Scope or THR, my choice but not resurfacing

[theonlysuz]

Hi, I am new here, female, athletic, 65 and live in central Vt.

I have a torn labrum and cyst on my left hip. The injury happened in Jun 2002 during a tough ski conditioning class and was only diagnosed in April 2010.  For 8 years I had trouble sitting, lying on my back or my left side.  I had PT with 5 different groups, pain management including an opioid patch which I still have, psychologists, acupuncture and other alt therapies etc.  None of these would have fixed the torn labrum and if I had been diagnosed earlier I may not have had the extent of injury that I have now - don't know this.  There is some arthritis there now as well.  But anyway... I kept looking for a better answer and finally...

So, I saw Dr. Ivan Tomek at Dartmouth twice in Apri and May and after more MRI's and x-ray he said that he would prefer to do a scope because he wants to preserve bone but that my chances of success may be 50% or less because of a connective tissue disorder (EDS Type IV).  Otherwise I can have a THR, cementless ceramic, with a muscle saving incision, and a quicker recovery.  He did not suggest a Debridement / resurfacing (same thing?) although he says he does all the procedures.

Is there anyone here who has had resurfacing with EDS as a contingency?

Also, I have been introduced to Dr. Corey Burak in Sleepy Hollow NY who does a lateral MIS surgery and he suggested I send him my films and history and he would advise.  Any opinions on this?

Thank you for the site.

Susie

[resurface]

Susie

Hi.  I had a similar experience in that I was years late in knowing that I had a labrum tear.  A debridement ss just what you think.... removal of something usually tissue, meniscus, etc.  It is not resurfacing.   I have no idea about EDS.  As far as a lateral MIS, this is the approach that was done with my resurfacing procedure.  My surgeon does all his in this fashion {Dan Snyder at Newton Wellsley}.  THR procedure are even done more anteriorly.

I bet the decision comes down to "damage" as a result of the labrum tear, this EDS thing, your age, expected implant longevity (THR vs resurfacing] and being a female. 

Good luck...

[Pat Walter]

Hi Susie

Welcome to Hip Talk.  I know many people have not had the scope work well for them and I think there is a long recovery time.  Can't tell you for sure - but you need to ask about the recovery time and the sucess rates of that type of procedure.

Also make sure if  you consider a THR that you get a large ball MOM metal on metal or ceramic on ceramic.  If they give you a small ball oldfashioned metal/plastic THR - you will have many limitations and possibly dislocations.  The large ball, modern MOM and ceramic THRs have a ball size that more match your original femur bone ball and don't dislocate easily.  That is why resurfacing is so great - you keep your full femur bone and a metal cap is placed on the ball of your femur while a metal cup is placed into your acetabulum.  It is the same cup for both a resurfacing and a MOM for the acetabulum.  ONly the femur components are different. 

Make sure to ask a lot of questions about your recovery and what device you will get.  What you can and can't do after your heal. Ask for the names of other patients to talk to to see how their surgeries went.  You need to use very experinced surgeons for THRs just as you do for hip resurfacing.  Since you are 65, it might be diffiuclt to find a surgeon that would give you a resurfacing.  You would have to ask someone like Dr. Gross of SC.  You can send him an email with a copy of your x-rays in a digital format as a .jpg and he will give you a free phone consultation.  He has done almost 2000 resurfacings and is one of the best in the world.

Pat