16 year old daughter has problems with both hips

[devonm123]

My 16 year old daughter was experiencing left hip pain.  I recently took her into a hip doctor.  They took x-rays and found that her left hip has femoral acetabular impingement and her right hip has hip dysplasia which has no symptoms at this time.   For her left hip, they have put her on anti-inflammatory medicine, recommended that she avoids soccer and any activities that aggravate her symptoms,  and have started her on physical therapy.   If this does not work, they are recommending an MRI to see if anything is torn.   They said in the future she will be a candidate for resurfacing before the cartilage is damaged beyond repair and she would need a full hip replacement.    For the right hip, in the future, she may need rotation of the hip.   

I am very concerned given she is so young and the issues are permanent.  I am looking for guidance on where to go from here.   From my novice eyes, the x-rays do not show anything major.  Currently I am looking to get a second opinion.    We are located in Denver and am wondering if I need to contact the best in the U.S. rather than keeping close to home.  My daughter is very upset about it all as well and I don't know how to calm her fears since I know so little at this time too.

Thank you in advance for any guidance anybody can offer.   

[hernanu]

Hi, I'm truly sorry your baby is dealing with this, I have two daughters of my own (24 and 20). Welcome to the site, we will try to help.

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

Dr. Rector is in Boulder, and is a highly experienced HR surgeon. He could provide a second opinion. There are several Rector hippies here, who can give you an idea of how he is.

Pat also provides a list of some doctors who will accept XRays and other information and give you their opinion without a charge. They are some of the best available, all you have to do is email them the information.

Good luck, keep asking questions here, we are glad to help.

[Boomer]

Devon,

I live in Arvada and had both of my hips resurfaced by Dr. Rector in Boulder. Everything turned out good for me. Dr. Rector is excellent, as is Peter Lammons, another local surgeon. You can get very good medical advice and treatment here. Let me know if I can do anything to help you.

Boomer

[Miguelito]

I am not too familiar with hip dysplasia so can't comment, but for the hip with FAI (and just generally) I recommend that you consult with a hip surgeon who fixes FAI and labrums. Fortuitously, perhaps the most highly regarded such doctor in the entire world is located in Vail, Dr. Marc Philippon. For someone so young, fixing the labrum and the FAI should be considered before a resurfacing.

As way of background, I am 43, have FAI in both hips, had one resurfaced last year (with the amazing Dr. Gross) and am leaning towards having the other done next year. I have had hip problems since I was 11. When I was 14 they were talking about bilateral hip replacement if things didn't improve. They did, and aside from one flare at 18, I had little only relatively minor hip problems from 15 to early thirties (after which I had an eight year odyssey of pain and misdiagnoses).

I do not recall (being just a child at the time) if there was a diagnosis in my case beyond "inflammatory arthritis". My understanding is that the hip labrum and FAI was not well understood in the medical community at large until ten or 15 years ago (I'm generalizing). Even now, it was much harder to educate myself (using the web) on FAI/labral problems than it was on resurfacing/replacing.

Check out Dr. Philippon. I hope that you find the best possible treatment for your daughter.

Mike

[Miguelito]

Hi again. I just wanted to add that the basic surgery I am talking about (if it ever comes to that, which I hope it doesn't) involves shaving down the bony impingement (FAI), repairing the torn labrum (the protective socket around the hip), and (I think) performing some sort of microfracture that may help the cartilage out. As you may know, the problem with FAI is that the bony protuberance tears up the cartilage (the very thin, super-smooth covering that covers the cup and ball of the hip socket and allows them to slide essentially frictionless by one another. I have read that the recovery time is lengthy and not much different than a resurfacing/replacement. (Please forgive my layman's speak and any particulars I have gotten wrong. And there at least two distinct types of FAI and I think men and women tend to have different types).

This is a newer surgery. Doctors don't like doing it on people past about 40 as the labrum is already badly frayed and the cartilage may be too worn away (cartilage can't be repaired or replaced, yet).

But even mentioning this surgery is putting the cart before the horse. Definitely push for a consult with a top hip specialist like Dr. Philipon and don't take no for an answer. As I discovered because of my hip, we have to strenuously advocate sometimes to get the right diagnosis and proper treatment, and I know that you being here means that you are doing that for your daughter.

Mike