What should I do?

[Renee P]

Hi Everyone,

My story is a long one and I'll try to keep it as short as I can.  Basically, I hurt my hip 20 years ago in college.  After 19 years of undiagnosed pain, I had a hipscope and my OS found a labral tear, loose bodies and OA worn to the bone in an area of my acetabulum.  None of this showed on x-rays or MRI.  I was told about resurfacing, went to a new OS after a problem with the other one, and the new OS also found hip dysplasia.  He said I am a candidate for resurfacing, and to let him know when I'm ready to do it.  He said I have time because I have cartialge left and I am not yet limping.

Now 5 months later, my pain has increased somewhat, I am taking tramadol for pain when it gets really uncomfortable.  The tramadol doesn't always work.  I am starting to get knee pain and some lower back discomfort.  A friend suggested I see if I have a pinched nerve.  I went to my chiropractor, he evaluated me and does not believe my back is the issue.  He thinks I have referred hip pain.  He said I have amazing ROM and that I am hyper-flexible...which can be explained by having shallow hip sockets. 

My question is this:  Should I go back to the OS yet and have updated x-rays, or should I wait until I have a significant increase in pain and am limping before I go back?  Am I nuts for wanting my hip to just deteriorate completely so I can have resurfacing and be done with it?  I'm so sick of this pain...it's been decades...and I'm only 39.

I really appreciate any advice anyone is willing to give!

Renee

[Pat Walter]

Hi
Welcome to Hip Talk

I am sorry to hear about your pain.  Only you can decide how much pain you want to put up with and how much it is affecting your life.  I will also say that you can wait too long and go beyond the window of opportunity to have a hip resurfacing.

I would assume if your OS says you are ready for a hip resurfacing - you are ready.  Most of the really experienced hip resurfacing doctors will not do hips that do not require hip resurfacing yet.

I had my left hip resurfacing with Dr. De Smet in Belgium and asked about my right hip.  It has always had pain too.  He reassured me that it was not time.  1 1/2 years later I had new x-rays and again he assures me it is not time.

I would also suggest that if you have speical problems like hip dysplasia that you use a really experienced hip resurfacing surgeon.  The medical studies suggest a surgeon with at least 100 hip resurfacings.  But personally, I wanted one with thousands or at least many hundreds.  HIp resurfacing is a very technical surgery, much more than a THR, and you need experienced to pull of difficult cases.

DO you know how many hip resurfacings your OS has done? HAs he/she done many dysplasia hip resurfacings?

You are very young at 39 and should have your life and activities back. You don't want to take a chance that you will wake up with a THR. I don't know where you live, but you can see many of the experienced surgeons on my doctors list.  If I had a difficult hip problem, I would want to get input from several of the really experienced surgeons. You need to ask what chance there might be of waking up with a THR.  Your surgeon should be honest with you.

Hopefully some other people will talk with you.  Sounds to me like you want to get on with your life and that is by having a hip resurfacing.

Pat

[tseeley]

Hi Renee,

I say make a stand and don't tolerate any more pain. I'm in the same boat as you and I refuse to take it any more, and neither should you.

best,

tom

[Maggie]

Hi Renee
in my experience the condition of your hip can change very rapidly for the worse and as Pat says the window of opportunity can pass for a resurfacing. I will have my first resurfacing in 10 days time. I have been struggling for a number of years, and like you still had great ROM until 12 months back, due to the shallow socket and some hypermobility. This had confused many OS's I saw because they expect hip OA to leave you with stiffness and very limited movement. Fortunately my surgeon Professor Richardson is an expert on early OA and recognised my difficulties! I had  my second arthroscopy a year ago and he still thought I wasn't ready for the resurfacing but I didn't recover from that op and infact got much worse very quickly, by July I was bone on bone and went straight on his list (I'm an NHS patient in the UK). I don't know if the arthroscopy actually speeded up the deterioration, certainly we were all shocked by my last MRI and plain Xray including the surgeon! The wait should have been 5 months, but I have been called early. We won't know for sure that my hip is good enough for a BHR until they get in there and I may still end up with a THR (not ideal at 45, even less at your young 39!) so my advice would be get on with it. I know I speak from the pre-op side of the debate but I also know that I will be so much better after this! Pain grinds you down and you know when you've had enough.

Good luck

Maggie