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:

Friday, 28 January 2011

New consultant


I met with my new consultant last week. In the same day, prior to meeting him, I had a double MRI, a CT, a series of x-rays and met with his physio for ROM and pain tests. The wait for this new consultant was long, but worth it. He appears to run late because he makes time to go through everything with each patient in turn. You can't however complain then when the same consideration is applied to your case. He took an hour and a half to discuss my hips and the way forward.

He surmised that my case was indeed complicated and that at first glance results, I have bi lateral FAI and (I didn't know this bit) possibly some pubic symphasis from my second child, 2 years ago. The course of action was to have a local anesthetic injection, mixed with steroid, into my hip sockets. This I had done yesterday.

The procedure was smooth and well ordered. You arrive to a lovely room and super helpful nurses. Later I was checked by a physio for ROM and pain inducement, Then some hours after I was sedated and injected with the dye, anesthetic and steroids into my hip socket. Once awake I was fed (hurray!) and re-tested soon after by the physio.

I had mixed results though, as only some symptoms were gone. The impingement seemed more obvious on left unoperated hip. I must say though, I felt anxious knowing so much would depend upon the outcome of these tests and could scarcely think clearly to answer my pain in numbers. I find it hard to quantify pain, esp the fleeting kind induced and find I almost question my own answers. Still it seems a better exploratory process than I have experienced before.

Here's the additional consideration, I desperately want a third child, which I've left and left because of the drawn out situation with my last consultant. Now the clock is ticking, or might have stopped ticking altogether, for all I know! How do I fit this in? A decision I have been agonizing over for months. Do I do one hip, hope it heals fast, then try squeeze in a baby, then fix my other hip? What to do?

Before you leave the hospital the consultant revisits you with a course of action.
He arrived, calm and considered well thought out as ever.
He said he would give me 2 options and said which-ever I choose, he is fine with.
Option one: go away and have that 3rd baby, then come back and he will do his best to fix my hips. Or 2: we take what most likely will be the best part of a year, to get both hips fixed and that's the best case scenario... if all goes well.
I knew my decision the minute he finished his sentence!

He also wants to monitor how the steroids work in both hips in the coming weeks and months. He said there is nothing shocking on my scan to make him think a disaster is imminent. So if I can manage the pain, then to take the time out, as its most likely my last opportunity to try have a baby.

He also said mine is not a straight forward case, as there is pain inside and outside the joint and he can't be sure which is the most troublesome. He thought my left hip had more evidence to suggest bone impinging issues on anesthetic test, but wanted to collate all the information before drawing any final conclusions.
He did seem to suggest my hips wouldn't be easy to fix, I think for anatomical reasons, as well as the pain symptoms pointing to multiple issues... Yet for some reason I am more encouraged by that attitude, than by the 'no problem lets get in there' approach. I think this is because I feel that with my hips they are complicated and I am reassured he can actually see the hurdles.

He refuses to discuss all my scans thus far, (believing I'm a tad fixated with angles and percentages, where would he get that idea from?!) and saying he treat's patient's pain, rather than simply corrects their scans. He told me I have a 3 page detailed letter coming, so I can have my "fix" very soon!

I haven't had any surgery yet with this new consultant, but everything he says is so considered, honest and appears well thought out. This new consultant seems thorough with military precision, which appeals to my well organized personality type... He appears kind and thinks about you as a whole. I wish I'd seen him long ago.
I will, without doubt, be going back to him!

3 comments:

  1. Thanks for the good wishes emails and fcbks.

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  2. Hey Louisa, thanks for the comment on my blog! Glad you have been fully assessed and analysed - it must be reassuring to see someone get a full picture. I love the attitude of treating the patient and the pain rather than treating the scans. Great approach. Wish you all the best with your baby making ;)

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  3. Congrats on finding a good new consultant

    ReplyDelete