Femeroacetabular Impingement

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  • Have you had your second op now, mr moosehead? If so, was it the same as the other. Hope you're recovering well.

    Less than a week until my op now, so long as I can get rid of the slight cold (or maybe it's just paranoia...very similar to the feeling I get before every marathon!).
  • No, in on friday. Got an horrendous cold the week before the 21st, so rescedhuled for the 4th Nov.

    Breaking news though: Bradford and Airedale PCT have agreed the new NICE guidelines and are now considering cases for funding. No timescales attached to that process though, so I can't wait.
    going ahead on friday - possibility that I can reclaim some of my costs.

    Good luck!
  • Good luck back to you for Friday in that case. Hope all goes to plan this time.

    Pleased to hear that other PCTs are now seeing sense and considering cases for funding. Hope you get something back.

    Mild cold is still there but I've warned work that I might take Thursday or Friday off in order to minimise the risk of having to postpone. Given that I'm getting the op on NHS, I don't think I'd be able to reschedule quite so quickly as you.

    Is your first hip still doing well?
  • First hip doing ok. Some tightness in muscles over the front of the hip, and adductor as well.

    Doesn't stop me doing 6min/km over the moors. image
  • Hope it went ok today, mrmoosehead. Looking forward to your update.

    I heard at lunchtime today that Monday's op has been postponed. No reason given. No new date given either. Ok, the NHS op may be free, but it has been quite a long wait and a bit of messing around so far. Hips have been hurting quite a bit this week as well, which was making me all the more eager for the op.
  • aw, pipes. sorry to hear that. keep pushing at them - the sooner the better.

    written up the first 24 hrs on attackpoint:

    http://www.ar.attackpoint.org/viewlog.jsp/user_1874/period-7/enddate-2011-11-06

  • Thank you for blogging - hope you keep it up so that I can remain realistic and hopeful. I'm glad things went just as well - were you hoping they wouldn't have to do micro-fractures this time? Hope you sleep better tonight.

    Went out for a jog today to stress-relieve...hips are complaining now! May be more to do with the hours of sitting down working today rather than the run, or perhaps my head is exaggerating the pain because of the postponement. Either way, I'm walking like a 90 year old.
  • Hey pipes - you got a date yet?
  • No - heard nothing from hospital. I seem to have fallen off their radar completely. Phoned them on Tuesday and the admissions lady just said she had no new date and that the surgeon is very busy at the moment. I said I'd been on the waiting list since May (after being referred by doctor almost a year ago) and she said she'd 'have a chat with him'. Not really sure what to do next other than just wait and phone them occasionally.

    How are you doing?
  • ok. 2 weeks post op. Mobile, lots of exercises to do. Trying to fit them round working to pay off the cost of the op.

    Got to write a letter to the chief exec of the pct to try get some money back. Not hopeful.

    But all in all, feels good. Time will tell.
    Right hip aching as it's taking all the strain.
    Missing running. Missing biking. Missing the moor image

    If you funding has been agreed, you may be able to get the surgery done elsewhere if the PCT has a contract with said other place.
    Try to get a date or a timescale and investigate the other options. Quote targets at them. Don't take no for an answer.
    Where are you based?
  • How are you doing now, mrmoosehead?

    I'm in Oxfordshire. Phoned them today to see if there was any progress of my new date and was told 23rd December. That means seriously revising plans for Christmas. Ok, I should be grateful that I'll get the operation at last, but I can't help but feel resentful that my 2 and 4 year old will miss out on their trip away and that I'll feel rough on Christmas Day.
  • Doing ok. less than 3 weeks left on crutches.

    Some twinges in left hip, but it seems to be going well. Right hip still feeling the strain of doing all the work. Physio says not to worry too much at this stage with the right, just needs some work once off crutches.

    left hand ring and little finger starting to go numb from teh crutches again. hard work on the hands. So frustrating as well. At least I can drive already.

    Take the date. I know it's going to be hard - it being christmas and all, but your family will understand.
  • I'm so glad that i've found this thread as I've just been diagnosed with a hip labrum tear following an MRI Authrogram only last week.

    I'm 32 and was running on average 20-30 miles per week pre-injury, a member of Penistone Footpath Runners, ran the Sheffield half in April, just starting to discover fell and trail running, did a lovely Lakeland 10 miler in Coniston, was training for the Liverpool marathon in October, did zumba, liked spinning etc etc and I'm now completely inactive; even walking a short distance hurts. I've not ran at all since the summer.

    First started with my symptoms February/March 2011 was told I had ITBS and an unstable pelvis. Went to my GP in July who referred me onto an 8 week course of physio for suspected hip bursitis

    Physio did more harm than good and I asked to be discharged after just 4 sessions as he did (what I now know) was some sort of test to check for a labrum tear which left me in agony.

    My GP then referred me on 30th September to the Muscular Skeletal Service at Mid Yorkshire Hospital Trust. Luckily for me the consultant I saw was a runner himself and has had labrum tears in both hips!

    He did a few basic tests and straight away said he was 99% sure it was a labrum tear. Had the MRI authrogram last week, got the results yesterday and confirmed his diagnosis. The consultant has recommended that I undergo a hip arthrospcopy with an NHS surgeon at Leicester Hospital.

    However, my case now has to go to the PCT for a decision as to whether they will fund me to have the arthroscopy. If not, i'll be looking at open surgery at Leeds or Bradford. Unfortunately I will have to accept whatever the NHS can offer.

    They did say yesterday though that my 18 week referral to treatment target began on 30th September when I was referred so they in theory have to provide treatment by 2nd February.

    My pain is progressively getting worse. I walk with a constant limp, it hurts to drive, sit at my desk, pain when climbing stairs and a very loud clicking noise. I have pain when laid down which is interrupting sleep and limited outer movement (its like something just locks and my hip wont move any further) its just generally wearing me down and I'm missing being part of my club and the buzz I get from running.

    Just a waiting game now as to what the NHS will offer me. has anyone had open surgery??
  • Not had open. (First day without crutches today after surgery, yay!)

    What PCT are you?

    The nice guidelines are more generally focussed on the FAI side of things, rather than just a labral tear. If the tear was caused by FAI (which sounds likely, given the lack of ROM) then you should be able to get the surgery (non-open) on the NHS now.

    Don't give up hope. Sounds like you are in a lot of pain - are you able to cycle at all? At least that way you can get some exercise. I know it's not the same as running - totally understand the mental side of it.

  • How long ago was it you had your surgery? What's is FAI?

    My PCT is NHS Wakefield District - just got to wait and see.

  • 80% of all FAI's are the product of an unstable, but not necessarily painful, lumbar spine.

    FAI symptoms are caused by excessive hip movement which causes either the cam or pincer impingement. OS can shave as much as the bone back, but unless the underlying instability is identified and then corrected, having a painless post op hip doesn't mean that it's fixed.

    It also doesn't mean that having an op will not be successful (very) if it's not tailored up with a good functional rehab program that doesn't just concentrate on hip mobility and strength. It must incorporate lumbar spine stability patterning.

    Sorry....I'll get me coat

     HW

  • How would I know if my tear is a result of FAI?
  • @Heavyweaponary

    really? That's interesting. Haven't encountered those theories before - do you have any references to research that would help. I'm very keen on preserving what mobility I have now.
    image

    @loverunning
    http://www.hipfai.com/
  • Mrmoosehead - there are very, very, very few good longterm studies on the effacatiousness of ops to treat FAI, let alone a preventative route.

    Common sense has to prevail. The bone growth happens because of something for 80% of "suffers". There are many people with FAI on MRI that don't have symptoms. All I'm saying is that it's not what you've got, but what you do with it. We've loads of good effacatious but anecdotal evidence to support this.

    It certainly not about increasing gross movement (which can be hip, back and pelvis) to give more hip range of motion but it's about controlling what you've got, where - more commonly controlling the lumbar spine and not over stretching the hip. I think this is why physio fails and surgery prevails.

    HW
  • Hello to loverunning and HW. Good luck with your process, loverunning.

    My operation (arthroscopy) is tomorrow (unless it gets rescheduled again!). I'm getting nervous as I haven't done enough core work since the last one got postponed at the start of November. Life, a virus and frustration with the whole process got in the way. I vow to be better with recovery exercises and keep my core work going when I eventually get back to running. Got quite a bit of lower back pain and ache in my right hip at the minute, which isn't great when it's the left that's being operated on!

    How are you doing now mrmoosehead?
  • Scrap that...just had a call from the hospital to postpone it again image No idea when it is now, but my original appointment with the doctor/ referral was a year ago yesterday!
  • On noes. Sorry to hear that, pipes.

    I'm doing ok. off crutches for a week almost. Walking almost normally again. Been a bit crap with exerciese as work and parties got in the way. image

    Still got lots of rehab work to do on adductors, but I can stretch them now.
  • Poor Pipes. Paracetemol not helping? (I was thinking if you're already on the max daily dose, perhaps going to the GP to ask for better painkillers couldn't hurt... famous last words eh :/ ).
  • Good to hear you're doing well, mrmoosehead. I know what you mean about things coming before the exercises, but I'm going to do my best in the time I have left before the op to get a bit stronger in my core.

    F2D - I'm not taking painkillers. The pain isn't bad enough, even though it is pretty constant, and I don't want to be taking them every day. It's just worrying me that my back and 'good' hip might not be able to support my time on crutches after the op. I will survive, though, and may pop to Abingdon parkrun for a trot around before the op actually happens.
  • I'm in the system now and my case will be put forward to IFR panel which I've been told won't be till February time. I've read the commissioning policy for my PCT and it's clear they will not commission the procedure so don't really know if my IFR will be successful.

    I will have breached my 18 week RTT so I've written a letter of complaint to my PCT to try and get some answers. All seems a bit silly really when there is clear clinical support for me to undergo the procedure and I'm facing delays to treatment all because of a commissioning policy.

    Also worried that as my symptoms and pain are getting worse despite enforced rest and inactivity that any delays will be doing long term damage to my hip. Need some light at the end of the tunnel, want my life back and to enjoy all the things I used to enjoy! So blummin frustrating.

    Pipes - that's really bad news about the cancellation of your op. Any idea when they will reschedule? Lots of pressures with beds across the country with norovirus closing wards. You've waited a long time to get this op - is there any hope you can share with me re your experience?

  • Just had a call to offer me surgery next Wednesday (28th)! They got a cancellation and I was top of the list as I had been messed about so much. Fingers crossed it will happen this time.

    loverunning - what sort of hope would you like me to offer? I frequently read blogs and posts from people who have had surgery. I read one recently from someone who had achieved PBs, including 2:56 marathon, since surgery (http://www.captainapplesauce.com/fai/#ido). I don't think there's enough yet known about long-term efficacy, but I feel very hopeful that I will be back to regular running when all this is sorted.

    I understand your frustration - been there for over a year now, after having had a really good racing season just beforehand. Have they checked you for FAI? Did you ask your consultant what could have caused the tear? With me, I know there is something in my hips that will cause further problems, in addition to the tears that already exist. During my waiting time for this op, I have felt my condition deteriorate, mainly in my 'good' hip, so I want this op asap to avoid more and more damage. Your treatment, if it's just for a tear (without the need for bone-shaving too), should be simpler, if they agree to fund it. Hope the case goes in your favour.
  • FAI - emperor's new clothes?

    Symptoms are rarely caused by only having cam or pincer impingements. Prolonged rest (totally unrealistic!) would eliminate symptoms.

    The symptoms are most likely due to have having poor control, which caused the extra bone growth leading to the FAI....Control and function need nailing or failing to progress into invasive treatment.

    Even with invasive treatment, which some people will definately need, unless the control issue is nailed post op, I'm pretty sure symptoms will appear at a much later date.

  • 6p - when you refer to control, do you mean core stability?
  • Yes - and all that it entails. Spine, pelvis, hips, lower limb and foot.

    Ho ho ho
  • Hey pipes. I guess (hope) you've been done now and you're feeling ok.

    Keep piling the ice on - better than painkillers. image

    let us know how you got on and what the surgeon found.
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