Shallow hips with bone spurs?

[carolines]

For years, I thought I had a groin pull in my right hip.  Last December, I kicked a stair going up and caught myself, all with the right leg.  Instant pain. Went through December and part of January in pain.  Finally went to the doctor as I was not getting any better.  Originally thought to have a labrum tear. After X-rays, an MRI, more x-rays and another doctor, I was told I had bone spurs on the top of the right hip joint.  And surprise! Shallow hips.  The 2nd doctor gave me 3 options: a cortisone shot to deal with the pain right now; go in and clean up the joint, removing the spurs; or a Total Hip Replacement.  This was back in March 2010. I opted for the shot so that I could think over my options.  He wanted to do it that afternoon, but I live 4 hours away and had not planned to stay overnight.  So, I came home and made arrangements locally... that took 2 more weeks.  The local doctor did the cortisone shot under general anesthesia.  I was extremely sore for 2 days, and then I had NO pain.  I can't even remember when I had NO pain, so I've been living with the condition longer than I thought.  Anyway.  The local doctor was pleased, but did say that the effects are different on everyone.  If it lasts only a month, then I would need to look at something else; if it lasts longer, say 6 months, then he would be willing to give me another shot after that.
Well... it lasted a month.  Then I would have a couple of bad days and then some good days.  Now, Aug/Sept I am having more bad days than good days.
I work with a trainer 3 days a week.  I can do the eliptical machine for maybe 10 minutes. I am having difficulty getting in and out of a car and in general, not able to get around very much.
I'm 4'10", 174 ( I know, I am working on this... hard to do when you can't walk), 54, female. With the shallow hips, spurs and weight, is this Birmingham re-surfacing even an option for me?  My last bone density (last year) was normal.  Thank you for any advice/information!

[resurface]

Did you ask your doctor for his opinion about resurfacing? 

[Pat Walter]

Ask several of the most experinced hip resurfacing surgeons their opinions.  You are an older, small female which most surgeons won't do a resurfacing for.  So only the top surgeons will give you that option if you are a good candidate.  Many of the problems have occured in small people - both men and women.  Look at my list and talk to the top surgeons like Dr. Gross, Dr. Su, Dr. De Smet, Dr. Rogers and others in your area.  Be sure to choose the ones that have done 1000 or almost a 1000 resurfacings or more.  It is very, very important in your case.  They top doctors can do much more than the normal orthopedics.

http://www.surfacehippy.info/listofdoctors.php

Good Luck.

Pat

[carolines]

I am going to see the dr that is 4 hours away on the 21st to talk again about my options.  I felt the most comfortable with him when I met him in March.  He's a top sports ortho guy.  Plus, I can get updated x-rays to send to those top surgeons for their opinions.  Right now, the current x-rays are from March and February.
My blood work is all healthy, cholesterol is excellent, bp is great.
Thanks, Pat, for your response!  I already was leaning towards Dr De Smet, if I am a good candidate.  I want to go back to being as active as possible.
Family history: both my mom and my sister have had Total Hip Replacements on both hips.  My mom (4'10") may have a revision on one in a couple of years.  She was 59 for her first surgery.
My sister is 53 (5'2", now 5'3") and had her first surgery when she was 48.  Her second hip was about 2 years ago and got messed up... one of the nurses rolled her onto the surgical side and crushed the bone.  Big Mess.  Probably why I'm a little gun-shy about this whole thing.  I really have no problems with surgery... have already had a few for other things, so not new to the hospital scene.
Just want the  best options available.  Thanks!

[Luann]

Hi Carolines,
 I am a female only 5'2" and 45. I, too, had pain due to bone spurs (just a little cartilage damage was evident). I, too, was originally diagnosed with a labrum tear (not true!). And I, too, like I'm sure most people who have joint pain, had a cortisone injection done 1st (never worked even for a day!).
 Pat, of course, is correct to say that smaller framed people have more trouble with HR (due to bone density, I believe?). I decided to take the chance (I am of normal weight), and so far have not regreted a moment! I am back to riding horses, hiking, and no pain ( 14 weeks out)! Do get some Drs' opinions and see if it might work for you. Good Luck, Lu

[carolines]

Lu,
How bad was it before you had surgery? Had you resorted to crutches yet?  Right now, I'm not using anything, but limping quite badly.  Hubby thinks I need a cane.  I'm starting to use the electric carts at the grocery stores, but don't have a handicapped tag yet for my car.
I had a bone density scan last year that was normal.  What I don't know is what normal is that? Normal for my age with wear & tear, or regular normal, with no loss?
And which doctor did you use, if I may ask?
I would just about give anything to have my freedom back at this point.
Thanks for responding!

[Luann]

Carolines,
 It was moderately bad (on the high end of mod with some activities) at worst. Some days if I did not do too much, it was mild. If, however, someone where to take my pre op hip/leg and flex it just the right way... I would have screamed! I knew how to protect it. My gait was ugly, I walked with my foot pointed outward, limping pretty badly and leaning forward. I had not resorted to using any walking aid or tool yet.
  I decided not to wait until it was so bad that I couldn't do anything. I am super active and do not sit around and do nothing very well. Why wait until it gets that bad? If you wait until you are so miserable your not enjoying life, cannot do any exercising or enjoy any activities, JUST because you are afraid of surgery, THAT to me is just not living. I am WAY more afraid of wasting life than I am of getting an operation. Not that I wasn't a little "freaked out" about the whole thing. I was very apprehensive. It is a big step and commitment. But, I knew I needed it and was willing to take the chance to be able to move again and do the things I needed (yes, needed) to do.
 Now, you may not be that afraid, I was just commenting to many people who may be reading this who are. Don't wait until you have to use a walking aid. At least get an opinion soon. See if you're a candidate for HR and if not, look into the THR. I feel for you. You sound like you really want to lose weight, too, and you're right; if you cannot move, you cannot burn calories.
 I live near Portland, OR, so I used Dr Sparling in Vancouver, WA. Look at Pat's list and find some one who is really experienced even if you have to drive a bit. Some people even leave the country to get a Dr who is good. Good luck, so glad you found Pat's site. Lu

[carolines]

Thanks for the encouragement, Lu!  I appreciate it very much.  When I go tomorrow to the doc, I will be in a much better mood.  I am having days like you did.  Some good, some bad.  I do know what I can and cannot do and am VERY careful about moving the wrong way. I even gave up driving my Mustang because getting in and out of it was just too much. So, I like the idea of not waiting... I don't want to give up any more activities.  As it is now, I wait til I can't possibly wait any longer to go to the store or anywhere to pick up what I need around the house.  I do get out to the gym as I know I need to do that at least, along with the good feelings it generates.  Sometimes I come home and ice the hip, sometimes not.
So, I will post Wednesday what the doc has to say.  I will also have x-rays and stuff to send to the other docs on Pat's list to see what they recommend. Thanks again, Lu!

[Luann]

Good Luck! I am almost to the point where I do not even think abut my hip anymore (15+ weeks out)! I walk normaly (just a couple of "limpy" steps when first getting up from a sitting position) and just rode my horse in a 4 day intensive riding session (with Dr's permission). Felt fantastic afterward, too. If I had done that just 5 months ago I would have been in agony! Hope you will soon be enjoying life again, too!  Do keep us posted, Luann    AKA -Lu

[carolines]

An update:
The new x-rays show no cartilage left... my right hip is bone on bone.  Guess that explains the amount of pain here.
The specialist I saw last Tuesday was more about scoping the joints that actual hip work, so since there is nothing to scope, he sent me to his colleague in the same group.  The hip doctor was nice, explained his procedures and device (ceramic on plastic0 he uses, but didn't think I was a good candidate for re-surf.  He texted the other hip doctor that does re-surfing in the group and that doctor said I was too old.  50 is the cut off for women.
So, anyway.  I have an appt tomorrow with the hip doctor here locally that gave me the shot.  Turns out, he's supposed to be one of the best here in town.
I also sent the X-rays and information to Dr. DeSmet for evaluation.  So, we will see.   I do have to do something soon.

[resurface]

carolines

Hello.  I may be in the minority with this but I would like to add another perspective.  Why would you not go with a total hip.  You have a number of complicating factors that make resurfacing questionable.  Consider the risk / reward equation in your thought process  A new total hip will provide years of relief and an active lifestyle.  A resurfaced hip given your situation has many more possible complications.  It is not as if you are looking to run marathons again.  It sounds like you want to be active and lead a heathy lifestyle.   A total hip is one of the most successful procedures performed today. 

You can always find a doctor to do a HR procedure.  Not everyone is a good candidate for HR.  The question is, is it worth it?  If you have more surgeons telling you that it is questinnable then it may be a reason for pause.

I wish you all the best regardless of the path you carefully select. 

[carolines]

Dr DeSmet has responded to my e-mail.  He says I am a candidate for the HR.  I am encouraged by that.  My local hip doc said that they are going to ban the HR procedure here (for females) in the US because of the fracture rate.  However, Dr. DeSmet in 3300 patients has only had fractures in 3 males.
So, I'm torn between going to Belgium to get the HR done or having the total here, without traveling.
My insurance would most likely cover both.  Well, 80%.

[Pat Walter]

There has not ever been any talk about banning hip resurfacing for women in the US.  I don't have a clue where your otho got his information.  I am in contact with many of the top surgeons and medical companies.  Many less expeirnced surgeons simplly don't do resurfacing any more since it is very diffiuclt and they did not have good outcomes.  A lot also depends on a woman's size. Larger women have the same retention rate as men.  Smaller women are determined on a case by case basis.  I would stick with information from the top surgeons.  You can't do better than Dr. De Smet.  I paid for my surgery with my credit cards back in 2006.  I would do it again.  I wanted a very expeirnced surgeon since I was an older woman.

You might want to listen to Mr. McMinns video about all the negative press.  Much of the info is based on a small group of associates that did poor jobs in surgery. http://www.surfacehippy.info/mcminnnegativepr.php

The Belgium experince is wonderful along the the great De Smet team.  If your insurance will cover most of it, I would seriously think about using him.

Pat

[Luann]

Hi Carolines
 What is the news with you? Any sx date set? Decisions on HR or THR?
  I never heard any of the surgeons who I got opinions from (I just had it done this year, June) say anything about banning the HR for females, either. They just considered my case (small female) carefully.
 I am sure with all the information Pat gets/has, she would be one of the first to know!
 Let us know how you are doing. Lu