IT Band Lengthening/Release

[Trootmanp30]

For anyone that has doctor(s) suggesting hip IT Band release and/or bursectomy, please exhaust ALL non operative options then get another opinion. Sharing to help others evaluate with very real risks that some doctors won't share.

Right hip:
My doctor is a hip FAI expert in the U.S. and was voted a top doctor, working with an NFL team. That said, he suggested IT Band lengthening + bursectomy with the FAI arthroscopy as if it were a standard part of the procedure. That hip is pretty much totalled 4 years after surgery and far worse than the symptoms before operation. Glutes are permanently strained and my lower spine is chronically misaligned (hip hike/trendelenburg sign). IT Band, glutes, and surrounding soft tissues are vital for weight bearing up and down the kinetic chain. It's hard to believe surgeons and physical therapists would recommend this knowing the anatomical impacts of the release + scar tissue. I was a very active athlete and outdoor hobbyist before this. Diligent long term PT and dry needling in my 20's has me very concerned for a future of ortho health. Hip replacement is still inevitable, but it doesn't take a surgeon to know that won't solve the residual issues.

Left hip:
This same surgeon suggested SIMULTANEOUS knee + hip arthroscopy during evaluations for my left hip. The meniscus issue was minor and caused by overcompensating. I swifty turned this down, but was shocked at how telling this was for the MD's approach. This surgery was suggested after all the negative results with the right one (first surgery).

If you feel like more is being suggested than necessary, trust your gut. Some doctors have financial gain with each surgery code + subsequent PT.

I don't mean to be overly negative, but the truth is I completely regret going along with this and want to help others avoid a similar outcome. I see more of this on orthopedic specialists websites since my surgery, which is concerning.

Sore hips with activity and sports is manageable. A ruined hip and new lifelong spine issues are not.

-30 and white knuckling it post op.

 

[Elf1]

@Trootmanp30 welcome to the forum, not sure I can be of much help but I wanted to ask a few things that might help others with your predicament.

If I'm reading your post correctly you had a FAI of your right hip as well as IT band lengthening and a bursectomy, all in one surgery in 2018 sometime? If you could give me the date or dates of the surgeries it would be helpful.

Have you possibly been to another orthopaedic surgeon, especially one not connected in anyway to your previous surgeon to get a second opinion of what is going on?

And are you currently doing physical therapy of any sort and if so what/how much.

 

[Trootmanp30]

@Elf1 Thanks for the note. Correct, right hip October 2018 FAI arthroscopy + IT Band lengthening with bursectomy. Left hip FAI (cam) arthroscopy and acetabular labrum repair in 2019. I did extensive PT and dry needle throughout 2018-2020, then referred to a postural restoration PT. That was a bit of a last effort before being referred to a pain clinic. This specialty PT has not seemed effective because of anatomical changes/limitations. I have seen hip specialists at Mayo and Tria in my area, but unfortunately I trusted the leading expert at TCO as a first resort. The others can only offer more PT or a pain clinic referral. They've said "I'm sure you're learning a lot about anatomy at this point", which is an understatement.

Although hip replacement is invasive and challenging at times, my experience has not proved to be successful in aleviating the issue and preserving the joint long term.

My goal is to share this outcome for visibility given that the leading provider in my area is now listing this procedure as a solution. The post op attention has been limited because results weren't favorable. I haven't been to a spine specialist yet, but feel the residual issues daily.

I apppreciate any expert advise.

 

[Elf1]

@Trootmanp30 wow, you've been through the works. I know we have some folks that have had the bursectomy and believe there might even be some that have had the IT band release, I'll have to try to jog my memory.

If you do get the chance to see a spine surgeon, preferably neurosurgeon, it might prove helpful. I know I had a lot of pain issues prior to my L5/S1 fusion. Its not perfect but it stopped the discs from pinching the nerves every time I bent in any direction.

Bear with us, its been kind if slow since its the holidays so think a lot of staff are taking a much needed breather. Hopefully we'll have more folks on in the next day or two.

 

[Trootmanp30]

@Elf1 Thanks again for the contribution and hope you're alright in your circumstances. Right, it was presented so matter of fact-all within this doctor's FAI surgery plan, but has proved to be quite the works.

I'll be keeping an eye out in this forum and wish the best for others focused on some of the largest joints!

 

[Jamie]

Your experience is definitely not what we like to hear on BoneSmart and I'm so sorry that you have had so many problems with the procedures your surgeon recommended and performed. I know it would be inconvenient, but you might consider doing a long-distance consultation with the surgeons at the Hospital for Special Surgery in New York City. At least you would have some new eyes on your situation that might be able to offer help for you.

The messages you provide for our members are good ones, though. These surgeries are serious business and a person is better served with more than one opinion before having the procedure done. Even "experts" don't always have the right answer. And....trust your gut feelings when considering a particular procedure and surgeon.

 

[ljpviper]

Wow, your young to have all these hip issues. Yeah, wondering why they messed with your IT band when you had the scope. Never seen this done in parallel.

Unfortunately I do think a hip replacement is in your future. You have a valid concern of all the surrounding muscle tendon issues you have. The hip replacement will add more trauma to these areas.

I think one of the issues with multiple surgeries is scar tissue in the areas of the hip that develops. Some people develop more scar tissue than others. It can impede recovery long term.

I would get a few options from different surgeons how to proceed. Feel free to PM me as I have been through scope, resurfacing and hip replacement. My hip issues started at 39. I learned alot going through all the surgeries.

Thanks,

Larry

 

[clodaghcov]

Having had hip surgery from the age of 30 and first replacement at 33, which led to 7-8 revisions, 3 infections, spacers and much much more, I would always advise any one young to avoid surgery young as much as possible. I am now 75 and yes, have a artificial hip and can get around, drive and lead a normal life, but it has been no picnic. I became a medical secretary to learn a lot of what was going on with me and I was finally told I never should have been operated on, it all should have been done by physio, helps you to understand how I would want to prevent this happening to anyone else young. Good luck and big hugs xx

 

[Trootmanp30]

It's becoming more common to see hip surgery for people in their 20's-30's as it's often marketed as a preservation to stave off arthritis/replacement. I know 4 other guys that underwent FAI arthroscopy within that same year-all active former athletes in their 20's.

It appears similar to when meniscus and knee scopes received approval for common practice. While the hip and surrounding tissue have more kinetic chain implications.

 

[Elf1]

@ljpviper thanks for sharing your experience with @Trootmanp30 but would ask if you guys could keep as much on the forum as possible so others can benefit as well. And it sure would be useful and informative for the staff. I do understand that folks sometimes don't want everything out there in the open.

 

[ljpviper]

Ok sorry about that.

 

[DollyS]

Oh boy, this scares me to read! I’ve not been the same since bthr 2 1/2 years ago. I’ve gone to 5 doctors one of which was at Mayo clinic. No one has ever seen my condition before. . I have not been able to bring my legs together and in order to stand up straight it causes tremendous stress on my legs and back. This has caused my gate to be off and I trip and fall a lot. the last doctor said that my ITb are too short/ tight and that lengthening them would give me a normal life again. My hips were widened 3 to 5 mm during surgery which I’m told was within the normal parameters, but this obviously contributed to my issues.

 

[JusticeRider]

@Trootmanp30 thanks for sharing your experience as a cautionary tale. It’s a frightening reminder of how much trust we place in these surgeons and how at their mercy we are to a certain extent. I have had 2 FAI surgeries, one at 37 and one at 43 that had good outcomes. I did not have an IT band release and now I feel I dodged a bullet! I’m glad it was not offered to me…who knows, I may have agreed. I’m so sorry you are struggling with complications now. I know how devastating it can be to deal with pain and disfunction at a young age. I agree with Jamie that you need a fresh set of eyes (or two or three) to evaluate your situation, far away from the original surgeon who worked on you.

Wishing you health, healing, and hope in the new year!

 

[spaniel]

I cannot thank you enough for your very honest and frank appraisal of your surgical experience. My surgeon (Mayo trained) will not discuss the kinetic chain implications. In fact only the secretary gives advice shielding the surgeon at this point. As mentioned here, one thought is HSS but frankly I’d go in person before signing off on the criteria of the distance consultation. Another thought is NYU Langone as financially they seem to be easier to deal with. May I ask if your PT was financially connected to your surgical doc or center?