2nd hip arthroscopy to find any reasons for pain after 1st failed scope

Bones, joints and muscles
1

Hi everyone,

I posted 5-6 months ago about my experience with failed hip arthroscopy (2013), and low level of arthritis - so 4 different hip surgeons I consulted with did not feel confident that I would have a successful total hip replacement.

On April 3 2017 I had 2nd hip scope, surgeon found "a bit" of calcification and scar tissue at front of the joint. He says it *may* explain some of the pain I had after the 1st hip scope, but he's not sure. He found no significant arthritis.  (therefore, I'm still not a great candidate for THR!)

Recovery is much easier this time. The real test will be how i feel in 6 months, then 1-2 years from now...  I'm following the PT protocol, hoping the tendonitis & pain that occurs when sitting will subside. I don't know if/when I'll be able to ride an exercise bike, sitting and pedaling will hurt, but I want to try it.

What I'm really frustrated with, for all of us, is what are the options for older patients with confirmed labral tear + small amount of visible arthritis? Why do we have to stay in limbo (and in pain & disability) until joint space degrades? Is it truly a crapshoot to skip hip scope and go straight to THR?  If the answer is yes, can they explain why this is so? 

I consulted with 4 hip surgeons who do THR, and none of them could explain why, they just cited national data. (Well, I can't argue with that, I want to hear the data!)  Then they left it up to me to decide, saying "Well, it MIGHT help you, odds are 30-50% of good outcome".

Yikes.

I just wonder if the implants for THR are designed specifically for people who already have advanced arthritis. But even so, the procedure for THR is to grind out any remaining cartilage (labrum), so in effect that erases your joint space altogether, which is like advanced arthritis (to my feeble layman's mind, anyway).

2

Hi Glynell,

You mentioned that you had a labral tear.  Was this just fixed on April 3, 2017 (just over 2 weeks ago) when they also did you 2nd hip scope? 

I had a labral tear which was repaired along with a full hip scope 10 months prior to me having to have a FHR.  I can tell you by my experience that recovery from that surgery was worse that the recovery from having a FHR.  The reason being is that I was non weight bearing after the repaired labrum.  This alone put me approximately 3 weeks out before I was even allowed to put any weight (taking steps - walking) on that leg/hip.  Then I ended up (less than a year later) having to have a FHR due to severe arthritis and my joint degenerating quickly to bone on bone.   

If the cartilage were in better condition (mine wasn't due to the arthritis), my outcome would have been different, and at 49 years old I wouldn't have had to have the FHR. 

The question really seems to be, why are you still hurting.  As its only been 2.5 weeks since your last hip scope and repair, its way too soon to tell if this last surgery was a success.  It takes up to a year of recovery for this type of surgery. 

The reason why surgeons don't like to jump on the FHR band wagon is because they don't last forever.  Ideally, they prefer to wait until the patient is older but that isn't always possible for many patients. 

I suggest that you give yourself time to heal properly right now.  Make sure that you do everything by the book for a successful outcome.  If you are still having issues with pain a year from now, then I'd personally press forward with a FHR.  At that point you will have checked (ticked) all the boxes and you will know that you did everything you could.  I realize that it must be very difficult for you right now, especially as you are in the early stages of a 2nd operation.  Try to be patient and keep a positive mindset.  Tell yourself that this last surgery has fixed the problem and do everything you can do with rest, physio, ice packs, etc.. to make that happen.

I really wish you the very best.  Please keep us posted.  I'd love to hear from you in a few months telling us that everything went well and you are no longer in pain

3

hi glynell,

I am so sorry to read this ... how discouraging !

I don't know what to say - 4 OS have confirmed that you are not a candidate (yet?) for hip replacement surgery - strange that none of them were not able to explain why not ... 

have you seen the xray of your hip ? 

please let us know how you are getting on,okay?

big warm hug

renee