Bone spurs and torn cartiladge in hip(s)

[Chillman]

Good morning, all!

I'm sorry this is long - but it is a combination of 'venting' and questioning -

I will preface this by saying I'm 47 female.  I had been on this site looking for information on hip problems a month or two ago.  Not knowing what caused my hip pain, I made an appointment with doctors that were supposedly familiar with hip resurfacing, just in case my issues were severe enough to qualifiy for resurfacing, I wanted a 'history' with a doctor.

I made a trip to a doctor in Pittsburgh, (after extensive questioning of his office staff as to his type of practice/procedure experience),  who looked at my x-rays and said I was an 'aging athlete" and that I had osteo-arthritis.  Although he was kind and cordial, I didn't feel as if he had addressed all of my concerns. Then I found out he didn't do any type of hip surgery, but he was glad to give me a referrral to another of his partners.

I then took my x-rays to a Dr at the Cleveland clinic who said he believed I had torn cartilage in one hip.  He ordered an MRI of the hip (not "hips", unfortunately as I complained of bi-lateral hip pain).

I waited for days for results of the MRI and finally received a response to my calls, from a physician's assistant who said simply that I had torn cartilage.  He offered no other information as to location of the tear, or the condition/severity of the tear. I asked specific questions about the cartilage issue, and he responded with "I'm not qualified to answer that.  But here is the name of (another) Dr. so-and-so, make an appointment with him to discuss arthroscopic surgery..."

I took my x-rays to another dr and my MRI results were also forwarded to him.  He was the only dr that took a lot of time to point out on the x-rays what he felt my issues with BOTH hips might be, and explained the results of the MRI to me.  He said it was glaringly obvious that I have bone spurs in both hips, and that the hip that is currently giving me the least pain, is the one with the most bone spurs!  He said that the torn cartilage is undoubtedly causing pain in the one hip.  He is a chiropractor.  He had his office staff making all types of inquiries on my behalf to doctors he works with in Pittsburgh, to see if any of them did arthroscopic hip surgery.

So, my questions to the group are basically - when do you know when to keep looking for a doctor that will answer your questions, and not just send you to their 'partners'?  Does anyone out there have torn hip cartilage?  Did you have it treated or plan to? 
Have you been told you have bone spurs in your hip(s)?

At this rate, I can't afford to travel all over to 'find' a doctor that can evaluate, inform me and treat me.  I asked both the Pit Dr and Physician's assistant what my limitations are. One told me to bicycle, the other told me to do no physical activity. I certainly don't want to aggravate an existing condition, but I don't want inactivity to add to the 'problem'.

Sorry - I'm just frustrated, and time and $$ are limited and I just don't know what to do next.

I would appreciate any suggestions or comments.  Thank you for reading this far.

C*

[Elaine Y.]

Hi,

I can totally understand your frustration. My first orthopedic surgeon (OS) I went to said that I had osteoarthritis in both hips and bone spurs and he told me that he has seen people with worst looking x-rays than mine with little or no pain, and he has seen people like me with not too bad arthritis with lots of pain. My right hip was the one that was very painful. My left hip has and still does not have any symptoms. This first OS told me I had three options: total hip replacement, steroid injections under fluorosocopy, and medications. I opted for trying more medication. This was not successful. I then did steroid injections, of which after the first injection, my pain level was 0, and this OS said "This is how you will feel after a total hip replacement." I was 48 years old at the time, not an athlete, but an avid exerciser and walking was my main form of exercise.

To make a long story short (of which my whole story is under Hip Stories), I went to 4 OS before finding the one who did perform the hip resurfacing. I found out about this procedure through my brother-in-law, and then my search was on to see if I was a candidate. I was able to change insurance to a PPO and have free reign as to who I saw. I was 50 (almost 51) when I had my right hip resurfaced. The steroid injections helped me through (4 total) until I could find a surgeon to perform the hip resurfacing.

I would strongly recommend you go see a surgeon who does hip resurfacing. Use this site or the Smith & Nephew site to find a surgeon in your area or the closest one possible. I can't tell you about the cartilage issue. Sorry about that. But, I think you should pursue a physician that will give you answers. Just remember, you are your best advocate when it comes to medical issues, and you must be a pro-active person to get the answers you want. Stay strong and good luck!!!

Elaine Y.
RBHR -- Dr. Eugene Lopez, 1/22/08

[john]

Hi,

I just has my second resurfacing a week ago
the first is doing great and I expect this one will too
but it was worse and hurts more right now
just find a Dr who does BHR and look at their stats
my second hip, which the Dr said upon xray looked worse than the first, had no symptoms till I had to put most of my weight on it while the first healed
my advice would be to get it done as soon as you can
I think the longer you wait the more difficult the operation can be and the longer the recovery time 

[Chillman]

Thank you both for your posts.  I wish you both good health!!

I'm a bit confused about the resurfacing, because I specifically went to the Cleveland surgeon because he was mentioned on this site as a dr who did them.  I took x-rays with me and he said I wasn't a candidate, and that my problem was the torn cartilage.

Are bone spurs something that is specifically addressed with resurfacing?  Could cartilage issues be addressed during a resurfacing?

So, I guess I will just keep looking.  Obviously I am not in the 'market' for surgery!  I would like to have an accurate diagnosis as to my hip 'problem(s)', so that I can make an informed decision about treatment/permissible activity.  I've been healthy my entire 47 years, and don't make a habit of running to doctors looking for things to be wrong!  lol  Now I feel like a slug because I'm afraid to do anything active for fear of aggravating whatever it is that is going on in those doggone joints!

Thank you both for your comments and encouragement!

C*

[john]

as far as: Are bone spurs something that is specifically addressed with resurfacing?  Could cartilage issues be addressed during a resurfacing?

bone spurs yes- they grind them off and hope there is enough good bone below when they're done to attach the parts

the doctor told me I had no cartilage left in the actebellum (SP) and that I had grown a nice bunch of gristle or a stalactite or something in there in it's place that they had to chisel (my word) out. Must be why my leg hurts more with this one. Sounds like a lot of pounding. good luck to you also

[Pat Walter]

Hi

Sorry I am late to the party on this post.

The most experienced surgeon I know of in the Cleveland area is Dr. Brooks.

Peter Brooks MD, FRCS(C) - BHR trained McMinn 2006
200 Hip Resurfacings to date ***
Cleveland Clinic
9500 Euclid Avenue
Cleveland, OH 44195
Phone 216-444-4284 (toll free 800-223-2273)
Cleveland Clinic Website


Dr. Stulberg is also there, but not as experienced if I am correct.  He is also much more conservative and I know had at least one problem causing a revision.

The problem with the less experienced surgeons - meaning ones that have only done a hundred or so - is they are unwilling to do difficult surgeries.  Only the really experienced surgeons will tackle difficult problems.

That said, you can get some of the most experienced surgeons in the world to give you free email consultations if you write to them, attach your x-rays in a digital format as a .jpg file.

Many don't want to travel out of the country or travel distances, but if you have really difficult problems, that is sometimes your only solution.  Your hips are very important and once they are botched up - it is not easy to get them revised.

The doctors that will give free consultations are Dr. De Smet of Belgium, Dr. Bose of India, Dr. Su of New York, Dr. Gross of SC.  There are some others, but these are some of the most experienced that will tackle tough hip problems.  It won't cost you a penny to talk to the best in the world. Then you can decide on what the best course of action would be.

If you havn't talked with Dr. Brooks - I would try to call his office.  He is good, but not anywhere as experienced as the others I mentioned.  http://www.surfacehippy.info/doctorinterviews/brooksinterview.php  You can get the others email addresses off my doctors list  http://www.surfacehippy.info/listofdoctors.php

I spent $200 each on 4 crummy orthos who gave me bad advice also.  They did not want to give me a hip resurfacing and even lectured me against the terrible procedure. 

So many of us have traveled the same road you are on.  You need to have good information to make a good decision and that probably won't come from the local orthos close to you unless you live in NY, SC or CA.

Take some time and talk to the pros.  Dr. Gross will call you, but it will take a few weeks.  De Smet and Bose email very quickly. 

Keep in touch and don't give up until you get the real story from the real pros.

Pat

[Chillman]

Hi John, and Pat!

Thank you both for your responses to my inquiry.  It's so nice to 'talk' with someone who understands the frustrations of trying to determine the path of wellness when it comes to hip problems!

I appreciate your suggestion of sending the information to doctors who are willing to review previous test results (ie X-Ray, MRI, in my case).  And they will respond with their opinion as to the issues they 'see', and suggest a course of action?

I actually had no problem getting a film for my x-rays, so I don't suppose that it would be a problem to request it on a CD.  As for the MRI though, how do I request that information?  In what 'form'  would the doctor in SC be able to review it? (There is no possible way that I would be able to go overseas for surgery) I was never shown my MRI results, just told what they 'said' after I had the results faxed to the chiropractor.  I don't know if he actually saw 'pictures'.

Obviously, as I mentioned before, I would like to avoid surgery , but in no way do I want to aggravate a situation that I currently have, by doing nothing at all.

Thanks again for letting me 'vent'.  I appreciate the input!!

C *

[Pat Walter]

Hi

You can normally attach your x-rays in a digital format in a .jpg file.  I have a whole page telling how to take the CD and convert them into   .jpgs  here    http://www.surfacehippy.info/xrayconversion.php

As I say on the page, I actually took digital photos of my x-ray films.  The page talks about doing that too.

You just attache the .jpg files as an attachment.  That's how most of us got our consultations from Gross and the overseas doctors.

It is rather amazing to think you never leave your house  - you send off emails with x-rays attached as .jpg files and you get consultations from some of the best doctors in the world.

I did everything for my trip via computer - talked to the doctors, reserved my hotel and make my flight.  The internet is amazing any more.

Good Luck.

Pat

[Rick]

Just got on the site and wanted to pass on some info. I had to stop running 2 1/2 years ago to keep my right hip as long as possible. I am 52 and have a number of spurs and very little flexiblity. I can still handle the pain at this point. No drugs yet.

Dr. Clarke in Syracuse, New York is a good choice for resurfacing. He has done over 500+ operations and very qualified (www.nychr.org).

I had the same basic story when it came to diagnosis. I thought it was a groin pull for two years that I kept agrivating with running. It took an MRI and finally a simple normal pelvic xray to point out the spurs and arthritis. I went and saw Dr. Clarke a year ago. I asked if I was a candidate and when should I have the resurfacing done. Another words should I wait or should I have it done now. Since I am handling the inconvience and pain he said it depended when I wanted to do it. If I am not missing out on what I like to do then wait and if I want to get back to what I use to do then do it sooner. I decided to wait (hoping for continued proceedure and component improvments).  I have now reached the point that I want to do some of things I use to do and can't because of the hip. I am getting ready to schedule with him for November this year to have it done. By the way a friend just had his done by Dr. Clarke 7 weeks ago and he can't say enough of how pleased he is that he had it done.

[Pat Walter]

Hi Rick

Dr. Clarke is one of the most experienced hip resurfacing surgeons in the US.

I have a nice interview posted from him.  http://www.surfacehippy.info/doctorinterviews/clarkeinterview.php

I also have a few Dr. Clarke hip resurfacing stories http://www.surfacehippy.info/hipstories.php#Dr.%20Clarke

I hope, if you have your hip resurfacing with him, you will share a story with us.  I will be happy to post it on the main website.

I am glad to hear your friend is doing well.

Good luck to you too.

Pat

[Pat Walter]

I moved this reply to make a new topic because it is important.  I also did not want people to miss your reply so I made a copy below:

Hi Chillman,

I had torn cartilage in my right hip for 19 years that went undiagnosed until I had a diagnostic hipscope last year.  The MRI and x-rays showed a normal hip.  After the hipscope, my surgeon told me I also had osteoarthritis worn to the bone in my acetabulum and would need a THR when I couldn't stand the pain any longer.  He said the clean-up he did during the arthroscopic surgery MIGHT give me some temporary relief.  It hasn't.  I was 39 years old at the time and the thought of a THR was scary.  Luckily, someone told me about resurfacing.  It's now a year later and my hip is getting worse and worse.  NSAIDS have stopped helping and I was also taking Ultram which has stopped helping.  I started Celebrex a few weeks ago and it helped for about 2 weeks.  I see my OS on July 3rd for a new set of x-rays and hopefully a game plan with this hip.  I'm in need of some serious pain management at this point.  Anyway, my point is that if I knew the hipscope wouldn't help, I wouldn't have bothered.  I would have just waited until I could be resurfaced and then went for it.  In hindsight, the only benefit of the hipscope was a diagnosis after all those years.

[Chillman]

Renee,

Thanks for your posting.  Could you give a little more information about the "hipscope" that you mentioned?

Quote from: Renee P on Yesterday at 12:38:41 PM
Hi Chillman,

I had torn cartilage in my right hip for 19 years that went undiagnosed until I had a diagnostic hipscope last year.  The MRI and x-rays showed a normal hip.  After the hipscope, my surgeon told me I also had osteoarthritis worn to the bone in my acetabulum and would need a THR when I couldn't stand the pain any longer.

This is the first I've heard of that (hipscope) procedure.  Also, did I read your post correctly - You had BOTH X-rays AND an MRI and NEITHER indicated the severity of your hip/bone deterioration?  And during the same time-frame you had the hipscope that helped your doctor diagnosis your problem?

Sorry for asking so many questions, but I'm really frustrated and tired of not having the opportunity to enjoy just everyday things without fear of adding more injury to whatever it is, that is currently my hip isses.

Thank you for adding your comments, as I'm trying to find a solution to my constant hip pain!
C*

[drmike-s]

If you must stay in the U.S., choose an experienced hip surgeon who has performed at least 500 resurfacings, preferably more.  The best ones are Drs. McMinn & Treacy in England and Koen de Smet in Belgium.  They have done at least 5000.  About 4 years ago I had a Rt. BHR done by Dr. de Smet and he was wonderful. 

link=topic=447.msg2020#msg2020 date=1210691996]

Good morning, all!

I'm sorry this is long - but it is a combination of 'venting' and questioning -

I will preface this by saying I'm 47 female.  I had been on this site looking for information on hip problems a month or two ago.  Not knowing what caused my hip pain, I made an appointment with doctors that were supposedly familiar with hip resurfacing, just in case my issues were severe enough to qualifiy for resurfacing, I wanted a 'history' with a doctor.

I made a trip to a doctor in Pittsburgh, (after extensive questioning of his office staff as to his type of practice/procedure experience),  who looked at my x-rays and said I was an 'aging athlete" and that I had osteo-arthritis.  Although he was kind and cordial, I didn't feel as if he had addressed all of my concerns. Then I found out he didn't do any type of hip surgery, but he was glad to give me a referrral to another of his partners.

I then took my x-rays to a Dr at the Cleveland clinic who said he believed I had torn cartilage in one hip.  He ordered an MRI of the hip (not "hips", unfortunately as I complained of bi-lateral hip pain).

I waited for days for results of the MRI and finally received a response to my calls, from a physician's assistant who said simply that I had torn cartilage.  He offered no other information as to location of the tear, or the condition/severity of the tear. I asked specific questions about the cartilage issue, and he responded with "I'm not qualified to answer that.  But here is the name of (another) Dr. so-and-so, make an appointment with him to discuss arthroscopic surgery..."

I took my x-rays to another dr and my MRI results were also forwarded to him.  He was the only dr that took a lot of time to point out on the x-rays what he felt my issues with BOTH hips might be, and explained the results of the MRI to me.  He said it was glaringly obvious that I have bone spurs in both hips, and that the hip that is currently giving me the least pain, is the one with the most bone spurs!  He said that the torn cartilage is undoubtedly causing pain in the one hip.  He is a chiropractor.  He had his office staff making all types of inquiries on my behalf to doctors he works with in Pittsburgh, to see if any of them did arthroscopic hip surgery.

So, my questions to the group are basically - when do you know when to keep looking for a doctor that will answer your questions, and not just send you to their 'partners'?  Does anyone out there have torn hip cartilage?  Did you have it treated or plan to? 
Have you been told you have bone spurs in your hip(s)?

At this rate, I can't afford to travel all over to 'find' a doctor that can evaluate, inform me and treat me.  I asked both the Pit Dr and Physician's assistant what my limitations are. One told me to bicycle, the other told me to do no physical activity. I certainly don't want to aggravate an existing condition, but I don't want inactivity to add to the 'problem'.

Sorry - I'm just frustrated, and time and $$ are limited and I just don't know what to do next.

I would appreciate any suggestions or comments.  Thank you for reading this far.

C*
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