Has anyone had a successful Femoroacetabular impingement (FAI) surgery recently

KiliKili ✭✭✭
edited August 2017 in Health + Injury
Hi Guys,
I've recently had a diagnosis of a Femoroacetabular impingement ( pincer)(FAI) and have of course taken to the net to see what its all about and what can be done. A lot of the information I've read about (On these forums as well ) seems to be mostly in the negative.

I'm having to consider the operation and I've yet to see my local Orthopedics surgeon but word on the ground is my local hospital wont fund this operation and I'll be offered Physio. From what I've read Physio just cant cure this problem as bone needs to be shaved off.  It looks like I'll have to reach under the mattress and get some cash out and go private.

I'm desperate to hear from people who have had a successful Arthroscopy operation to correct this in the last 2 or 3 years as I understand this is now a common operation and if so did you have a positive result and are you now able to run as normal again?

Cheers Kili. :'(

Comments

  • How old are you? Do you have arthritis? Do you have pain?  Bone spurs are common in arthritic hips.  Recent research suggests bone spurs actually protect the hip, so removing them can be detrimental.  I see a lot of people who don't have any pain but have impingement on MRI.  Is your impingement causing the pain or is it a coincidence? MRI's can be misleading.

    Arthroscopy has exploded over the last 15 years, the majority of it most probably unnecessary.  Going under the knife should be an absolute last resort and for very good reason. (hip and knee surgeon)


  • KiliKili ✭✭✭
    edited September 2017
    hi Pewpewpew, thank you for taking the trouble to reply.

    I'm 59.
    According to my doctor I have a Pincer Lesion and there's no sign of Arthritis.

    I have had dull pain almost constantly for the last 3 months, not so much if I don't exercise.
    If I run I can feel the hip aching/throbbing and then I'm limping afterwards. I cant walk more than a quarter mile without finding myself limping.

    If I walk run uphill I can feel the pain/dull aching increase in intensity.

    If I cycle its fine and I don't feel any pain.

    I've read an article on what your suggesting that the spur protects the hip but I've also read as many stories that the only cure is a removal of the Pincer lesion.

    I've looked at a number of hip specialists websites including Professor Damien Griffins website which states:

    ' Activity modification or physiotherapy to strengthen hip muscles cannot cure FAI, but may relieve symptoms temporarily'

    This statement suggests that the only option is surgery although I agree with you a last resort but, I cant see any other option. I've done all the exercises to strengthen glutes, pirformis and lower back muscles etc... to no avail . If I cant run now can it be any worse if having the surgery does not resolve the problem I don't know hence my request from those who have had the op with a positive outcome to reply.

    I see your a hip and knee surgeon so your opinion is obviously  very much appreciated and relevant.

    Have you done any FAI Athroscopy operations?

    Thank you
    Kili
  • TTTT ✭✭✭
    Hi Kili, I am having hip FAI surgery in two weeks time! Tried injections, physio neither worked. I was told if I stopped running I might be okay. I also have a tear in my labrum. I am funding mine as I was told I was in the 10% so it might be 2018 or even later before I had surgery on the NHS. I had to fund all the tests as my GP could not refer me under the NHS either. By funding it I chose the surgeon, hospital and exact time of the surgery. My coach knows of at least two people who are now out running marathons/IM Tri. He also said do not go on the internet as it is full of the negative stories and not the positive. 'nurse on the run' is a good site to visit. Hope all goes well. 
  • Kili, you are correct, activity modification or physiotherapy will not cure FAI, but it isn't necessarily a problem for many people.   Who has assessed you so far? Are they as certain as they can be the impingement is causing your pain?  What scans have you had and who looked at them?  Have you had a second opinion? Was there damage to the labrum, labral tears?

    Have you had any rest during your three months of pain, or continued to exercise?  It's amazing how time can heal.

    I only do them where it is having a real impact on their quality of life or it impacts on their job (professional sportsmen).  After looking at the overall picture and the patients goals, there isn't that many that can justify surgery.  Generally, outcomes are good.


  • KiliKili ✭✭✭
    edited September 2017
    Guys, apologies for the delay in responding work and all that prevented me doing so earlier.

    TT
    Thanks for the info and good luck with you op. Fingers x for you. I'm not sure what ' I was told I was in the 10% ' means care to explain, does it mean only 10% of patients would qualify for the op?

    Pewpewpew
    Thanks for responding. I've had one Xray and been told I have a Pincer Lesion but no Arthritis. No mention of tears. Would they show up on an xray or would one need an MRI to see that much detail?

    I've been cycling and walking only for the last 3 months or so, no pain/discomfort when cycling but after a half a mile of or so of walking I can feel the discomfort and develop a slight limp but no real pain.

    I've now made a private appointment to see my local bones surgeon (7 week wait), the same bloke I would see if I'm prepared to wait six months for an appointment on the public list. Makes you wonder if consultants were not allowed to do private work would the public list be so long. Anyway moan over.

    I'm going to get an assessment from him  as to the best course of action hopefully. I'm not ruling anything out but the reality is I have to trust him as to the best course of action or seek another opinion as obviously I haven't a clue as to what I should do.

    Should I seek another opinion?

    If it is an Arthroscopy op he's the only surgeon that can do them on the island that I live on else its a trip to London. I'm concerned that if I do have an op he's not doing these operations regularly maybe two a year his secretary informs me.
    If It came to surgery would you seek out a surgeon well known for doing this kind of op or would you be happy with a surgeon that does hip replacements regularly and PINCER or CAM deburring/shaving ( think that's the terminology) occasionally?

    Who would you as a surgeon choose if you were having an Arthroscopy for a Pincer Lesion?

    Many Thanks for your time guys.

    Kili




  • Have you had a physical examination? That is your first port of call with a hip specialist.

    Hip scopes are very hard to perform, you need a surgeon who performs them all the time, certainly not twice a year!!

    Unfortunately your ages goes against you, depending on findings, surgical options may be limited.  


  • TTTT ✭✭✭
    Hi Kili, 90% of patients are meant to be seen within 18 weeks. I am in the other 10%. Therefore no-one was prepared to say when it would be except it would be most likely 2018 at the earliest.

    If you are going private you can chose where you go. The surgeon I was recommended to use does loads of these operations, and was the one my GP said he would use (as my GP is also a runner). My price also has all my physio included. Seven weeks is a long time when you are going private. I waited 10 days. 

    My physical exam was very thorough, all the MRI did was confirm his diagnosis.
  • KiliKili ✭✭✭
    Pewpewpew, thanks. Seeing consultant in seven weeks privately so hopefully will get a full diagnosis then.

    May have to go to London and find someone who does these regularly if I need it done but just not sure I can find the £8,000.

    TT  I'm not in the UK where I live its six months on the public waiting list just for an appointment to see the same guy under our health system that I'm paying £230 to see privalty but he's so busy there's still a 7 week wait to see him privately.

    Would you mind telling me which surgeon your using and where his based?

    Thanks guys
    Kili
  • TTTT ✭✭✭
    Hi Kili I have PM you.
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