# Surgery for torn labrum in hip/FAI - what a difference this has finally made



## Green Giant (Dec 19, 2003)

While I'm not prepared to call the surgery a total success, I am calling it a success thus far.

Without getting too much into it (older thread has the details). Broke Pelvis at 17, torn labrum at 35, treated for bursitis (failed), first indications of a problem were lower back issues, followed by hip achiness, followed by groin pain, finally followed by inability to ride without dealing with a week of pain afterwords, and constant aching in my hip regardless of activity, made worse by sitting or standing in one spot for a while.

So, last year I started with a MRI to my hip which showed a cyst like lesion, I then got a consult which the doc suspected FAI, but didn't spend much time with me said to get MRI with an arthrogram (not fun) and referred to his partner.

His partner without talking to me much came in and said we needed to do FAI surgery with a scope, a labrum repair, IT band lengthening, a bursectomy, and maybe a posas release. (This was at a major university hospital). He never mentioned my pelvis having been broken and never asked me my goals. 

Said it was "major elective surgery" and I would be on crutches 6-8 weeks minimum and at least a 12 month recovery.

Being in the medical field I didn't feel right about our lack of discussion of my goals, had done quite a bit of research on my own, and the fact that I'm 36 with two kids (and one on the way) - I went for a second opinion.

The second doctor took a lot more time with me (I was told he was quite good), and said we could do everything from nothing, to PT, to a scope for the torn labrum, a scope for FAI, and a full open procedure for FAI.

He was also honest, said I was 36, had clear arthritis in the hip due to the broken pelvis (telling me he took more time on my MRA and X-rays). Understood I was a father with a full time job, and only had one real major athletic goal - get back on the bike.

He told me the data for FAI surgery is very, very mixed. He also said that it is still worse for a scope, and it's worse as you get older and if you have any arthritis.

He said he would do any of the procedures mentioned but he wanted me to know the expected success of each with risks. 

I asked him what he would do if he were me. He said, get the scope for the labral tear. That will tell us how tight the joint space it, see if FAI surgery is possible or might help, and doesn't give you the 12 month recovery for a risky procedure that may or may not work.

Well, turns out it was the right decision by far. I do have arthritis and it would have been nearly impossible to do the full FAI procedure due to room in the joint. He also said that yes I will need a hip at some point but it could be a while (I learned this at the follow-up appt).

Well, as of this week I've been back on my road bike for 3 weeks, and 1 week for the MTB. I'm feeling as good as I have in a couple years, I'm not perfect, but I still seem to be improving and I can now work on losing some serious weight. I can't stand and rotate on the joint yet, but I can stand and climb a bit now. The scope was March 13th. 

What scares me a bit is how aggressive the first surgeon wanted to be, he actually has a good rep but I would have likely gotten a few things done that didn't need to be done as well as not being able to do everything as the joint space is just too tight.

Honestly, assuming I don't regress at all, I'm thrilled right now and would consider this a success. Over the next few months I will see what happens as I increase mileage and frequency of riding. (So far the most I have pushed it was a road bike ride one day for 17 miles and a 10mile mtb ride the next day, today will be another MTB ride and the 3rd in 4 days).

So, I've seen others posting about FAI and hip issues. I think this is a very new field still and results are all over the place as are opinions. No one is right, and it's likely no one is wrong. I would make sure to research things, and get a few opinions.

Frankly, based on my case and experience I might suggest just getting a labral tear addressed first (mine had to be clipped, no way to repair), and seeing how that goes. It was kind of a no-harm, no foul situation and thus far I'm amazed how much better I'm doing.


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## xcguy (Apr 18, 2004)

Here's hoping for a full recovery for you. Your point about getting a second (or third) opinion is so true. I've had surgeons, who I thought were on the same page as me, insist on surgery right away. With one I said, you know, since it's not absolutely clear what's wrong in there (left shoulder) I think I'll try to PT my way out of this. "Should I just let the pain be my guide" I asked him. He replied "I'll be the judge on if you need surgery or not". Really, doc?

I PT'd my way out of whatever was bothering my shoulder and I'm back 100% percent. No thanks to that surgeons opinion. Other surgeries I've had were absolutely necessary but you have to do your homework and be prepared to sift through the bogus opinions.


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## Green Giant (Dec 19, 2003)

*Just as a note*

I only had the torn labrum addressed, not the FAI, and they could only clip the labrum and get it out of there, they could not repair it or anchor it.

As an aside. I work with surgeons every day, MANY are excellent and have outstanding clinical judgement. That said, particularly with a lot of not so obvious orthopedic and spine related injuries I would typically always recommend 2 opinions.

Now with other specialites, sometimes surgery is the best course of action and folks avoid it with a less invasive procedure which makes surgical intervention worse later.


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## The Squeaky Wheel (Dec 30, 2003)

how many opinions should I get before deciding to proceed with a vasectomy?


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## Green Giant (Dec 19, 2003)

*Well...*



The Squeaky Wheel said:


> how many opinions should I get before deciding to proceed with a vasectomy?


Due to the microsurgery that that will likely require in your case, I would think several opinions before moving ahead with a decision on the surgeon.

That said, based on my understanding of that particular procedure, I would think only one opinion would matter. That being one's lovely and talented boss... the wife. :thumbsup:


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## Beatrices (May 22, 2010)

*Torn Labrum w/ Arthritis*

Hi, Green Giant. How are you doing now with your hip? I developed a torn labrum in my left hip last December and saw a surgeon in Baltimore (Marc Hungerford for any Baltimore-Washington people reading this) who would not operate on me. I also have osteoarthritis in that hip and he said that a repair to the labrum would not last long in view of the arthritis. Now I am thinking a clip/debridement to clean up the tear would be better than nothing, but I am wondering why he wouldn't recommend that?

At any rate, my range of motion is less than it used to be, I have resorted to some PT to strenghten regional muscles, correct my gait and fix my posture (which have helped take pressure off both hip joints - it appears in my case that years of misuse and misalignment issues are what led to my problem - _who knew_ you have to worry about your poor skeleton! NOW it makes sense but I had to get to this point to realize it).

I am also a lifelong runner (since high school) but I can see my running days are behind me (very depressing).

At any rate, I'd be very interested to read your update and to learn how you've progressed in the last year.

Best,

Beatrice St. Cyr


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