovery Aids: A comprehensive list for hospital and home
Recliner Chairs: Things you need to know if buying one for your recovery
Pre-Op Interviews: What's involved?

And if you want to picture what your life might be like with a replaced hip, take a look at the posts and threads from other BoneSmarties provided in this link:
Stories of amazing hip recoveries
 

Jaycey

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@Franqui62 Welcome to BoneSmart! Sounds like it's time to push for THR. As you know very well, the combination of needing pain medication and sleep issues is really dangerous in your line of work. If your current consultant won't consider this please do get a second opinion. Hips can go from tolerable to horrid very quickly.

If you need help finding a surgeon please give a shout.
 
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Franqui62

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Thanks @pumpkin and @Jaycey I had the physio session today and was in so much pain. Apparently I have to go to three sessions before it will be escalated. I was given some more exercises, but they are reasonably OK (whether I’d have been given more if I hadn’t been in such pain, I’m not sure). When I came out, the nurse said I was white and made me sit and have some water before leaving. The rest of the day I’ve been in loads of pain.

I’ve decided to get a second opinion. Do you know any surgeons in the North West UK who have experience with protusio? Thanks
 

Jaycey

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@Franqui62 I feel so bad for you. All that PT is only aggravating your hip. Unfortunately we are seeing a lot of these roadblocks to care here in the UK.

Can you tell me what hospitals are near you and who you saw earlier? We need to find a surgeon with no connection to your current OS.
 
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Franqui62

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@Jaycey I am in Ashton under Lyne, so anywhere Greater Manchester.
The surgeon I’ve seen is Mr Tony Clayson.
 

Jaycey

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@Franqui62 I have been doing some research. Would you be willing to travel to Stepping Hill Hospital in Stockport? Mr Mike O'Connor has some good numbers for THRs performed (153 in a year) and focuses on younger patients (you are in that category). His profile looks very good with an interest in the more challenging hip cases.

If you are interested in seeing him you would need to get a referral from your GP. Insist on a refer to a designated consultant. They may push back - but it is your right to choose.

One route I always recommend is that if you can afford to see a consultant for a private consultation, start there. You will get an appointment in a matter of days. Take your list of questions and have a good discussion with the consultant. Then ask to get on their NHS list. I've done this with both my THRs.

Just a heads up - wait times for orthopaedic are at record high levels.

Let me know if this guy is too far for you and I will suggest others.
 
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Franqui62

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Thanks @Jaycey . I have noted Mr O’Connor, but as the pain is so bad at present, have managed to book a private consultation with Professor Max Fehily at The Spire on 16th. Will let you know how that goes, and thanks for your help.
 

Jaycey

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@Franqui62 So glad you could get something quickly. Prof Fehily's numbers on his private site look good. They don't match what was on the National Joint Registry but that might be more of a reporting error from the hospitals he works in.

Get your list of questions ready and if you have a copy of a recent x-ray do take it with you.

Please let us know how it goes. Fingers crossed for you!
 
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Franqui62

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@Jaycey thanks. How do I go about getting copy of the X-rays etc? Will the surgeon be able to access my NHS file, where I presume they’re stored?
 

Jaycey

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You could request a copy from the hospital radiology lab. It will probably cost you around £10 for each image (x-ray and MRI) and they usually put it on a CD. In my experience surgeons can't access your files - unfortunate as there is tons of duplication. Getting a copy of the MRI might save you a bit of money.

Your new surgeon might want a fresh x-ray for his own use, so I would stress about getting the old copy.
 

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