Failed hip arthroscopy to resurfacing

[dav0]

Hi there,
I am a 29 year old UK police officer who sustained a labral tear to my left hip last year whilst detaining someone for a drugs search (the subject was as high as a kite and during the takedown, i landed from about 6ft onto a kerb on my hip).  It took me til March '12 to get a diagnosis (started off with unexplained lower back pain, then my groin started hurting which was the real clue) and in May 12, I was scoped and had a large cam bump removed from the femoral head, the tear debrided and a small amount of grade 3 arthritis smoothed out.  Recovery was great until 5 weeks post op, and i have been left in more pain than pre surgery ever since.  I can't sit without feeling like im being knifed in the groin, basically.  Not good when i paid privately nearly 10k in total for the surgery...

Anyway, my consultant seems in denial about the outcome and can't really provide any answers, which is very frustrating.  Like all of you on here, i mourn the loss of active lifestyle - i used to work on a tactical team, easily the best uniform job in the police - but can't really do anything now like i used to.  In short, I can't carry on like this as my quality of life is nil and for someone who was so physically active, the hardest part of all of this has been the mental aspect of it, which frankly has left me in bits.

I am unsure if I am a good candidate for resurfacing as the arthroscopy removed a fair bit of bone from the neck of the femur and i understand that this can be a problem with neck fractures etc.  Has anyone had a successful resurfacing after FAI surgery whereby their femoral neck was ground down?

Repeat MRI scanning has shown thinning of the articular cartilage in my operated hip - not bone on bone by any means - but frankly, a thr or bhr is clearly in my future and i don't see the point of putting up with this level of pain and disability if something can be done about it now, i that makes sense?  It is extremely frustrating to watch everything i've worked for in the last 10 years going down the pan because of this, and i refuse to believe that there isn't something that can be done.  I've had post scope cortisone into the joint etc, but still with no change, so have come to the conclusion that the pain is due to a degenerative joint.  Reading this site and the success stories on here has given me some hope, so thanks for that...

Thanks for reading,
dav0

[Dannywayoflife]

Dave who was your scope surgeon? It is fairly well accepted that once there is arthritis in the joint a scope won't generally work(obviously with some exceptions).
If there's still joint space in the joint I suspect that most surgeons will advise waiting for more joint space narrowing to occur. They will likely suggest cortisone injections as the next course of action.
However you will get the best opinion from a top hip surgeon. The one who did your scope doesn't sound particularly interested. I would suggest a private consultation with Mr Ronan Treacy of Birmingham. He's the most experienced HR surgeon in the world and co developer of the BHR.
Welcome to the group always good to see another Brit on here
Danny

[rubyred]

Dave, reading that was like reading my story pre-surgery.

I'm 31 and was born with mild to moderate dysplastic hips, however this went unknown until about 3 years ago when I sustained a labral tear during a Combat class. I went through all the consertive treatment, two lots of injections and an arthroscopy each time leaving me in more pain than before the treatment.

My then surgeon refused to help me further saying that I've had every possible treatment and to just 'not do anything that will aggrivate it'. Frustrated and in an immense amount of pain, I got myself referred to Mr Treacy who has worked a miracle. I'm 17 days post op after having my left hip resurfaced. It's early days, but I can already feel a new lease of life is on the way. I was actually told that I should never have even been given an arthroscopy and that had probably made my condition worse.

Get yourself referred to a GOOD surgeon, Mr Treacy if you can, he does NHS work too if private isn't an option as it isn't for everyone, and you'll, at the very least, get an expert opinion on your condition and what he can do to help. From personal experience, if he can't help you then he will find someone who can. He definately won't leave you in pain.

[Dannywayoflife]

Having a private consultation is a good way around nhs red tape you actually get face time with him too, which is something that often doesn't happen with the nhs route thanks to him treating soooooooo many people. If it were me Dave I would pay the £150 for a private consult with him and if you don't have private med cover if he says it's appropriate and your a good candidate then ask him to refer you back to him on the nhs

[rubyred]

I was just giving him another option Danny. Not everyone can afford £150. I know I couldn't so was very thankful he still works for the NHS. Lord knows, he doesn't need to which shows how committed he is to patient care.

[Dannywayoflife]

Yep very true Ruby. Waiting on the nhs can take a while though as he does only work so many months and does see a lot of patients. He defiantly does not need the money but I think he enjoys the large volume of patients he sees on the nhs.

[rubyred]

I think you can definately tell that he enjoys his work and helping people. I think I must have been very lucky in that I got to see him personally on every appointment I had, although I'm aware that this isn't always the case. It might be worth noting that on your first consultation you usually see the main consultant and further appointments it's a bit pot luck according to time issues, how many patients, if the surgeon is even in clinic etc...

[dav0]

Thanks guys.  Danny, i have read your story and hope you are still doing well with your BHR recovery.  I can see you are quite like me in your goals and approach to this problem, and the kind of life you want to lead.

I won't name my hip surgeon... yet, but needless to say he is aupposedly one of the top UK scope surgeons, which is why i went to him.  He doesnt do BHRs though and seemed against them.  I am back to see him next week, but really don't understand why i am in so muh pain when i was told 'you should do well' after the op!  My femoral head cartilage was pristine and the aetiular cartilage only had a small patch of damage, so i was supposedly a good candidate for scoping?!  I don't have dysplasia or anything like that which is normally a no-no for the procedure, so I am surprised they scoped you Ruby - who was your scope surgeon, if you dont mind me asking?

Ruby, you have certainly been through a lot and i hope the new hip gets you your life back.  I have read your pre op story and really feel for you - its amazing how this can wreck people's lives so easily.  I take it both of you had bone shaved during arthroscopy and still went on to have the BHR?

Mr Treacy will certainly be getting a visit from me in the near future if this carries on, as i really dont see the point in wasting he best years of my life - already lost a year and 10k to this - waiting in pain for something that isnt going to improve...  Where does

I have had a cortisone shot into the joint at 8 weeks post op, but with little result. 

[rubyred]

Thanks guys.  Danny, i have read your story and hope you are still doing well with your BHR recovery.  I can see you are quite like me in your goals and approach to this problem, and the kind of life you want to lead.

I won't name my hip surgeon... yet, but needless to say he is aupposedly one of the top UK scope surgeons, which is why i went to him.  He doesnt do BHRs though and seemed against them.  I am back to see him next week, but really don't understand why i am in so muh pain when i was told 'you should do well' after the op!  My femoral head cartilage was pristine and the aetiular cartilage only had a small patch of damage, so i was supposedly a good candidate for scoping?!  I don't have dysplasia or anything like that which is normally a no-no for the procedure, so I am surprised they scoped you Ruby - who was your scope surgeon, if you dont mind me asking?

Ruby, you have certainly been through a lot and i hope the new hip gets you your life back.  I have read your pre op story and really feel for you - its amazing how this can wreck people's lives so easily.  I take it both of you had bone shaved during arthroscopy and still went on to have the BHR?

Mr Treacy will certainly be getting a visit from me in the near future if this carries on, as i really dont see the point in wasting he best years of my life - already lost a year and 10k to this - waiting in pain for something that isnt going to improve...  Where does

I have had a cortisone shot into the joint at 8 weeks post op, but with little result.

My scope surgeon was just a local consultant here in Essex. I since found out that I should never have had the scope as often it makes the dysplasia worse, but I was a but uninformed at the time and didn't realise. I had to go around the houses a bit to get to this point, but as of right now, was completely worth it.

[Dannywayoflife]

At what point were you diagnosed with grade 3 OA Dave? The scale generally goes to 5 I had 4 at my hip scope.
I believe Dave that you can only have 2 cortisone shots per year as any more and it's pretty toxic to the bone.
If your in such bad pain I would seek another opinion mate.
Danny

[dav0]

Prior to the scope it was just slight joint space narrowing on xray, but there was a small patch of grade 3 arthritis diagnosed from the scope at the edge of the acetabulum where the labral tear was.  It's called the chondrolabral junction, i think.

Yep i am dubious about any more kenalog shots as there's no such thing as a free lunch, and my hip responded well to one prior to the surgery but that'll be 3 i've had in the space of 6 months, so no more!

Ruby, interesting that your consultant didnt pick up on the dysplasia.  Hip scopes seem to be something where surgeon selection is key as there are a lot of surgeons out there who seem to want to get as many under their belt as possible as they are still learning.  I shopped around and thought i'd picked wisely - my one does 5 a week so is quite experienced - but now i'm not so sure!

[Dannywayoflife]

People here just seem to blindly trust surgeons just because there surgeons. After my experience with the idiot my GP sent me to who didn't understand the proceedure at all i will now always research surgeon in great depth!

[dav0]

Yep i have to agree with that.  I saw a couple of surgeons privately before the op and didn't go with the first opinion i had (guy wanted to detach my entire healthy labrum, grind down the acetabulum pincer part and reattach it... er, no thanks!)

GP's seem to be totally ignorant about most orthopaedic issues in my opinion.  My one didn't know anything about hip scopes etc.  Totally missed the diagnosis - didn't even consider it - and told me it was psychological cos a back MRI had shown nothing up!

Can't believe how frustrating this has been.  I always thought if i seriously hurt myself it would be from a motorbike accident or something, but certainly not like this!!

[Dannywayoflife]

My GP at the time said that the surgeon who did my scope was a lier as he had never seen OA in a 28 year old so he didn't believe it! Needless to say I nearly pulled his head off!

[Anna]

Hey,

How much pain are you in at present? Does it effect your everyday life? Or is it that you want your active sporty life back?

Either way, I would probably go with Danny and Ruby and say get an appointemet with Mr T. I paid the £150 to see him and got an appointment within 2 weeks but as Ruby says there is always the NHS option too if you dont want to pay the money. I was sadly told that im not suitable for a BHR. People who do not know about these problems keep telling me it was a waste of money and time but I completely disagree. It was worth every penny. If I hadnt have seen Mr T then I wouldnt have settled for anything else. He is the best in the world and if he says no, then its no and thats fine. Its worth the appointment just to find out. ... even if he thinks you should wait. At least you know from the best.

These conditions are heartbreaking and totally unfair but unfortunately we are all going through it or have gone through it. Theres alot of people on this site who are very active and I think everyone knows how you feel. This place is a great little community and everyone on here will share their knowledge with you. I cant offer too much knowledge as im still at the beginning of my road but I can defo offer support and jokes! Im also in a very similar position as you with my job so if you want to chat further about that then feel free to PM me.

We will look forward to your progress and updates.

Anna.

[John C]

Welcome to the site davO. I had a thought on your question about the FAI work that they did on the femur. I am no expert, but from what I have seen, this work is usually more around the base of the head, near the head/ neck junction, which is where the osteophytes often form. I would not think that this would be a problem for a resurfacing, since this area is often taken off as part of the reaming process to prepare the femoral head. Just an optimistic thought for you.

[dav0]

Thanks John, that's reassuring.  He was very aggressive with what was removed - if i can find a way, i'll put the xray shots up - but when i saw it i was amazed at how much had gone.  I did ask him about this pre surgery and he said it shouldnt be an issue, but he took way more bone thn he thought he would.  That really would be the final insult to find that my failed scope has scuppered my chances of a BHR too!!

[Dannywayoflife]

Hopefully you'll be fine Dave, get plenty of calcium down ya neck!

[hernanu]

Hi Dav0, welcome! Danny and Anna have given you some great advice. I think you're in the first steps yet, with the end being a good resolution to all of that pain.

A great initial step is to talk to a really good surgeon, who can give you a decision on what kind of device would be good for you. Being an HR recipient, I highly recommend that. A THR is also very good at relieving the pain and returning to some activity.

When you do meet with the surgeon, be candid with him or her (hopefully it's Mr. Treacy), let him know what your goals are, then if your candidacy for HR is set, I'd ask about when you can get back to the type of activity you want.

There's no guarantee, but I've been able to return to fairly intense martial arts training after two years. Other people have returned more quickly, I do believe each person is different in the pace of their recovery.

Good luck and I hope you're a candidate for HR, it has been a life changer for me.

[Spanielsal]

Hi Dav0, welcome, you've come to the best place. I think you are right to push for a BHR, they are better but like Mike and me, it's not a total disaster to end up with a THR, however the revision clock starts ticking - I'm hoping to prove them wrong!

I had an arthroscopy years ago, was never terribly convinced by it but I did work on fitness (that won't be your problem) I did then see some improvement but arguably pregnancy hormones also help -again, not something you'll need to think about! Unusual that they aggressively removed bone, that seems contrary to most surgeons outlook of preserve bone. I'm sure it won't scupper your chances but you will find out by going to the best surgeons and Mr T is definitely one of the top two.  Good luck

Sal