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Hip scope, looking for some advice/input.

sandman512

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So, was experiencing some pain in my right hip. After an MRI, here are the results:

RESULTS: Mild hip joint degenerative disease with diminished articular cartilage and labral tear/degeneration anterosuperiorly associated with cam femoral acetabular impingement.
Mild gluteal insertional tendinosis and trochanteric bursitis.

My original orthopedic surgeon actually said that I was backed into a corner because he would never let someone scope his hip. He recommends PT. My PT pretty much says, you need to see a specialist, you have a real problem.

Fast forward, I wind up getting an appointment with an orthopedic surgeon affiliated with HSS in NYC. He recommended to have the hip scoped, the labrum re-secured and the bone shaved down. Approximately an hour long procedure. He indicated the recuperation can be tough. I wanted to have the surgery at the end of the summer, he said I probably won't make it (more damage/pain). So, I am scheduled to have the procedure on 5/24.

Any words of advice/wisdom.

Have to be honest, I am a little nervous. Thank you.

Thanks!
 

SE Florida

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Welcome to the forum. I can't comment on your specific situation but I'm sure one of the forum's experienced advisors will be checking in with you soon. You came to the right place for support in your journey!
 

Jaycey

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@sandman512 Welcome to BoneSmart! If you follow this link you will see a list of all the Hip Arthroscopy threads in the hip recovery area. Yes, recovery can be a bit more complex than THR. But as your surgeon suggests - it's best to get this done soon so that you are not limping around causing more impact to other areas.

Fine to ask question on that side. But as you will notice many of the members there have not posted in awhile. They are off living life again! Or feel free to tag members to come and chat on this thread.
 
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sandman512

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Got it, thanks. Hopefully they jump in.
 

Pumpkin

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@sandman512
You will notice I moved your post in recovery to your pre op thread, you will receive more responses to your questions and concerns here. Members from the post op forum check here frequently and will comment with their experiences.
 

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I am facing a similar situation, I have a torn hip labrum with some mild arthritis. Recently had a steroid injection, it is helping, I can sleep at night.
My surgeon is suggesting an arthroscopic surgery to repair the labrum. With the arthritis and being older than you I am thinking a THR might be a better option.

Your going back to work after a week is ambitious, IMO I would plan for more time off.

@Rdwolfe94 and @kdhm0515 have had arthroscopic surgery recently and may be able to advise.
 
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sandman512

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To me this indicates a hip replacement.
So, I have seen two orthopedic surgeons, neither felt a THR was in order. The guy who will be doing my scope(from HSS who specializes in hips) was specifically asked if I needed a THR; he indicated no.
 

Rdwolfe94

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@sandman512. I had the hip scope about 6½ months ago. It was a disaster. My MRI showed less than what your MRI is showing. The recovery is brutal.

My recovery has been ongoing because my joint was too tight and my hip socket was too deep to access the joint but they still shaved cam and pincer impingements and debrided the labrum but because they could not get into the joint, I have tons of damage from the surgery.

Make sure you ask the surgeon what they will do if they cannot access (distract) the joint. I did not know that was even a possibility before surgery. IMO, at your age, 2 years older than I, I would wait it out if you can and get the THR or see if you can get the THR if the pain is too bad right now.

I see a THR Dr on Tuesday. I have seen two Orthopedic Hip scope surgeons at two of the top hospitals in Ohio. Both are Drs for professional sports teams. One did my surgery. They are both recommending against another scope for me at this time. One says replacement. The other says resurfacing or replacement or possible surgical dislocation (HSS states they do not do over the age of 45). If I could do it over again, I would not have gotten the scope.
 

Rdwolfe94

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@sandman512 my MRI said I had unremarkable articular cartilage. I had the surgery because I am or now was a runner and wanted to run again. Again, be cautious. Hindsight is 20/20 but I agree with @Josephine saying that it indicates a hip replacement. I only got one opinion before my scope. Huge mistake. Get multiple opinions and take your time.
 
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sandman512

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Thanks for the reply. I am sorry to hear that your procedure was a mess.

Have to be honest, while I am extremely nervous about this, I feel that I have chosen the right surgeon at HSS (Hospital for Special Surgery). He is a the head team orthopedic surgeon for a professional team as well. We did ask him about a total hip replacement and he indicated that I am not a candidate for that procedure. I can say that the pain has not gotten any better has time goes on.

I have gotten two opinions and both have indicated NO to a hip replacement. This is one of the more nerve racking things I have been through in a while.
 

Rdwolfe94

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@sandman 512 I wish you luck. I do know one running friend of mine who had a good result. She was 46. I know the Dr. you speak of at HSS. I would still get a 3rd opinion. Most Hip Scope surgeons will recommend surgery unless they see severe arthritis. Hip brace and ted hose for 13 days. I was on crutches for 27 days. Off work for just under 12 weeks. Hopefully, they repair the labrum. If not, well as I said, wish I would not have gotten it. Even when successful, it is a brutal recovery. I have had several people tell me that the THR is actually and easier rehab and recovery. Plus at over 50 there is going to be some arthritis. Keep me posted on your journey.
 
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sandman512

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@Rdwolfe, not sure if Drs names are allowed, so I will PM you. I am having a third ortho guy, as a courtesy, review my films and reports. From what I have read the recovery can be tough.

I spoke with the surgeon's PA the other day and she indicated what is an expected recovery (she was viewing my films as we spoke). At this point, I feel like I'm stuck between a rock and hard place. The pain has gotten to the point where I have trouble getting out of a car and can't sit up from a laying down position.
 

Rdwolfe94

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No problem on the PM. I can tell you that my pain is where your pain is now and was not there before surgery. I could bike, lift weights and run a little (not to my liking and why I got the surgery). Getting another opinion never hurts.
 
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sandman512

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Hey, thanks for reply. Just to add a little more, I mentioned about waiting until the end of the summer to have the procedure. My doc replied, you probably wont make it until then. Apparently the labrum is pretty well torn. I can tell you that it's not getting better. Funny you mentioned Dr. Kelly. He was my first choice based on reputation, he doesn't take my insurance.
 

Josephine

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Folks, please don't share this information via PM. I'd prefer that comments like this go in your thread and not in a private message. Otherwise the general readership is deprived of the information which is why BoneSmart works as well as it does. Thanks very much for understanding this.

and the bone shaved down
This is a surgical way to achieve in minutes what arthritis does in months!
 
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sandman512

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@Josephine, I am confused at your comment, "This is a surgical way to achieve in minutes what arthritis does in months!". My orthopedist, a highly regarded surgeon performs multiple procedures a year in which I assume involves this. Is he speeding up an inevitable arthritic condition? While at this point, I would probably like a THR, two surgeons have said that I am not a candidate. I currently have a third surgeon reviewing my case. Thank you.
 

Josephine

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Is he speeding up an inevitable arthritic condition?
Exactly! Sorry to be the bearer of bad news but it's the truth. Surgeons are much like any other keen work man, give him a Dremel tool and he look for rough bits anywhere to smooth out. Only in hips and knees, it has the adverse affect.

dremmel.JPG
 

CPH

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Or as we say in the US, "if all you have is a hammer, everything looks like a nail".
Although everyone's case/experience/Dr. is different, my highly regarded OS (one who will be doing my surgery in 2 weeks) said after looking closely at my X-rays from a year ago, that it looked like I may have had a labral tear that was probably caused by pincer lesions and some hip dysplasia (Ortho at that time diagnosed me with Adhesive Capsullitis "frozen hip") When I asked my new OS if repairing the tear it at the time would have prevented the need for THR he said probably not. He indicated that labral repairs are not often successful when OA is present and there are other structural issues like the pincer lesions. He said most of the success in making repairs are on younger patients where there has been a traumatic injury, but otherwise no structural issues.
 

Rdwolfe94

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@sandman512 I looked at your original thread again. As I said, I had less on my MRI before my scope. 6 and 1/2 months later, I am worse than before surgery. And interestingly. My MRI I had 6 months post op now shows exactly what your MRI is showing and I have been told by two hip scope surgeons and a replacement specialist that another scope would be a complete waste and may give me relief for 2-3 years minus what could be 18 moths of rehab and the success of going back in would be 50/50.
 

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