Labral Hip Tear with Impingement
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Long story short, I have a large labral tear in my left hip caused by an abnormality in my hip joint which is creating an impingement. My surgeon said he would shave down the bone which is causing the impingement and repair the tear. I've had the problem for at least 6 years but the past 2 years it has gotten significantly worse. I was just wondering if anyone on here as gone through the surgery and opinions on whether it worked for you? It's about a 4-6 month recovery time so I'm really trying to weigh some options here |
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I had the same thing done about 10 years ago. I'd say it went well. I can do anything I want now without any sort of pain related from the previous injury or surgery. I do have less hip flexion in that side but I've also got scoliosis which could be the main cause of that mobility imbalance. Have you tried serious physical therapy? If not I'd at least try that before going under the knife. If you do decide to do the surgery,be diligent with the rehab and see if you can find a good ART practitioner that can help with scar tissue and range of motion. |
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skik2000 wrote: So I did do P/T and it worked well in the beginning. But the problem was whenever I had a high impact day, like a full day of climbing, long distance running (which I have since stopped) it would start to hurt again. The stretches and strength training they had me do seemed to work for around 4-6 hours and I would need to do them again. That, coupled with the range of motion that never changed, I felt as though it was just delaying the inevitable. I really want to try and put it of but based off of my MRI and the xray of my hip, even I can tell that it's a direct result of the hip joint, and strengthening the area around it won't really lessen the pain that is being caused from the impingement. I'm honestly just trying to weigh whether or not the pain (which sucks, especially when I'm really active and I'm limping around at the end of the day), is worth it versus how well the surgery can actually solve all of this. So would you go through it again? How long was the recovery, or maybe how long until you started climbing post operative lol |
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I ran in college and of the people I knew with labral tears in the hip. Four had surgery and two have resumed normal life and the other two haven't be able to consistently run in 8 years. |
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I didn't really climb at the time so I can't say when I would have been able to return to climbing. I'd say the 4-6 month recovery time is about right as far as full recovery goes. Based on social media, Sasha DiGuilian recently had both hips done. I don't know if she had the labral tear/FAI or something else but she could be person to pay attention to as it relates to a return to climbing. |
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Hips are really tough to dx. Three of the most well respected hip docs that work extensively with athletes are Mark Phillipon in Colorado, Shane Nho at Rush in Chicago, and Michael Terry at Northwestern. If you can travel for a consult or do one remotely, I'd definitely recommend that. |
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Princess Puppy Lovr wrote: so you're saying I have a 50/50 shot lol |
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Tyler M wrote: Yeah of my small dataset, also if the two shoulder labrum tears I have know it is the exact same. Honestly I don’t think anyone is worse from it, it’s just a lot to go through and not have it fixed. In your situation I might consider a medical second opinion. |
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I just had hip labrum repair surgery #3 on September 18 with Marc Safran at Stanford Ortho. Source seems to be hip instability and mild dysplasia. Doc thinks he fixed the instability via a capsular plication (tightening the socket is my non-technical understanding), so hopefully no more tears in the future. Surgery #1 was just the labrum repair (same side as #3) and Surgery #2 was labrum + plication on the other side. If you’re young and you want to keep doing endurance days, surgery is really the only viable option since your labrum isn’t capable of being repaired without surgery due to lack of blood flow. I do a whole bunch of long runs and alpine stuff and ski touring, though...it might be a different cost/benefit equation if you’re not doing long distance stuff or you have a pack mule team readily available. I haven’t bothered with pre-op PT for the last two tears — just straight to surgery as soon as I could schedule it so I could get back to full function ASAP. Both hips returned to 100% function from my first two surgeries (although a slight loss of rotational flexibility on hip 1) with no issues. Obviously too early to tell for #3, but I’m about a month out and can walk a few (flat) miles with a mostly normal stride. Not allowed to really rotate it in any direction yet, but I think that’s allowed soon. First two weeks are non-weight bearing and kind of a bummer, but I only needed pain meds for a day or two. I can probably try to start super easy top roping in a week or two? I’m hoping to be 100% skiing/climbing by month 5, but 7 months is probably more realistic. Anyway, I’m happy to answer questions about my experience. No doubt that surgery is a huge bummer and, since this is America, an enormous expense, but I have no regrets. |
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My wife had labral tears in both her hips and had surgery to repair them about 9 years ago. The head of her femur was "out of round" and was causing impingement. She lived with pretty bad day to day pain for years as she could not get an accurate diagnosis on the cause of her pain. In fact, she had a doctor from Kaiser tell her she needed a psychiatrist and not a doctor because all of it was in her head. At it's worse she could barely walk up a flight of stairs. She got lucky and found a wonderful doctor who was on the cutting edge of treating shoulder and hip labral tears here in the Denver area. He diagnosed the issue in our first office visit. The doc shaved down her femur and placed anchors to reattach the labrum, 6 in one hip and 5 in the other. We spaced the surgeries apart by about 6 months. Quicker than we wanted but we'd reached our deductible with the first surgery. Recovery was tough and took a long time. She would go through it all again though in a heartbeat. If you've tried all the non-surgical treatments and are still suffering and not able to do the things you love, get the surgery. The problem will get worse if left untreated. PM me if you want more information. |
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Were you diagnosed with FAI? |
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J G wrote: I don't believe so. Basically I fractured my hip in high school from a fall while running and when it healed it caused the head of the joint to create a protrusion. This was the cause of the labral tear from the continual rubbing against the labram. |
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Man I feel you pain. Or rather I used to. I tore labrum in my 20’s and ignored it for 20 years until I was hobbling around sideways to avoid the pain. I also had pincer and cam impingement of the hip and severe arthritis on the femur. Think -dinosaur ridgebacks on the femoral head.. My labrum was basically gone at that point and beyond repair. Doctors wanted to do a total hip replacement but I eventually opted for a “Birmingham hip resurfacing” (metal on metal) because I was in my 40’s and still really active and didn’t want a ceramic Hip which can potentially shatter on severe impact. |
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I had FAI (cam and pincer) surgery w/ microfracture cartilage repair, labrum repair, and repair of a cyst in my femur by Dr. Philippon three weeks ago. So far the recovery has been smooth, I was off pain killers by day two. They told me I could start easy toproping again around the two month mark. The doctor said my outlook is very good, though it's too soon for me to say about the outcome either way. The things that convinced me to get the surgery were:
It sucks to be on crutches for 7 weeks (it would have been less if they hadn't needed to perform the microfracture, which they didn't discover until during the surgery), but at this point I feel like I made the right call. Happy to answer any questions, though as I said, it's too soon for me to have a conclusion about the longterm outcome. EDIT: I'll echo what Matt Ward said and encourage you to consult a hip surgeon with a stellar reputation, in this case I think it makes a big difference. |
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You guys have been awesome! Thanks for all the replies it really did help with the decision. I'll be going in on December 12th to get it done since I'm close to meeting my deductible from the MRI and X rays. Hopefully all goes well and I'll be back climbing by spring and maybe get back into running. Also for those who had it done, how necessary was Physical Therapy afterwards? Like, once you get all the info down on stretches or whatever they'll have you do, were most of the exercises able to be done at home? I ask because, ya know, money. |
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PT is important. My doctor connected me to an app that has my entire rehab program day by day. so I'm doing the bulk of it on my own at home. Twice a week I go in for PT and that's mainly just been soft tissue work and going over exercises/answering questions to make sure I'm doing everything right. The PT will also perform certain tests to make sure I'm ready to bear weight on the hip again. Then she'll give me specific return-to-sport plans for my various activities once im ready (I was told running takes the longest), that are also dictated by my doctor with their own tests. I don't think that's all the norm though, I've heard in most cases the doctor's team isn't providing the PT plan. In short, I would expect at least some PT. It also helps a lot if you have someone at home to help you with passive-motion exercises. My wife has to pick up my leg every day and move it in circles as part of my plan. |
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Kevin Corrigan wrote: Did they break your hip in 3 places and screw it back together? Or was this much less invasive? I was told my labral tear would just happen again due to the FAI morphology. The doc said he would have to break my hip and put it back together but that was a few years ago. I wasn't ready for such a massive surgery at the time. Now I'm back at square one...trying to figure out what my options are. |
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@Jordan R, No, it was much less invasive. It was arthroscopic surgery where they shaved down the sides of the femur and the hip socket, no breakage or screws required for the FAI. The "microfracture" I had was to repair a very small area of cartilage damage and that involved drilling a small hole into the hip bone so that stem cells would bleed out into the damaged area and form new cartilage. I have one screw where they removed a cyst in my femur from where it was banging into the socket due to the FAI. The screw will dissolve and help form new bone. Honestly didn't even know most of these things were possible before the surgery as they didn't know they'd need to deal with the cartilage or cyst before they got in there. I'll only have two labrum anchors and two narrow, half-inch incision scars when all is said and done.. |
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@Dan, One surgeon I spoke to for a second opinion would have done a 3D CT scan for the day of surgery imaging, not sure if that could be an option for the initial diagnosis as well. |
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Just had the surgery yesterday morning. Surprisingly not sore at all. The surgeon said he had to put a few more anchors in then he originally intended, so it ended up being almost 2 hours, but all went fine. After these two weeks of recorvery I'll be starting back up on P/T. Hopefully I'll be back to climbing in about 2 months or so. Thanks for all the input guys! |
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Any tips for training post surgery? Thinking I'll be getting mine done next month. Any general tips for getting through rehab? |