Hello All,
I am a 35 y/o male who is 1 year 4 months post-op from arthroscopic surgery on my left side and 1 year 6 months on my right side. Right side is doing well, but the left has given me continuos problem. Recent MRI shows osteophytes on my femural head.
My question is has anyone had experience with having resurfacing done after FAI surgery? I had both cam and pincer osteoplasty done and I am scared that the bone shaving done may rule me out being a resurfacing candidate.
At this point, I am willing to travel anywhere to be pain free and get my active life back.
Thanks!
I can't comment on having had any surgery prior to my resurfacings but I know there are plenty of others here who have. It will not have any impact on you being a candidate for resurfacing.
I just turned 40, had mine done at 39 and have been suffering since about 31 so similiarish to your situation it seems. I cannot say enough good things about the results of my surgeries and I'm still recovering and improving.
Get into contact with the surgeons you see on this site, the more experienced the better and see what they can do for you. I don't think you'll regret it.
Good luck.
Thank you so much for your reply. I am currently in Chamonix, Fr trying my best to enjoy the mountains, but I am quite limited.
I have a plan to reach out to Dr. Gross, Dr. Su, and Dr. De Smet.
All the best!
You're welcome. You've come to the right place, you'll find an incredible amount of info here and plenty of very very helpful people with experience with exactly what you're going through.
Sorry to hear your hips are badly affecting your trip! I've been there, I totally get it.
You're looking in the right direction for sure. I had narrowed my search to Dr. Su and Dr. Gross. I went with Dr. Gross and couldn't be happier with that decision.
8) Yep Hi Shoto I sent you a message so I hope you have received it.
Yes the bone shaving can make it worse for the resurfacing surgeon however De Smet has had experience at me and I was very very difficult case as expressed in the message.
If your dominant pincer type as I was your internal and external rotation will suck I mean suck..... mine now is about 80 degs before and after the FAI surgery it never changed much this was a massive indication I was not normal.
So keep at asking the questions...
Age - Gender - height - frame size. Cheers K
Thank you so much Karlos. Your message was very kind and insightful. I have reach out to Dr. De Smet, he has already responded to me. I have to send him X-Rays to discuss further.
My FAI surgeries were quite complex as well. Each surgery was just over 3 hours long. I had huge cam deformities, complete labral repair with graft, and acetabular (pincer) resection to address the chondral damage. When I decided to go this route, the surgeon I chose had over 2000 hip arthroscopies and from what I understood at the time, it was the best decision. Knowing what I know now, I would have never gone through with it. It is easy to say this after the fact, but I am so much more limited now then I was before!
Anyhow, trying to stay positive. I have great people around me and this website is such a resource! What this website has done to share experiences and help out is exactly what the world needs! Thank you to all of you for your contribution! I will continue to post updates and more about journey to continue the sharing.
8) Nice Shoto.
Cam deformities are normally ok reduced. 1 has to be careful if and when this is done then ---- resurfacing is that loading on the femur is not fully functional until about a year later due this may be the weak spot. The joint will take it but be careful. Ok also from what I know they in some countries do not touch the ace tabular socket anymore due once they muck around with this it is all over rover,,,,
They make it worse.... So if any one is getting FAI surgery done personally now from what I have seen do not touch the socket only reattach the labrum and remove the cam otherwise they make it worse.
hence mine was a strong pincer or socket FAI I was screwed......... Deep sockets..... But there is light at the end of the tunnel........ Resurfacing "if it is done well"....
Hope it all goes well.... :) Cheers K
Quick update here while I can't sleep (2:45AM here), but at least I got my german shepherd puppy sleeping next to me :)
I had two cortisone injections today. One in the intra-articular and another in the psoas bursa. Hopefully some comfort to come from this. I got them done in Geneva, Switzerland; not cheap as I don't have Swiss insurance! On another note, the fluoroscopy showed the narrow joint spacing and new osteophyte since my surgery 16 months ago. It also showed the acetabular resection and a subchondral cyst on the femoral head. I am ready for surgery! I am just worried about all the bone shaving done that may affect a resurfacing outcome.
On a extremely positive note, I emailed Dr. De Smet two days ago and he responded in less then 24 hours. He said previous ahtroscopic surgies usually don't affect resurfacing, but wants to look at x-rays to be sure. We had a back and forth and all responses were within minutes. Next plan of action is to get new x-rays in France and send them to him. New x-rays will be going to Dr. Gross and Dr. Su as well.
As I keep on trying to sleep, all I remember is my previous surgeon telling me that the scope surgery was a medical no-brainer. This is someone I had done my homework on, had 2000+ scopes, and wasn't in-network!
If anyone is wondering what I am doing in Europe, I'll be more than happy to share..
Shotohips, I got about the same from my hip scopes roughly 2 years then they failed. Dr.Gross has done many patients with failed scopes.
Good luck,
Larry
8) You be fine with the bone shaving just a point to make don't over do it when you get better... take it easy.... You be fine.
The point with FAI an some other hip conditions is they never get worse they issues just go around and around and it limits your functionality in life...
Typically this is what I experienced "it never got worse" But it was bad enough to put me on crutches for 8 years of my life lose a job and create havick for my family as you were now disabled.
I had pictures to the normal surgeon that had cartilage still in my hips so no one was ever going to touch me like that except De Smet. I used to get "your got young man hips"
Good luck Shoto.
Cheers K
I think there is a lot more controversy now in the scope world of what can and cant be fixed in your hip. I frequent some of the other forums and it seems scopes could solve about anything even minor arthritis with the microfracture technique in the past, but surgeons are taking a step back.
I believe they are seeing more failures with the patients with even minimal arthritis. Also, even some of my CAM impingement grew back, so it makes you wonder how effective these FAI scope procedures are if you have large CAM impingements and your hip is torn up, even if you are young.
Interesting topic.
Larry
Thanks for the encouragement, Larry and Karlos. I am looking forward to getting out this cycle. I am really working hard to maintain my very active lifestyle. Like many others, my life revolves these activities and its really engrained into who I am. With that said, I hope I am lucid enough to learn from these experiences and hopefully apply these experience to make me grow as person.
Regarding the scope topic, knowing what I know now, I would not advise it to anyone who has sever case of any impingement or any kind of cartilage damage. I would take how I was feeling before the two surgeries over how I am feeling now any day. I did my right side 1.5 years ago and the left side 1.25 years ago. Prior to the surgeries, I was doing long hikes, multi-pitch climbing, and long days out on my road bike. Now, I haven't even gotten close to that level. I have had setbacks after setbacks. Although, I would say I have learned how to paraglide in the last 4 months :)
Larry, did your scope surgeries include any resecting of your acetabular? My surgeon resected parts of my socket 5mm back. I am concerned this will affect the amount of bone I will have around the new cup, also making me use a smaller one as well. Anyhow, I am very early in the process. The first surgeon should get my x-rays next week.
Thanks again for your input everyone. I am very nervous and scared!
8) Shoto don't be nervous...... Be cool calm......... Ok yep I had all of what you have had done. Resecting .... cam. pincer resection right and left anchors etc..... Bla bla... I was a most difficult patient took hoursand hours of scoping. Did it work nope it made me worse...... Ask De Smet about the patient from New Zealand he will say it was difficult but he made silk out of a sours ear........ Awesome for me..
I do know about all the differences with FAI and your are fighting a losing battle if it is quite bad. As in not normal angles, not normal depth of socket, your activities.... to do with it all.
Resurfacing gets you back on the road again stops knee pain, feet pain, back pain. I can vouch for that.
Don't Panic it takes along time to come right but it will happen... If you have an experienced Resurfacing surgeon.
Cheers K
I had failed scopes, I am just over a month post-op on resurfacing with Dr. Pritchett. My recovery has been slow or normal. I had some serious adductor issues as which might be slowing me down.
He did not mention any issues due to the bone shaving of the FAI. Feel free to PM me if you have any questions.
Thanks for the messages. I sent both of you a PM.
A.S. - hope you have a speedy recovery. I currently have a bad case of psoas tendinitis and bursitis partly because my adductors aren't firing properly. I have been working on this for a while and I definitely want to have this under control incase I am a candidate for the surgery.
I am living Chamonix, FRand it is dumping snow! It's so hard!!
Shotohips, I don't think he touched the acetabular area, I could be wrong. What a an ordeal two surgeries for nothing just like me.
good luck,
Larry
I can totally relate. I had an FAI scope, and two scopes for labral tears. After the first on the labral tear felt better, but my SI joint got really bad. After the second one, I was never able to walk normally again. For three years I limped around in horrible pain, couldn't stand for more than a few minutes, couldn't walk more than a couple of blocks.
Finally I had the resurfacing with Dr. de Smet in December and I'm past that! I feel great, and am getting ready to start seriously riding, and rowing next month.
One of the things I never understood was why it got so much worse after the second surgery. de Smet said that when you have dysplasia (I was born with it) and you do a scope, it often makes the dysplasia worse. It made total sense to me. If you read the literature, scopes for impingement and labral tears work about 50% of the time, and when they fail, it's usually because arthritis is present.
Hopefully this helps. I don't know if resurfacing is what you need, but the surgeons will. Another guy who had surgery the same day I did had FIVE previous scopes, because he was in his 30s and no one wanted to do a hip replacement. He's doing great as well.
Glad to hear you are doing well! It is very encouraging to hear this.
What do they do with the anchors that were installed for the labrum repair?
Shotohips, one thing I recommend is be really slow on your HR recovery. I noticed the psoas on former scope patients is especially finicky. I just got a psoas injection Monday, and know another recent HR patient that also has some PSOAS issues.
Maybe its all the surgeries, who knows just go slow, trust me does not take much to aggravate even with a perfect resurfaced hip.
Good luck,
Larry
Thanks, Larry. My psoas and bursa are already completely inflamed on my left side. I just got a cortisone injection in the psoas bursa and it has helped 40%, but the tendon is still inflamed. Basically, rest is the only thing that makes it feel better me.
This is one of my concerns, I do not want to go into surgery with tendinitis already present. I am a long way out before I get operated, so hopefully this will be put to rest prior the surgery.
My psoas is very problematic on the right side, even after resurfacing. I am hoping the injection I had on Monday helps it out.
Good luck. Hope it feels better soon.
Any tendonitis or tendinopathy I have ever had has taken a lot of rest :/ I am seeing a new PT on Thursday, I will relay any good info I get.
I didn't have any anchors or hardware after my scopes. I do know that the guy I had surgery who had five said there was a lot of scar tissue de Smet had to deal with but it worked out.
As for tendonitis, I had tons of psoas problems before hand. PRP really helped with it, but the hip disfunction just made it impossible to settle. After the surgery I had bursitis on the UN-operated side for a few weeks, probably because of the way I was walking, and that cleared up.
Yesterday working with my trainer (who has a PT on site) we thought my psoas was acting up, but he had me do some specific moves and said the movement that made it hurt indicated that it was indeed a hip flexor but not the psoas, so quad stretching and such are recommended. Some people have psoas problems if the device is not properly placed. With an experienced surgeon this should not be an issue.
8) From my experience having a crook hip joint creates a massive amount of issues due the inflammation from the joint itself, It is never the same issue day in and day out.
But if worn due to age , congenital issue, or injury the issues sometimes are similar. The joint leans itself to this due it is a 3 dimensional joint. So the muscles, tendons, ligaments all change to accommodate the wear and tear or issue.
That could be adductors 1 day, abductors the next, hip flexors the next day etc... hamstring another day....
If this is fixed correctly the opposite happens but it does take some time to readdress itself and strengthen the tendons, muscles and ligaments back up so it is the reverse.
Basically what I have experienced.
Yep had the anchors all the mods to the hips of FAI and it makes you worse.... is what I experienced.
Cheers K :)
Karlos, that makes a lot of sense its seems the people with the prior scopes often have more psoas issues than the un scoped hip to hip resurfacing.
I am dealing with a bad psoas issue, the problem is if you completely stop excessing the glutes shut down and stiffness sets in the HR hip.
Not fun as I thought the HR would be the end to all hip issues
larry
Von - regarding the PRP injection, the radiologist in Geneva, Switzerland who recently administered my cortisone injection into my bursa and the joint said PRP in the tendon was not as responsive because it has to be very accurately placed for it to be effective. On the other hand, I once had a PRP injection in my patella tendon and with a serious rehab it closed the micro lesions. Can you please share this experience with us? I would be willing to give it a go. How long until you felt the affect of it?
As for the psoas itself, it really is a tough one. The one consistent theme I have heard and read is eccentric strengthening and lengthening. I think this is where a good PT comes in. They can tell you wether is really needs to be stretched out or not. I have a hunch over stretching in certain situations can really irritate it.
For my case, I recently went to a new PT here in Chamonix and the PT ordered me to stop doing single leg raises because he thought it was too much! Now he is recommending bent knee raises to chest in a very slow motion and small range of motion. Once there is no pain, then I can progress to a larger range of motion and then eventually to the single leg raise. The theme is to go slow to lengthen and strengthen. From my understanding, the tendinitis or tendinopathy means you have small micro lesions in the tendon which get repaired with other tissue, but sometimes these tissues can restrict your movement and cause stiffness as well. The slow eccentric exercises will help break the tissue and re-allign the new tissue for better movement?? With all this said, does it address the underlying biomechanical issues which Karlos mentioned, probably not. I have been told, I can do any strengthening excercise for the hip as long it doesn't irritate the psoas. Another good reason to have a good PT to work with you..
I am seeing another sports medicine doc here next week who specializes in administering PRP and Prolotherapy. Any feedback on these subjects would be greatly appreciated.
On another subject, I got my X-rays and the are off! Yesterday, my X-rays went to Dr. Brooks, Dr. Gross, Dr. Su, Dr. Pritchett, and Dr. De Smet! I guess I will start another thread to share my experience with the whole starting out process, but so far I have had a really good experience with all of them. I would say Dr. Su's office seemed to be accommodating, but least personal. All the other offices were very responsive. More detail on this in the other thread..
Hope everyone here has a great Saturday morning and an awesome day filled with positive thoughts.
~ RG
8) Sorry Shoto Larry how long has it been since your HR??
Mine has been 10 months since HR with Gross. Had a scope in the same hip Jan-11
The PRP for my psoas wasn't a silver bullet because my hip was still wrecked, but it allowed me to ride many miles and row from Oxford to London even though I had bone on bone arthritis. Without the PRP to the psoas I could barely walk up stairs. I took 2-3 sessions.
But the thing that was important for me was the ultrasound. The doc could look at the tendons on the ultrasound and show you what was going on, fluid, tears, etc. And they used the ultrasound to guide the PRP injection to make sure it went to the right place.
It's not perfect, but if you can stand a cortisone shot, which has side effects, why not try PRP, which has none (as far as I've seen)?
I also just think my soft tissues need all the help they can get with the structural problems I had!
Hi guys, I just read this thread now, some great information from all of you. I am in Ottawa Canada, and had a bilateral scope done by Dr. Beaule 5 years ago for Cam FAI. The scope went well and I recovered quick, but I didn't see this massive change.
Before knowing I had a hip issue, I had dealt with back pain for almost 20 years. Constant sciatica, but managed this through exercise. I played hockey, but found that my lateral movement and balance wads getting significantly worse. I can do anything in a straight line, but it's the moment I open my hips where I am in pain. I have zero internal hip rotation to speak of. I am a police officer and when we do ground fighting training I am in pain the moment I have to open up at the hips.
All that being said, I still remained fairly active. Ironically, despite my bad hips, I always focused on my back pain, and the worst part was thoracic pain and constant tightness.
[/size][size=78%] This past May I woke up with 2 bad bulging discs and was bent over at a 90 degree angle before back surgery in Oct. This went extremely well. I am now scheduled for a bilateral hip resurfacing at the end of April! Hopefully the new metal parts will be the solution I have [/size][size=78%][/size]been looking[size=78%][/size][size=78%] for.[/size][size=78%]
I gave you a bit of may background to show how I ended up here. You are looking for solutions to an FAI scope when it didn't go well. My situation didn't have the severe pain you had, but a steady deterioration and increase in back pain. Dr. Beaule saw me two weeks before my back went out and felt that my pain indicated the need for a resurfacing. I was not at the pain level you are, but perhaps is was the time that had passed that factored in to his decision.
I am a firm believer in using exercise as a major, if not THE biggest component of your health and recovery. Joint mobility work, foam rolling, glute activation and strengthening, have all been aspects of my daily regime to maintain some sort of health level. My current goal is to get in the best shape I can leading into the bilateral resurfacing. I packed on 20 lbs when my back went out!
I bring up all the workouts as I honestly believe it is a component of recovery, pain management, and health maintenance and improvement far to often overlooked. Perhaps overlooked is to strong, but people are hesitant to get active again after surgery, and only get minimal results. As for professional treatment post surgery, I have stayed with my chiropractor who is excellent at A.R.T. treatment to loosen the tight muscles. NEVER went to physio and designed my own workout rehab. I have tried many soft tissue techniques including myofascial release, acupuncture and Rolfing, but nothing was as effective as ART. Not sure if you have tried this for work on your posas.
I have had a few colleagues and friends go through hip resurfacing and two in particular. Both these guys were hockey players in their 40's and each had single hip resurfacing with no previous scopes. One, like me, was a huge workout guy as well, and quickly got back working as a K9 officer, jogs as part of his job and training, and plays a high level of hockey. The other, perhaps it was more psychological or other life stuff that got in the way, but never got the relief he thought he would have. He has never played hockey again, and is much more sedentary than before. He is nervous about his hip. He admits to not having done much to help his recovery and is eager to see how I turn out!!
Sorry for such a long post guys. Seems like a few of you had ongoing issues with your psoas and constant pain. My pain, other than constant thoracic pain, was only aggravated through certain movements I learned to avoid. i hope to be able to open my hips with the new parts. I feel that a planned, progressive program of exercise consisting of mobility work, stretching and strength work to bring about body balance is needed to see the real benefits that this surgery can bring.
If you managed to get this far, thanks.
I hope some of this helped a little. Good luck with searching for more answers. I for one am going all in with the bilateral hip resurfacing and am extremely happy with the work of Dr. Beaule here in Ottawa.
:) Cool hockey guy.
I did 2 hours riding my racing bike toady non stop....... I don't know when this thing is not going to stop getting better and better maybe when I am 60...... I enjoyed the ride no pain. Muscles are getting stronger. I would also pay attention to diet as well. This has been excellent for tissue regeneration. Poor diet poor regeneration.....
However I wont blurb on this is Shoto's post.
Good to see some positive people with HIP Resurfacing...
Cheers K
Thank you for the info everyone. I just finished seeing a sports medicine doctor her in Chamonix, FR and he stated the same thing the doctor in Geneva said about PRP, it is difficult to get good results in the psoas tendon because the size of the tendon and it needs to be placed fairly accurately. I wish there was a doctor here who would administer it under ultrasound. I would still give it a try..
Hockeyguy - Thanks for chiming in and sharing your experience. I wish you the best for you procedure. Keep us updated.
I have spoken to two surgeons so far and waiting for others. I'll eventually create a new post to share those experiences.
RG
Karlos, excellent that you are getting to exercise more and more. I believe so much in diet as well and will be working my best to keep it as clean as possible. My wife is a diet nut and will keep me honest!!
Shoto, I am in Canada and depending how far you are willing to go Dr. Galea in Toronto is a top guy in North America for PRP injections. My wife had several PRP injections by Dr. Galea and it was amazing how many pro athletes travel the world to be treated by him. They have a 4D ultrasound when doing their injections, and also have other options such as bone marrow and stem cell options for the most difficult cases.
Exceptionally far for you, but thought I would throw it out there. Perhaps if you contact them they can tell you where there is a 4D ultra sound machine somewhere on much closer to you.
8) Hockey. 2 books I go by now.
Scientific evidence and facts..
Loren Cordain "The Paleo Diet".
Loren Cordain "The Paleo Answer".
Paleo means old.....
Keep it simple.
2 books world of knowledge.
If you get more interested and want to find out more send me a message get my email.
Rock on.... :)