FAI Hip Impingement (Femoro-acetabular Impingement)

FAI Hip Impingement Awareness facts - It is estimated that approximately 15% of the young, adult population have hip impingement, so who do you know that might have it?
Hip impingement causes painful labral tears within the hip socket.
Hip FAI symptoms are misleading to the average medical professional, as FAI hip impingement pain frequently presents as low back pain and interesting only 10% of back pain is ever clinically diagnosed and cured... Which begs the question what percentage is actually caused by hip FAI or hip impingement, as its otherwise known.
The more active you are, the more likely you are to trigger hip impingement symptoms, so busy mums and gym bunnies beware... but at least you're in good company as many premiere league football players have also suffered FAI hip pain.
Hip impingement is diagnosed through x-ray and labral tears are diagnosed through MRI arthograms - but both need to be read by hip consultants specifically trained in FAI hip impingement.
There are 60,000 hip replacements every year in the UK and it now appears that FAI hip impingement, over the years, could be the leading cause of hip osteoarthritis. A silent epidemic.
Hip arthroscopy can reduce the hip impingement and reattach the torn labrum to the hip socket. This surgery can eliminate the pain and disability caused by FAI hip impingement and divert the need for hip replacement in later life.


Also please feel welcome to join in our help and advice forum for support. We have 3 advising FAI expert hip surgeons, 3 PT/physios and a sports medicine doctor as well as the largest international FAI hip impingement forum on the net:

Wednesday, 11 November 2009

hip arthroscopy non recovery 18 wks

Changing the name of this blog to 'MY FAI HIP WINGE' as of the previous blog entry. I know its probably madness but I came of my 2 x meloxicam 3 days ago. Had to know where I was at, as I have been masking pain ever since it re-emerged when I came of my crutches. Not too surprisingly I'm not in a good place.

Its not good and I may have to go back on the meds. I am gutted to see everyone else doing so well, I don't mean that in a mean way, I just can't see why not me too? What's wrong with me? I started out so positive and this blog was so positive and I just if I'm honest believed that the hip arthroscopy failures either had duff surgeons, or didn't follow there PT exercises, or had negative attitudes, or something. But I've done it all, good surgeon, religious about physio therapy and added daily hydro and had a positive outlook.

Even with the kids I was hands off until last week and couldn't manage then, so now they're in school and nursery so I don't get to look after them! ..and I still can't work as I can't sit. Apologies for temp blip of feeling sorry for myself, just I keep watching my body clock and increasing trying to accept that I may not have my third child because of my stupid hips, seen as I can't even pick up the ones I have. If I were a wild dog I think I would just knaw off my leg from the hip joint and have done with it!


In fact I'm going to stop writing I'm making myself miserable! Going to go sharpen my teeth to see whether knawing off my leg is actually an option!

23 comments:

  1. Louisa,
    First of all, sorry that you're having a rough time. Don't be hard on yourself, everyone heals in their own time. If you are still having problems and hurting this blog will be comfort to those who are still hurting as well.

    Some things are beyond our control no matter how positive our attitudes or how hard we work in PT. God forbid something may still be wrong, but regardless of what is causing the pain, it's not your fault!!! Who would choose this crap?

    I'm sorry, it's shitty. But you can't beat yourself up over it and you can't knaw your leg off like a wild dog.

    Vanessa

    Vanessa

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  2. Oh, and if it's any consolation to you I had a shitty-painful week too:)

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  3. Well it is actually! Your blogs all fluffy and happy and giving me a complex!! X
    In fact can everyone just be a bit more miserable please, least whilst I get thru this rough patch, too many happy smiley hips brings out all my insecurities and inadequacies, of which there are many!

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  4. Thanks for your positive comment on my site...I hope you don't REALLY accomplish knawing off that leg! =)

    SHC

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  5. Your daughter, or kiddo born with CHD too?? Thats how I discovered my 6 yr crippling back pain was my hip, when my now 1 yr old was diagnosed they then considered my hips, though I have FAi pincer from retroversion and she CHD, can't believe there is no link!! Your site is great with loads of referral info, like Vanessa and Jessica's ..I keep saying I'll do that, but as sittings a pain I keep it simple! Damn!

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  6. Hi Louisa,

    I have been following your blog with interest for a little while as I too have retroverted acetabulum. I'm not sure on the exact degree but I know its severe. I have had a right reverse PAO in dec 07 to correct the retroversion, then a follow on open debridement to sort out damage in joint in march 09.

    I am 2 and half weeks away from a combined reverse PAO and open debridement on the left. My surgeon - Mr Fern in Truro, thinks I have a labral tear or detachment on the left, as I am now on crutches fulltime as I can't walk much at all.

    I was still on crutches at 16 weeks post my debridement, as I had inflammation problems, needing a steroid injection and then my screws removing, as they were rubbing on my psoas. Perhaps your pain is just inflammation of everything in the area, and it just needs more time to settle it right down again (not easy with a little one and 3 flights of stairs I appreciate).

    I don't know much about arthroscopy, but it sounds as though he has taken the retroversion away by cutting the acetabulum off the front of your hip, giving you more clearance. It may be that a CT or MRA is needed to be sure you can see the impingement has gone.

    I'm sorry your recovery is not going so well, you sounded so positive a few weeks ago. I hope you get some answers from the Prof when you see him soon.

    Sam xx

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  7. Sam thank you what a lovely message and so sorry to hear what a tough time you're having also.

    How did they find your retroversion? Was it the Xray pointy bone bits within the pelvis? How did you find out the degree? What were your symptoms? Sorry to deluge you with Q's but you're prob the first person I've come into contact with with retroversion!

    I sounds to be taking a lot of time out of you're life, are you still able to work?
    Thanks v much for getting in touch xx

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  8. Hi Louisa,

    I am a medical student based down in the south west, so I have to attend hospital placements, and have done throughout this, just taking up to 4 weeks off each time I have an op.

    My history is a little complicated as I broke my tibia/fibula aged 8 and it didnt heal quite right, so my foot was externally rotated by 27 degrees. Therefore ever since then I had knee pain on the right side. I was told I was too young to have anything done so learnt to ignore it. Then I decided to train for a half marathon 3 years ago (age 20), and after around 6 weeks of gentle training I started to get groin pain. I was referred to a hip surgeon, who said, something doesnt look right with your hip, but lets get the bottom of the wonky leg sorted first, so I referred to a knee surgeon. I had a derotational tibial osteotomy in april 07.

    After that, with the med school I moved down to Truro. I was still getting groin pain, but my knee surgeon said it was just my 'limping'! I asked to be referred to someone in truro to have my screws removed from my tibia as they stuck out under the skin. Fortunately, it was Mr Fern, who I mentioned the groin pain too, so he examined my hips and found I had zero internal rotation of them at all. He sent me for xrays which apparently showed an extremely weird shaped pelvis and retroversion. I then had the MRA on the right (at this point and up to 6 months ago, leftie was asymptomatic), which showed around 50 degrees or more retroversion I think, but cant remember the exact numbers. This all led to all the following surgeries.

    The xray has the classic crossover figure of eight sign, but my whole pelvis has an inlet view as its tilted forwards, so when I lie down, my sacrum is at 90 degrees to the rest of my spine. My left hip is slightly dysplastic as well, in that the femoral head isn't as far in the socket as it should be.

    My symptoms are groin pain mostly, which is constantly there despite pain meds. In the left leg I now get catching too, which stopped me in my tracks last week. I never had that with my right hip. My walking tolerance is very low now, and I can't really go outside without my crutches.

    Hope that helps, its very nice to chat to someone who has retroversion too, I haven't found anoyone else, and I know mr Fern has only ever done one more reverse PAO since me. I don't know if he has done scopes on people as well though.

    Sam xx

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  9. Hi Sam gosh you're really young to be suffering all this! You sound much worse tahn me in that been unable to go out without crutches must be limiting for you,but seriously good on you for keeping up with work and I'm absolutely sure whichever area of medicine you go into this will make you better at your job!

    Given that pincer is mostly caused by retroversion there used be more people with retroversion, though maybe how relevant it is is all down to degrees. If you're right and my problems (please God or whoever!) are down to inflammation then perhaps its not severe enough to need POA, which I pray.. I want another child and to look after my 2 now and haven't the 2 yrs per hip for PAO!

    Has the side aready operated on recovered? Catching sounds like labrum or psoas? Is your dysplasia global or at the rear because of retro? Or is the socket too shallow?

    Does your pelvis have a strong anterior tilt then (lordosis) or posteria.
    My Xray looked normal, bar the crossover sign and where there should be a smooth line of the interior pelvic wall and emptiness there are two triangular protrusions pointing inwards and thats a sign, beyond that I know nothing, but need to find out more if only for piece of mind.
    Do you blog? If not will you stay in touch, its lovely to, I nearly said meet, to speak to someone in a similar position, though in fairness if I escape with just arthroscopy surgery to trim the acetabulam, from what I've read on PAO I've got off a little lightly!
    xx

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  10. Hey chickie !!!
    I felt like I was reading my own blog. You are at the same point I am with the frustration and pain, from what I can see here you have a huge support system compared to my own. It really is ok to be miserable and bitch. This hurts and it does make you feel like there is no hope and it will never get better. I would hope since we are only a few days apart with our surgeries that this is normal and that we just need to turn the bend. Who knows, maybe the pain meds were helping more than hindering .. something I am finding in my own case.
    Either way, chin up my wonderful friend and bitch all you want !

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  11. Thank you Erin, I just facebooked you to see if you were ok, cause you've been quiet.. Are you OK, are you back on Meds? I'm 3 days off, had 2 good days and then today wipeout! And no reason!??

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  12. Louisa, I haven't had a look at the sticky out bits on xray, but will get them out today and have a look to see.

    I think you are right, and its all down to degree of retroversion, as if you only have a small amount, then it can be easily trimmed with a scope and tidyed up. I think the pure reason I have had to have it all done open is that retroversion is just part of my wonkyness, unfortunately because my femoral head is so abnormal (rugby ball shaped not spherical) and the femoral neck is also banana shaped, there is no way it could all be dealt with by scope.

    I'm quite sure the Prof was satisfied he could sort you out via a scope, otherwise he wouldn't have tried. It will take time, but you will get there.

    I was thinking about this sitting business, as I too had real issues sitting once I was weight bearing after the dislocation surgery. I tried putting 3-4 cushions on a kitchen chair, sat on them like that so the angle between my thigh and body was about 160 degrees, did that for 3-4 days until that was comfy, then took a cushion away and repeat the process until no cushions anymore. I wonder if that may help you too? Don't forget where the bone was cut off will be all raw and sore, so its no wonder when it sits against the femoral neck (as it should on sitting), its going to hurt until it settles. The other thing I had a problem with was my screws were sticking into my psoas tendon, which surprisingly to me caused groin pain ... perhaps your hammys going a bit mental by the sounds of things is causing the sitting and groin pain, not anything in the joint?

    hope that my help, I dont want to scare you into thinking you need a PAO, because I'm sure you don't and its just my unique complete and utter wonky pelvis and bones that led me to having them.

    I have just started a blog - http://thewonkymedic.blogspot.com
    its been about my elective placement in canada, but thought I mayaswell continue it as a hip blog from now on.

    Sam xxx

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  13. Brilliant will go and visit! So sorry you've had such a rotten time.
    If I sit I sit on cushions, my hubby calls me the princess and the pee!! Except in the car where my head would hit the roof. I hope it is inflammation. It just foxes me that it comes and goes, yesterday ALL day horrific pain, today after a good night no problem and I can't see the trigger, does inflammation just go like that? Is this the most complicated condition ever these hip things.
    Whats your speciality??
    Right going to pop by yours now!

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  14. Not 'if' I sit, I always sit on cushions, I must stop rushing!

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  15. Lol, hmm but that was how I found it with the psoas stuff, could be ok for a while, then wham, one really bad day. I think it depended how much sitting I was doing/how much walking around. Unfortunately, it tends to be once things are inflammed, they just stay that way for a while until you get a really good rest e.g. overnight, then things settle, so you go out the next day, happy with a less painful leg and flare it all up again!

    Have you tried lots and lots of cushions and slowly reducing them down? Wheat bags on your hip, alternating with ice packs?

    I am currently in GP placement, then back to the hospital (after the op) and do a variety of specialities. I don't have to decide which I want to go into for another 2 years, luckily!

    xx

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  16. I'd go with orthopedics, you'll already know a chunk of it thru experience!
    I often use those deep heat heat patches, on hip side on onto glute med, they're amazing! Fix onto skin and last 12 hours. And sometimes ice if feeling brave!

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  17. I can so relate with all of you. I had surgery on 10/9/09 and have been in a frozen hip hell...unable to sit for long...nor stand. I thought this would be so easy. I never thought I would be hurting so long. I thank you for posting this....I now know I am not alone. I am an xray tech. and am going back to work 7 weeks after surgery......I walk all night. I fear I will come home in an ambulance tomorrow night (my first night back) and that will be the end of my career. Thank you so much for all your posts...I am not alone!

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  18. Dear anonymous,
    Only just got this! Mainly only see new comments on latest posts, that's why.. How did it go? Did you/are you managing with work and walking?
    No, you are far from alone, the longer this blog goes on, the more people I come across and the more people you connect with, the better you'll feel in yourself ..look at my blog lists of other hip blogs, there's loads of us and ever growing, welcome!!

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  19. Dear Louisa, You have no idea the importance of your blog...I was so depressed thinking I was so slow in healing. Always hurting and sometimes unable to walk at all. I went 4 wheeling in May (side by side like a jeep) came home from vacation and was unable to walk for a couple of days. I finally saw an orthopaedic surgeon and had the FAI surgery on my lt. hip Oct. 9th 2009. I am waiting to see if it works before I have the other one done. I went back to work 3 days ago at the 7 week mark...and I did fine....very sore though! After reading about all your stories I figured I may as well go back to work and stop losing money.....because this is going to be sore for a long time. I was alone in this nightmare and then I saw I was not alone...that made all the difference in the world. Thank all of you for sharing with all of us for we are all in the same boat! I honestly sometimes think this surgery doesn't work! We'll see. Nancy

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  20. I have also gone through hip arthroscopy under the supervision of orthopedic specialists of Seattle and the surgery gone right now I’m fine till now.

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  21. Hi Nancy,
    Glad you're managing with work , you're doing better than I did at 7 weeks! I have in week 21, turned a corner and suddenly things are feeling MUCH better, not normal, but improving.s still. So it shows even when you think all hope is lost you can suddenly improve! Hang in there. And thanks, the blogs doing what I hoped then!
    Aarone,
    I couldn't quite work out if you're saying your op worked or not, did you have bone work done? When was your op?

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  22. I am at week 8 post FAI surgery (also having had the head and neck of the femur shaved)...and at the end of my work day (xray tech.) I am in so much pain. My hip joint gets stiff....thigh swells...burning sensation in joint. I feel I will never get better. Has anyone actually ever gotten to a good point with no pain after this surgery??? I am so discouraged. Nancy

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  23. Nancy, Yes they have I know a good few, way faster than me too... I am only just getting there, but only from week 20, I'm now week 22... please hold on, 8 wks I remember sounded ages, but its not.
    I have my next op in Jan and I'm utterly dreading it and I think more than the op, its the never ending fear that you'll never get better and I know I will feel like that again and its currently turning me into a nervous wreak. But slowly slowly you do get better. Keep in touch and let me know how you are going, but try comment at the latest post so I see you sooner.
    Hang on in there!

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