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  1. #1
    Join Date
    Apr. 14, 2001
    Location
    Fort Collins, CO
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    16,180

    Default Labral tear? (Cartilage tear in the hip)

    Has anyone had one of these? Had surgery for one of these?

    I was diagnosed via MRI and arthrogram and am seeing guru surgeon at the end of August. Curious to hear from people who have gone through the surgery or have chosen to not go through the surgery. I'm in pretty impressive pain now from the hip and would like to preserve as much "soundness" as I can...



  2. #2
    Join Date
    Oct. 31, 2006
    Posts
    928

    Default

    I have one combined with arthritis and bursitis. I just had the injection (just like horses). They have to put you under and do the injection while looking at the radiograph. It worked wonders and will put off having any surgery for a while. If your tear is not too bad you should try it. I couldn't even go to the grocery store because I had to walk too far before the injection.



  3. #3
    Join Date
    Jan. 5, 2010
    Location
    VA--> Washington (state)
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    346

    Default

    i had one and it was horrid. i didn't have any intervention, just waited it out.... took about 9 months of pain, limping, MRIs, etc. getting into and out of the car was excruciating. riding was awful.
    i also worked in specialty orthopaedics when i tore it, meaning i had myself, plus 5 residents, and two handfuls of surgeons to talk about it with.... the verdict was they are a PIA to diagnose, or treat.
    good luck!
    And the wise, Jack Daniels drinking, slow-truck-driving, veteran TB handler who took "no shit from no hoss Miss L, y'hear," said: "She aint wrapped too tight."



  4. #4
    Join Date
    Sep. 12, 2004
    Posts
    999

    Default

    the surgery is awful! went that route on hip #1 back when they were doing people of all ages. converted to total hip a year later.

    how old are you? they found that the surgery tended 2 be much less effective on people with any cartilage degradation in the joint. i was 51 when i had the first one done.

    tore the other hip and am managing on injections every 6mos, lots of pilates on the glute meds, and walking w/2 sticks if i want 2 go on a long walk.

    first tear was shredded off the bone - injections did squat. second one is more just frayed. long periods of sitting tick it off, as does hills, stairs, and wide horses.



  5. #5
    Join Date
    Sep. 12, 2004
    Posts
    999

    Default

    ps...if you opt for surgery find out where the guy fellowed and what he does. if you have fai and just have the tear debrided or repaired it tends 2 re-tear.



  6. #6
    Join Date
    Apr. 14, 2001
    Location
    Fort Collins, CO
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    Default

    The surgeon I'm seeing at the end of August is the guru in Colorado who uses a minimally invasive endoscopic approach. I asked the doctor who has injected my SI and who referred me to the guru guy if we should toss some steroid and hyvisc in the hip, and she said to see him first. She does hip injections ultrasound guided. redhorses, shocked to hear they put you under for your injection--I had a fluoroscopy guided injection for the arthrogram, and it was a total non-event. No sedation, and certainly not put all the way out.

    Sounds like I'm doing the right thing by going to the expert and we'll see what he has to say. I'm 34 and not at all interested in a replacement. There is also some bursitis, IIRC (I'd have to go look at the MRI report again...) I have a 3 year old I want to get started this year yet and hope I can swing that :-/



  7. #7
    Join Date
    Oct. 14, 2000
    Location
    Now In the Sandhills, NC mostly
    Posts
    6,752

    Default

    Had one in my shoulder, and it SUCKED. At times my arm would go numb and tingly from the swelling. I had it injected which helped immensely--the pain was nearly all taken care of. I needed two injections in a short time, but after that it started bothering me less and less. But honestly it took about two years before I went "hey! my shoulder doesn't hurt anymore!" and since then, no more issues. I know it's not the same, but hopefully you can try injections before surgery.
    Buck Davidson tore his labrum in his hip, and he complained that it, too, sucked out loud.



  8. #8
    Join Date
    Oct. 14, 2000
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    Now In the Sandhills, NC mostly
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    Default

    Also, raise your hand if anytime you tell someone you tore your Labrum that you had to also explain....IT'S NOT MY LADY BITS!!!

    Just me? Oh.


    1 members found this post helpful.

  9. #9
    Join Date
    Sep. 12, 2004
    Posts
    999

    Default

    the guy who did mine fellowed w/ steadman. at 34 you probably have a pretty good chance of improving.

    i had significant bone work done w/ mine to address pretty severe fai.

    My guys rehab protocol was LONG - 6wks no more than 20 lbs on the leg - don't know if that is steadmans or not.



  10. #10
    Join Date
    Apr. 15, 2008
    Posts
    2,638

    Default

    Quote Originally Posted by FairWeather View Post
    Also, raise your hand if anytime you tell someone you tore your Labrum that you had to also explain....IT'S NOT MY LADY BITS!!!

    Just me? Oh.
    (that wasn't my first thought, but i *did* have to look it up. )
    Gravity works, and the laws of physics are a bitch.

    Member: Rabid Garden Snail Clique



  11. #11
    Join Date
    Sep. 12, 2004
    Posts
    999

    Default

    ps - i've had hip injections both ways...the one where i was out hurt a lot less afterward. its really light sleep as opposed to general. but they skip the lidocaine so you dont have any irritation from that afterward.



  12. #12
    Join Date
    Oct. 2, 2012
    Posts
    1,701

    Default

    Quote Originally Posted by RAPIDFOXRACHEL View Post
    Don't want to have Sx.
    I got the labrum reference right away, but this one took a minute.

    I wouldn't want to have sx either if I had to ice my crotch.

    I do have to ice my hips nightly to stay comfortable due to bursitis. Your pain does not sound like bursitis.
    A helmet saved my life.

    2014 goal: learn to ride like TheHorseProblem, er, a barn rat!



  13. #13
    Join Date
    Apr. 14, 2001
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    Fort Collins, CO
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    Default

    And...it's surgery, folks. Scheduled for November. 4 - 6 weeks on crutches, 4 - 5 months of rehab. Tear is evident on the MRI, cartilage looks "unhealthy"...and considering what we all do to our bodies as riders, I bet it's going to be ugly in there. There is already some narrowing in joint space.

    Doc said this surgery was actually worse rehab than total hip replacement, but should be curative. Takes four hours, overnight hospital stay, two weeks off work. It is Big Deal.

    But right now I'm on a boatload of vicodin and gabapentin and I'm still in quite a bit of pain when I ride. I feel like I'm doing damage to my hip continually. It's tough to sign up for such scary deal, but I want to fix this. I think I'm doing the right thing by going with the guru doc. I should be cleared to ride again by spring. Horses are at a barn with no indoor, so no real riding all winter, anyway...

    Good news? Lots of time to spend on COTH while healing.



  14. #14
    Join Date
    Mar. 1, 2013
    Location
    PHX, AZ
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    32

    Default

    GOOD LUCK, Simkie.
    Please keep us posted on your progress after Sx.
    I wish you a fully successful outcome.



  15. #15
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    Sep. 12, 2004
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    Default

    Simike - the THR was a cakewalk compared to the labral tear/fai surgery. Best of luck to you!



  16. #16
    Join Date
    May. 30, 2006
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    Little Rhody
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    Hi Simkie,
    Good luck with your surgery! Sounds awful but the outcome promising. You have your age and detemination on your side!

    Hope you don't mind if I steal your thread for a moment to ask a few questions. How did you find out about the tear? Did your pain come on suddenly such as from a fall or other type of accident? Just wondering how this level of diagnostics was determined.

    The reason I'm asking is because I've had pain in my right hip (groin region) for a couple of years and can not lift my right leg very well most days. I even have to grab my pants to lift the leg to get into my small SUV. No way could I swing that leg over a horse (I own 3 but haven't been on one for years).

    Anyway, since I've been on a high dose of steroids for a prolonged period for a life threatening autoimmune disease, the docs are always worried the ball and socket in my hips will snap so I've had a series of x-rays whenever I walk into one of their offices limping. The radiographs show only mild to moderate osteoarthritis (I know they can't show soft tissue problems). I suppose this is the least of my health problems but should request something further such as a CT scan or MRI?



  17. #17
    Join Date
    Mar. 1, 2013
    Location
    PHX, AZ
    Posts
    32

    Default

    Simkie: You may want to look at the info on this surgeon's website.

    It is very informative. He states arthritic hips with narrowing of the joint space are not good candidates for arthroscopy. His recovery time seems shorter than the others. I am not sure why, maybe he is using a different technique or maybe he is more selective of his candidates?

    Dr. Kostas Economopoulos in Phoenix, AZ

    http://www.phoenixhiparthroscopy.com
    Last edited by RAPIDFOXRACHEL; Sep. 11, 2013 at 06:59 PM.



  18. #18
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    Apr. 14, 2001
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    Fort Collins, CO
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    Default

    Sorry all...don't frequent this forum terribly often! Thought I'd check back in to see if there were any new responses and saw your replies.

    Quote Originally Posted by tollertwins View Post
    Simike - the THR was a cakewalk compared to the labral tear/fai surgery. Best of luck to you!
    Ugh...that doesn't sound promising. What approach did you have? Can you tell me about your recovery and how bad you were to start (in PM if you don't want to share with the class?)

    Quote Originally Posted by rcloisonne View Post
    Hi Simkie,
    Good luck with your surgery! Sounds awful but the outcome promising. You have your age and detemination on your side!

    Hope you don't mind if I steal your thread for a moment to ask a few questions. How did you find out about the tear? Did your pain come on suddenly such as from a fall or other type of accident? Just wondering how this level of diagnostics was determined.

    The reason I'm asking is because I've had pain in my right hip (groin region) for a couple of years and can not lift my right leg very well most days. I even have to grab my pants to lift the leg to get into my small SUV. No way could I swing that leg over a horse (I own 3 but haven't been on one for years).

    Anyway, since I've been on a high dose of steroids for a prolonged period for a life threatening autoimmune disease, the docs are always worried the ball and socket in my hips will snap so I've had a series of x-rays whenever I walk into one of their offices limping. The radiographs show only mild to moderate osteoarthritis (I know they can't show soft tissue problems). I suppose this is the least of my health problems but should request something further such as a CT scan or MRI?
    I came off a horse HARD about six? years ago. It's one of the worst falls I've had--came off the left side and landed hard enough on the hip that I thought I'd fractured my pelvis. I could walk, though, so I got back on the horse and rode the other one, and went to the urgent care in the AM. (We're stubborn, aren't we?) Radiographs showed nothing, so they sent me home with pain meds.

    After that, I just hurt, even after I should have healed. My doc diagnosed sacroiliac dysfunction and sent me to PT, which was pretty successful. My pain was pretty well managed until this spring, when I really started riding again after a 4ish year break. I also came off a horse again right around then...not a bad fall, but maybe it played a roll?

    My pain was really sacro-iliac on both sides and pain down the front of my left leg to the knee. I thought it was just a sacroiliac issue, and saw a ortho and requested an injection...got that, pain didn't stop. Further study--first a lumbar MRI, which was clean--and then an MRA (MRI arthrogram) finally revealed the labral tear. Picked up another SI injection on the other side, too. SI feels pretty good, hip now hurts like hell, both groin pain and in the back.

    I really think part of my difficulty here has been a complex of things going wrong and causing pain which has made it hard for me to pinpoint exactly what hurts, and hell--maybe I didn't even HAVE a hip problem until I came off this spring.

    But a radiograph is a totally USELESS took for diagnosing this. If you suspect a tear, you are not going to see it unless you have an MRI with an arthrogram--they will inject MRI dye into your hip. Even then, some tears don't show up. Gold standard for diagnosis is an actual arthoscopy. Your pain and issues with moving the leg certainly sound like you need some imaging!

    You might find this a useful overview: http://www.western-ortho.com/Western...ts-3-11-13.pdf

    Quote Originally Posted by RAPIDFOXRACHEL View Post
    Simkie: You may want to look at the info on this surgeon's website.

    It is very informative. He states arthritic hips with narrowing of the joint space are not good candidates for arthroscopy. His recovery time seems shorter than the others. I am not sure why, maybe he is using a different technique or maybe he is more selective of his candidates?

    Dr. Kostas Economopoulos in Phoenix, AZ

    http://www.phoenixhiparthroscopy.com
    Hmmm. Interesting. I'll have to look into this guy more--thanks for bringing him up. I'm looking for a consult from Dr Mark Phillipon who is local (ish) and I found him because his name kept coming up in published stuff about labral tear repair. He appears to be a world-expert. Interesting that Economopoulos looks to have gone a different route with his fellowships and education. The doctor that I currently have surgery scheduled with is a student of Phillipon.



  19. #19
    Join Date
    Mar. 1, 2013
    Location
    PHX, AZ
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    32

    Default

    That power point presentation link for Western Ortho was very informative, Thank you.
    It sounds like the doc has done a lot of those procedures with a good success rate; use of cadaver tissue was new info for me & it sounds very innovative.
    The recovery period looks tough, though.



  20. #20
    Join Date
    Apr. 14, 2001
    Location
    Fort Collins, CO
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    Default

    Quote Originally Posted by RAPIDFOXRACHEL View Post
    Dr. Kostas Economopoulos in Phoenix, AZ

    http://www.phoenixhiparthroscopy.com
    Alright, I took a little closer look at this guy, and I wanted to bring this to attention in case you were looking for someone to check out your hip, RFR:

    I found this pretty concerning:

    http://phoenixhiparthroscopy.com/wp-...-June-2013.pdf

    He spend Jan - June of this year in a fellowship on hip arthroscopy. That's his only time spent specializing on hips. That's *awfully* recent.

    Granted, he's also spent some time in a sports medicine fellowship, but overall, I'd call him lean on experience with labral tear repair.

    He's also not published anything about labral tears. His focus seems to be more focused on hernias.

    RFR, I'd look further for someone to check out your hip problems (if you were even targeting this guy for that.)



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