I always wonder how many other people have fallen into this predicament as well. What I have noticed is that these are key words that often bring people to my blog. I have no way to really keep track, but often I will scan my sitemeter which will tell me the search words used by readers. It doesn't always work, for example, "Landsickness" through google brings up my blog, o the top 10 (I checked), but so do other key words, like FAI, hipscope, hip arthroscopy,psoas....and my all time favorite, "Bryan Kelly hipscope", my blog is #1 on google if you put in those words. This is quite embarrassing as well as pretty funny, if you ask me! (If he knew, he probably wouldn't agree!)
So, my point is, I was curious, who has had a failed hip arthroscopy? or failed FAI surgery? or failed surgery for a labral tear? Who has retorn their labrum?And even more importantly....why...what reason were you given??
Now would be a great time for all lurkers to share their story, so we can all learn from each other.
Me? An conservative surgeon who didn't want to take down too much bone if it was unnecessary. We found out the hard way that it indeed was necessary, but a happy ending for all involved parties!!!
Showing posts with label retear. Show all posts
Showing posts with label retear. Show all posts
Monday, May 19, 2008
Thursday, May 1, 2008
Failed Hip Arthroscopy and Revision Hip Arthroscopy Articles
Radiologic and Intraoperative Findings in Revision Hip Arthroscopy
Presented at the Annual Meeting of the American Academy of Orthopaedic Surgeons, San Diego, California, February 2007.
Benton E. Heyworth, M.D., Michael K. Shindle, M.D., James E. Voos, M.D., Jonas R. Rudzki, M.D., Bryan T. Kelly, M.D.
Arthroscopy. 2007 Dec;23(12):1295-302.
Purpose: The purpose of this study was to identify possible causes of failure of hip arthroscopy by reviewing the intraoperative and radiologic findings in a series of patients requiring revision hip arthroscopy. Methods: We retrospectively reviewed 24 revision hip arthroscopy cases performed in 23 patients (14 female and 9 male; mean age, 33.6 years; 1 bilateral). The review included indications for surgery, intraoperative findings, and arthroscopic interventions for both the primary and revision surgeries. Imaging studies, including radiography, magnetic resonance imaging, and 3-dimensionally reconstructed computed tomography scans, were analyzed for the presence of preoperative bony impingement lesions (e.g., femoral head-neck junction “cam” lesions or anterosuperior acetabular “pincer” lesions). Results: The mean interval between previous hip arthroscopy and recurrence of symptoms was 6.1 months. In 13 of 24 cases (54%), patients had no significant improvement at any point after the primary hip arthroscopy. The mean interval between the previous hip arthroscopy and revision surgery was 25.6 months. Unaddressed or undertreated bony impingement lesions were found in 19 of 24 cases (79%) and were identified on imaging studies before revision hip arthroscopy. A tight psoas tendon and corresponding labral impingement lesion were identified by arthroscopic visualization in 7 of 24 cases, for which partial psoas tendon release was performed. Eight cases of failed labral repair were addressed with labral debridement and removal of suture material. Of these 8 cases, 6 also had bony impingement, which was also addressed at the time of the revision surgery. Conclusions: Failure to address bony impingement lesions of the hip and a tight psoas tendon are key factors in unsuccessful hip arthroscopy and may require revision surgery. Furthermore, failure of labral repairs may be the result of unrecognized bony impingement at the time of initial surgery. Level of Evidence: Level IV, prognostic case series.
Revision Hip ArthroscopyMarc J. Philippon, MD*, Mara L. Schenker, Karen K. Briggs, MPH, MBA, David A. Kuppersmith, R. Brian Maxwell and Allston J. Stubbs, MD
Am J Sports Med. 2007 Nov;35(11):1918-21. Epub 2007 Aug 16
Background: Hip arthroscopy has become increasingly popular; however, little is known about revision hip arthroscopy.
Hypothesis: Revision hip arthroscopy is associated with unaddressed femoroacetabular impingement. The purpose of this study was to describe reasons for revision hip arthroscopy.
Study Design: Case series; Level of evidence, 4.
Methods: Between March 2005 and March 2006, 37 revision hip arthroscopies were performed by the senior author. Data were collected through retrospective review of clinical and operative notes.
Results: All patients required revision surgery because of persistent hip pain. There were 25 women and 12 men with an average age of 33 years (range, 16–53 years). The average time from prior surgery to revision was 20.5 months (range, 2.9–84 months). Common findings among patients needing revision were hip pain, decreased range of motion, and functional disability. The average modified Harris Hip Score was 53 (range, 22–99). Thirty-six patients had radiographic evidence of femoroacetabular impingement at the time of revision. Revision procedures included 34 (95%) for femoroacetabular impingement, 32 (87%) for labral lesions, 26 (70%) for a chondral defect, 23 (62%) for lysis of adhesions, and 13 (35%) for previously unaddressed instability. Two patients had total hip arthroplasty after revision, and 3 patients required further revision. Of the remaining 32 patients, early follow-up was obtained on 27 (84%) at an average of 12.7 months postoperatively (range, 6–19 months). Outcomes showed patients regained some of their lost function within the first year.
Conclusion: Patients commonly required revision hip arthroscopy because of persistent impingement.
Presented at the Annual Meeting of the American Academy of Orthopaedic Surgeons, San Diego, California, February 2007.
Benton E. Heyworth, M.D., Michael K. Shindle, M.D., James E. Voos, M.D., Jonas R. Rudzki, M.D., Bryan T. Kelly, M.D.
Arthroscopy. 2007 Dec;23(12):1295-302.
Purpose: The purpose of this study was to identify possible causes of failure of hip arthroscopy by reviewing the intraoperative and radiologic findings in a series of patients requiring revision hip arthroscopy. Methods: We retrospectively reviewed 24 revision hip arthroscopy cases performed in 23 patients (14 female and 9 male; mean age, 33.6 years; 1 bilateral). The review included indications for surgery, intraoperative findings, and arthroscopic interventions for both the primary and revision surgeries. Imaging studies, including radiography, magnetic resonance imaging, and 3-dimensionally reconstructed computed tomography scans, were analyzed for the presence of preoperative bony impingement lesions (e.g., femoral head-neck junction “cam” lesions or anterosuperior acetabular “pincer” lesions). Results: The mean interval between previous hip arthroscopy and recurrence of symptoms was 6.1 months. In 13 of 24 cases (54%), patients had no significant improvement at any point after the primary hip arthroscopy. The mean interval between the previous hip arthroscopy and revision surgery was 25.6 months. Unaddressed or undertreated bony impingement lesions were found in 19 of 24 cases (79%) and were identified on imaging studies before revision hip arthroscopy. A tight psoas tendon and corresponding labral impingement lesion were identified by arthroscopic visualization in 7 of 24 cases, for which partial psoas tendon release was performed. Eight cases of failed labral repair were addressed with labral debridement and removal of suture material. Of these 8 cases, 6 also had bony impingement, which was also addressed at the time of the revision surgery. Conclusions: Failure to address bony impingement lesions of the hip and a tight psoas tendon are key factors in unsuccessful hip arthroscopy and may require revision surgery. Furthermore, failure of labral repairs may be the result of unrecognized bony impingement at the time of initial surgery. Level of Evidence: Level IV, prognostic case series.
Revision Hip ArthroscopyMarc J. Philippon, MD*, Mara L. Schenker, Karen K. Briggs, MPH, MBA, David A. Kuppersmith, R. Brian Maxwell and Allston J. Stubbs, MD
Am J Sports Med. 2007 Nov;35(11):1918-21. Epub 2007 Aug 16
Background: Hip arthroscopy has become increasingly popular; however, little is known about revision hip arthroscopy.
Hypothesis: Revision hip arthroscopy is associated with unaddressed femoroacetabular impingement. The purpose of this study was to describe reasons for revision hip arthroscopy.
Study Design: Case series; Level of evidence, 4.
Methods: Between March 2005 and March 2006, 37 revision hip arthroscopies were performed by the senior author. Data were collected through retrospective review of clinical and operative notes.
Results: All patients required revision surgery because of persistent hip pain. There were 25 women and 12 men with an average age of 33 years (range, 16–53 years). The average time from prior surgery to revision was 20.5 months (range, 2.9–84 months). Common findings among patients needing revision were hip pain, decreased range of motion, and functional disability. The average modified Harris Hip Score was 53 (range, 22–99). Thirty-six patients had radiographic evidence of femoroacetabular impingement at the time of revision. Revision procedures included 34 (95%) for femoroacetabular impingement, 32 (87%) for labral lesions, 26 (70%) for a chondral defect, 23 (62%) for lysis of adhesions, and 13 (35%) for previously unaddressed instability. Two patients had total hip arthroplasty after revision, and 3 patients required further revision. Of the remaining 32 patients, early follow-up was obtained on 27 (84%) at an average of 12.7 months postoperatively (range, 6–19 months). Outcomes showed patients regained some of their lost function within the first year.
Conclusion: Patients commonly required revision hip arthroscopy because of persistent impingement.
Wednesday, August 29, 2007
The Appointment
Ahhh, the dreaded/ anticipated appointment. I went with my friend Amy, also a two timing hipster, so I had someone to hang out with in the waiting room. I met a blog reader (Lakewood) who said "Susie, as in Susie711?" It was nice to see there are actually real people who are reading this that I can meet!! I didn't catch your name though, but I hope your appt went well, if you have any more questions feel free to email me suzq613 @ aol . com (take out spaces).
So, I waited about an hour. Dr. Kelly came in with Arianna, we discussed the injection, and what happened with the right hip and what is going on with it now. He quickly checked my ROM, nothing else really, and said he is not really sure of what is going on. I mentioned that I had gone over the radiology reports and noticed that there is cam impingement in that hip (thanks Rachel), he sighed and said "I know" in a concerned tone. Then he sat down. Let's see what happens with the injection, if it is an inflammatory reaction, then the cortisone from yesterday should take care of it, call us in 2 weeks and we can talk about it. He also said that when he was in the joint with the scope, he didn't think the labrum had torn from the cam, since the lesion didn't look 'peeled back', it looked to be consistent with the pincer impingement, that's why he left it. Then he looked at me and said "you don't look too convinced", I said no, I'm not, I have always had residual pinching, even from the very beginning, with the second surgery, I had great ROM from the very beginning, so looking back, something has been not right with the right. I have pain with flexion, IR and adduction, so no, I am not convinced that this is inflammatory. So he said, sometimes, he does need to go back in a second time to correct more impingement, this did not make me at all happy. Then he said, you know what, call early next week instead of in 2 weeks so we can figure this out and figure out what the next step is. So this is where I stand, no concrete answers yet, but the possibility of a third surgery looms.
So, I waited about an hour. Dr. Kelly came in with Arianna, we discussed the injection, and what happened with the right hip and what is going on with it now. He quickly checked my ROM, nothing else really, and said he is not really sure of what is going on. I mentioned that I had gone over the radiology reports and noticed that there is cam impingement in that hip (thanks Rachel), he sighed and said "I know" in a concerned tone. Then he sat down. Let's see what happens with the injection, if it is an inflammatory reaction, then the cortisone from yesterday should take care of it, call us in 2 weeks and we can talk about it. He also said that when he was in the joint with the scope, he didn't think the labrum had torn from the cam, since the lesion didn't look 'peeled back', it looked to be consistent with the pincer impingement, that's why he left it. Then he looked at me and said "you don't look too convinced", I said no, I'm not, I have always had residual pinching, even from the very beginning, with the second surgery, I had great ROM from the very beginning, so looking back, something has been not right with the right. I have pain with flexion, IR and adduction, so no, I am not convinced that this is inflammatory. So he said, sometimes, he does need to go back in a second time to correct more impingement, this did not make me at all happy. Then he said, you know what, call early next week instead of in 2 weeks so we can figure this out and figure out what the next step is. So this is where I stand, no concrete answers yet, but the possibility of a third surgery looms.
Wednesday, August 15, 2007
Highlights From My MRI
I am missing the last page of the MRI report (sound familiar), hopefully tomorrow I will be able to get it (sigh), nothing can be simple, ever!!!
To illustrate the absurdity of my life at times, the chinese delivery person no longer rings my doorbell or knocks on my door, rather, just pushes it open and announces her arrival. I guess she feels that being 'invited' over 3 times per week (at a minimum) has made her a part of our family, and she can simply come and go as she pleases! The doorman no longer calls up when she arives, not that we would turn away food, regardless of whether we had ordered it or not!!!
Ok, back to the MRI, once I have the full report, I will type it up and add it, in the meantime I will just point out the parts I found interesting. Both hips are observed on the scan.
Left hip (most recently operated on, not reason for MRI)- incidental note is made of a moderate amount of fluid in the left hip joint, not present on prior study on 1/07. In addition, mild high signal is demonstrated in the anterior margin of the proximal left gluteus medius and minimus muscle, without established muscular atrophy.
Right hip- mild bony offset at head-neck junction of the proximal right femur that may contribute to a cam-type femoroacetabular impingement. There is an attenuated and frayed anterior labrum, as well as a deficient anterosuperior labrum, without a displaced tear.
Progressive Chondral loss is seen in the interval since the prior study of 1/07 with focal small full thickness defect over the superomedial margin of the acetabular dome, adjacent to anterosuperior labral detachment. (Rest of cartilage looks good, no synovitis, muscles and tendons look good, nothing going on in the pelvis)
To illustrate the absurdity of my life at times, the chinese delivery person no longer rings my doorbell or knocks on my door, rather, just pushes it open and announces her arrival. I guess she feels that being 'invited' over 3 times per week (at a minimum) has made her a part of our family, and she can simply come and go as she pleases! The doorman no longer calls up when she arives, not that we would turn away food, regardless of whether we had ordered it or not!!!
Ok, back to the MRI, once I have the full report, I will type it up and add it, in the meantime I will just point out the parts I found interesting. Both hips are observed on the scan.
Left hip (most recently operated on, not reason for MRI)- incidental note is made of a moderate amount of fluid in the left hip joint, not present on prior study on 1/07. In addition, mild high signal is demonstrated in the anterior margin of the proximal left gluteus medius and minimus muscle, without established muscular atrophy.
Right hip- mild bony offset at head-neck junction of the proximal right femur that may contribute to a cam-type femoroacetabular impingement. There is an attenuated and frayed anterior labrum, as well as a deficient anterosuperior labrum, without a displaced tear.
Progressive Chondral loss is seen in the interval since the prior study of 1/07 with focal small full thickness defect over the superomedial margin of the acetabular dome, adjacent to anterosuperior labral detachment. (Rest of cartilage looks good, no synovitis, muscles and tendons look good, nothing going on in the pelvis)
Monday, August 13, 2007
He Called...finally
So after 2 messages an email, and a conversation with his PA (unrelated to this issue) he called me!!
Here's the deal....the MRI report shows a fraying of the labrum, when comparing the MRI images to the scope pics, he says it is normal, and in the area of the debridement. There is no large flap or loose body in the joint. There is no sign of synovitis, but it is usually not reported, and there is some fluid around the psoas. There is also some loss of cartilage in the area of the original tear, which apparently we knew about after the surgery (I don't recall this though).
I can get the psoas injected if I so desire, at the time of our conversation, I was in no pain, now of course I am!! I told him I would prefer to have the joint injected, since I think that is where my pain is, and that I will call him when I go back to work since that is what has been causing me the most pain. I will decide then.
As for now, I am unsure what this all means. Obviously, a frank, obvious retear would be devastating, but I am pretty sure it is not my psoas.
I have PT tomorrow morning, I will have P really check everything out and we can come to a decision (hopefully together!!) about what to do next!
Here's the deal....the MRI report shows a fraying of the labrum, when comparing the MRI images to the scope pics, he says it is normal, and in the area of the debridement. There is no large flap or loose body in the joint. There is no sign of synovitis, but it is usually not reported, and there is some fluid around the psoas. There is also some loss of cartilage in the area of the original tear, which apparently we knew about after the surgery (I don't recall this though).
I can get the psoas injected if I so desire, at the time of our conversation, I was in no pain, now of course I am!! I told him I would prefer to have the joint injected, since I think that is where my pain is, and that I will call him when I go back to work since that is what has been causing me the most pain. I will decide then.
As for now, I am unsure what this all means. Obviously, a frank, obvious retear would be devastating, but I am pretty sure it is not my psoas.
I have PT tomorrow morning, I will have P really check everything out and we can come to a decision (hopefully together!!) about what to do next!
Thursday, July 26, 2007
Uncertainty
I have had a day of indecisiveness!! If I had had time, I would have posted my question to all of you and maybe had some help, but I ended up coming to my own decision. So...what the heck am I talking about???
As you know, my right hip has been pretty bad, it is at the point I was before surgery, sex hurts too, so when I am ready to actually go to sleep at night, I am in so much pain, it is hard for me to fall asleep. I really don't know what to do, I was afraid that if I called Dr. Kelly, he would blow me off, tell me it is compensation, and leave me even more annoyed and frustrated, which I cannot handle now. But I was getting so frustrated with the pain as well...I didn't know what to do. My friend Amy, who has been through a lot of hip shit told me to call him, she didn't understand why I wouldn't, P, my PT said not to bc he knew I would be pissed. So after much deliberation....I called!
My message went like this: Please tell Dr. Kelly that I am having a lot of issues with my right hip, and it is not from compensation!
He called me about 4 hours later, in the past, I have waited 4 days for a call back! I am highly impressed!
I explained that I am having a ton of pain in the right, very much like I had pre-op, pain in the joint, non-palpable. He said it could be the muscles acting up, maybe we should inject the psoas...I repeated that the muscles are fine, my PT worked on them ART'd them...they are not the issue. He said it could be synovitis, the joint is inflammed from the added stress. I reminded him of the twisting episode, and how I am not sure what to think of it, especially since I went on crutches 3 days later, and I really don't know what to do, thats why I called! He said I could get the joint injected if I wanted to. Again, I don't know what I want! So he read the chart over for a few minutes, he said he is confident that I did not re-tear the labrum, this is why he likes to debride, bc there is nothing left to tear. Sometimes, the mechanics of the joint change, causing the muscles to act up. I could get an MRI if I want, but sometimes it is hard to read in the area of the old tear, so it may show nothing. Ok, I really didn't know what to do. He said continue working on it in PT, have somene work on it, modalities of my choice.... still looking through my chart...ok, get an MRI, then we can decide on the injection!!
So, now I am glad I called, at least it is all out in the open, not just on my blog! So, he thinks it is synovitis, I think his first thought is the psoas, possible tendonitis, but the joint hurt first, the psoas does occassionally flare, but it is in response to the joint flaring. So now I am nervous. First of all, my last MRI was awful, I almost panicked. I had a really bad cold and was really congested, also had a cough. Midway through, I needed to cough, alot, but I was afraid to move. But I really had to, I pressed my button, I informed the technician of my needs, he said I could under so circumstances get up bc the machine takes a picture of the hip angles in the beginning and uses them to compare all the images. So I stayed there, and began having a coughing fit, then all this gunk got stuck in my throat and I felt like I couldn't breathe, it was such an awful feeling. I have had awful flashbacks of it, and have been petrified to have to ever have another MRI, I never thought I would! Then comes the issue, what if he finds something bad? I don't want more surgery? Or, what if he finds nothing? Where does that leave me? Crazy????
As you know, my right hip has been pretty bad, it is at the point I was before surgery, sex hurts too, so when I am ready to actually go to sleep at night, I am in so much pain, it is hard for me to fall asleep. I really don't know what to do, I was afraid that if I called Dr. Kelly, he would blow me off, tell me it is compensation, and leave me even more annoyed and frustrated, which I cannot handle now. But I was getting so frustrated with the pain as well...I didn't know what to do. My friend Amy, who has been through a lot of hip shit told me to call him, she didn't understand why I wouldn't, P, my PT said not to bc he knew I would be pissed. So after much deliberation....I called!
My message went like this: Please tell Dr. Kelly that I am having a lot of issues with my right hip, and it is not from compensation!
He called me about 4 hours later, in the past, I have waited 4 days for a call back! I am highly impressed!
I explained that I am having a ton of pain in the right, very much like I had pre-op, pain in the joint, non-palpable. He said it could be the muscles acting up, maybe we should inject the psoas...I repeated that the muscles are fine, my PT worked on them ART'd them...they are not the issue. He said it could be synovitis, the joint is inflammed from the added stress. I reminded him of the twisting episode, and how I am not sure what to think of it, especially since I went on crutches 3 days later, and I really don't know what to do, thats why I called! He said I could get the joint injected if I wanted to. Again, I don't know what I want! So he read the chart over for a few minutes, he said he is confident that I did not re-tear the labrum, this is why he likes to debride, bc there is nothing left to tear. Sometimes, the mechanics of the joint change, causing the muscles to act up. I could get an MRI if I want, but sometimes it is hard to read in the area of the old tear, so it may show nothing. Ok, I really didn't know what to do. He said continue working on it in PT, have somene work on it, modalities of my choice.... still looking through my chart...ok, get an MRI, then we can decide on the injection!!
So, now I am glad I called, at least it is all out in the open, not just on my blog! So, he thinks it is synovitis, I think his first thought is the psoas, possible tendonitis, but the joint hurt first, the psoas does occassionally flare, but it is in response to the joint flaring. So now I am nervous. First of all, my last MRI was awful, I almost panicked. I had a really bad cold and was really congested, also had a cough. Midway through, I needed to cough, alot, but I was afraid to move. But I really had to, I pressed my button, I informed the technician of my needs, he said I could under so circumstances get up bc the machine takes a picture of the hip angles in the beginning and uses them to compare all the images. So I stayed there, and began having a coughing fit, then all this gunk got stuck in my throat and I felt like I couldn't breathe, it was such an awful feeling. I have had awful flashbacks of it, and have been petrified to have to ever have another MRI, I never thought I would! Then comes the issue, what if he finds something bad? I don't want more surgery? Or, what if he finds nothing? Where does that leave me? Crazy????
Monday, July 23, 2007
3 Weeks post-op
I went the whole day without crutches, I think I am in the clear, but my SI joint hurts, probably because I still need a crutch, or maybe a cane, but I am so not doing a cane!! If the SI doesn't resolve, I will have P fix it on Thursday, it is not too bad though, I have taught J how to fix it for me in the past! I tend to get awful SI issues at 3 months post-partum, it happenned both times, but I have trained J well!
I had PT today, I almost broke down, but the look on P's face when he saw that I might cry was enough to make me hold back my tears, and boy did I have to fight to hold them back. He had that look that men get when a girl is aout to cry and they really don't know what to do! I am laughing now thinking about it! My office was pretty busy today, so we didn't have a room, so I really didn't want to cry in the gym, so I held back. I finally just came out and said I think my first surgery failed (then fought really hard again to hold back the tears). What??? Are you sure? I thought it was just compensation??? So he looked at it, again, and all of my symptoms were back, my original November symptoms, decreased ROM (I have practically lost all IR), sitting pain, pain with ambulation during the stance phase of gait. So he worked on that side today, TFL, psoas, both super tight. He also did some mulligan belt mobs, to try to increase my ROM, and some anterior hip glides. For the other side, he stretched/ ART'd my psoas and worked on my scope sites. Originally, I had decided to not let anyone work on the scope sites and see what would happen, and compare to the other side since they had been worked on extensively after my first surgery, but they really looked and felt awful today, so I gave in, so my trial is over!
I had to cut back on the single leg stance exercises today bc my operated leg was beginning to get irriated, probably from all the stair climbing this weekend, and lack of crutches. The (sort of) good news is that I am having anterior tightness now, I didn't develop this until much later on last time, so hopefully it is a good sign, that things are progressing quickly. I need to take an "off day" tommorrow and let things calm down in the operated hip a little, it has definetly been abused the past couple of days. I have some pain in it, it is similar to my pre-op/ post-injection pain, it is tolerable!
I added a link today in Learn From My Experience/ Mistakes, it is called Orthopaedic Considerations for Intercourse. It is not made specifically for hips, there are some positions approved for total hip replacements, these are labeled THA. What I think will work best is if you know what positions are painful for you, and use the pictures to help guide you in choosing a position that would work for you, like most things, sex after a hipscope does not come with cookbook instructions. What is helpful are the "tidbits of information" on the bottom about each position. But you may need to trouble shoot in the beginning until you find what works for you. The 7th position works best for us early on. We have been having intercourse since 2 weeks, 2 days post-op, without too much of an issue.
I had PT today, I almost broke down, but the look on P's face when he saw that I might cry was enough to make me hold back my tears, and boy did I have to fight to hold them back. He had that look that men get when a girl is aout to cry and they really don't know what to do! I am laughing now thinking about it! My office was pretty busy today, so we didn't have a room, so I really didn't want to cry in the gym, so I held back. I finally just came out and said I think my first surgery failed (then fought really hard again to hold back the tears). What??? Are you sure? I thought it was just compensation??? So he looked at it, again, and all of my symptoms were back, my original November symptoms, decreased ROM (I have practically lost all IR), sitting pain, pain with ambulation during the stance phase of gait. So he worked on that side today, TFL, psoas, both super tight. He also did some mulligan belt mobs, to try to increase my ROM, and some anterior hip glides. For the other side, he stretched/ ART'd my psoas and worked on my scope sites. Originally, I had decided to not let anyone work on the scope sites and see what would happen, and compare to the other side since they had been worked on extensively after my first surgery, but they really looked and felt awful today, so I gave in, so my trial is over!
I had to cut back on the single leg stance exercises today bc my operated leg was beginning to get irriated, probably from all the stair climbing this weekend, and lack of crutches. The (sort of) good news is that I am having anterior tightness now, I didn't develop this until much later on last time, so hopefully it is a good sign, that things are progressing quickly. I need to take an "off day" tommorrow and let things calm down in the operated hip a little, it has definetly been abused the past couple of days. I have some pain in it, it is similar to my pre-op/ post-injection pain, it is tolerable!
I added a link today in Learn From My Experience/ Mistakes, it is called Orthopaedic Considerations for Intercourse. It is not made specifically for hips, there are some positions approved for total hip replacements, these are labeled THA. What I think will work best is if you know what positions are painful for you, and use the pictures to help guide you in choosing a position that would work for you, like most things, sex after a hipscope does not come with cookbook instructions. What is helpful are the "tidbits of information" on the bottom about each position. But you may need to trouble shoot in the beginning until you find what works for you. The 7th position works best for us early on. We have been having intercourse since 2 weeks, 2 days post-op, without too much of an issue.
Sunday, July 22, 2007
A Pain in the Butt continued
I am home (sigh of relief)! The carride home was uneventful, L and Jk slept for most of the time. Now I can vent about the weekend without fear of things being left behind on other's computers!
So the whole issue with the stairs, it sucked. It is hard for me to ask for help, so I don't. I also don't always get the help I need from my IL's. I found it hard to keep asking for other's to go get my things, a diaper, wipes, a book... and bedime came, so the kids wanted me, so up and down the friggin steps again and again. As i mentioned in the first half of this post, my right hip was pretty bad all weekend, left was ok, and when I was putting Jk to bed, I had my first meltdown, tears and all, more on my numerous meltdowns soon.
Its not that I don't get along with my IL's, it is just an uncomfortable tension that exists, and has always existed between us. To make matters worse, J's grandparents were there as well, they can add tension to any situation. I just did so much walking, stair climbing and standing there, I am exhausted.
So now, at 12:40 am, I am in my own bed with my laptop. My operated hip is stiff and tight, but I just sat in a car for 3 hours. I am developing the anterior tightness I had last time, but much earlier,I remember bringing it up to Dr Kelly at my 8 week appointment, so things are moving quicker this time.
I had a few other "tearful" moments this weekend, I think I am accepting the fact that I retore the labrum on the right. I know, I said no jumping to conclusions and its too early to tell, but this pain is not compesation pain, once you experience the torn labrum pain, you don't forget. And I have no imaging to back me up, which is fine, this way it is not really reality, at least not yet. I have been upset and angry about it. I really thought I did everything right, I went to a top hip guy, we found the impingement and thought it was addressed, rehab went great, but somewhere along the line, something went awry. I keep saying that I feel like I wasted so much time, 4 months of PT, 4 weeks of crutches, and all for nothing,I am back where I started. Looking back, I don't know what I could have done differently, but I feel like I failed at this. I hope I am wrong, I hope I am having an emotional/ hormonal day and completely overreacting about it, and in 2 weeks I will wake up and have no pain!
Ok, I feel better now! Got that off my chest! So I ended up leaving my crutches behind this afternoon,Jk and I went to the mall, I got a pair of ballet flats http://www.gap.com/browse/product.do?cid=34759&pid=514975 (very cute if I do say so myself), walked around a little but then had to go home. I can't expect to be able to walk for hours on my first day of of crutches! My gait was not perfect, but it is improving each day, and I used my excursion as personal gait training,I tried to focus and swinging my leg straight through, and not around!
After the mall, Jk and I picked L and J up from the basebal game, she had a blast, as did he! We got home, I was trying to unload the car and help L run in to use the bathroom, and the nxt thing I knew I was on the ground.I tripped on some water thing on my IL's sidewalk. It was so scary, luckily, I landed on my knees/ hands and spared the hips, but I just sat on the ground, stunned, with J asking if I am ok, and if I hurt my hip. I was fine, the only damage as the grass stain on my white leggings!
So now i am home! It is such a great feeling! I can focus on my rehab and returning to work, no later than a week from tommorrow!
So the whole issue with the stairs, it sucked. It is hard for me to ask for help, so I don't. I also don't always get the help I need from my IL's. I found it hard to keep asking for other's to go get my things, a diaper, wipes, a book... and bedime came, so the kids wanted me, so up and down the friggin steps again and again. As i mentioned in the first half of this post, my right hip was pretty bad all weekend, left was ok, and when I was putting Jk to bed, I had my first meltdown, tears and all, more on my numerous meltdowns soon.
Its not that I don't get along with my IL's, it is just an uncomfortable tension that exists, and has always existed between us. To make matters worse, J's grandparents were there as well, they can add tension to any situation. I just did so much walking, stair climbing and standing there, I am exhausted.
So now, at 12:40 am, I am in my own bed with my laptop. My operated hip is stiff and tight, but I just sat in a car for 3 hours. I am developing the anterior tightness I had last time, but much earlier,I remember bringing it up to Dr Kelly at my 8 week appointment, so things are moving quicker this time.
I had a few other "tearful" moments this weekend, I think I am accepting the fact that I retore the labrum on the right. I know, I said no jumping to conclusions and its too early to tell, but this pain is not compesation pain, once you experience the torn labrum pain, you don't forget. And I have no imaging to back me up, which is fine, this way it is not really reality, at least not yet. I have been upset and angry about it. I really thought I did everything right, I went to a top hip guy, we found the impingement and thought it was addressed, rehab went great, but somewhere along the line, something went awry. I keep saying that I feel like I wasted so much time, 4 months of PT, 4 weeks of crutches, and all for nothing,I am back where I started. Looking back, I don't know what I could have done differently, but I feel like I failed at this. I hope I am wrong, I hope I am having an emotional/ hormonal day and completely overreacting about it, and in 2 weeks I will wake up and have no pain!
Ok, I feel better now! Got that off my chest! So I ended up leaving my crutches behind this afternoon,Jk and I went to the mall, I got a pair of ballet flats http://www.gap.com/browse/product.do?cid=34759&pid=514975 (very cute if I do say so myself), walked around a little but then had to go home. I can't expect to be able to walk for hours on my first day of of crutches! My gait was not perfect, but it is improving each day, and I used my excursion as personal gait training,I tried to focus and swinging my leg straight through, and not around!
After the mall, Jk and I picked L and J up from the basebal game, she had a blast, as did he! We got home, I was trying to unload the car and help L run in to use the bathroom, and the nxt thing I knew I was on the ground.I tripped on some water thing on my IL's sidewalk. It was so scary, luckily, I landed on my knees/ hands and spared the hips, but I just sat on the ground, stunned, with J asking if I am ok, and if I hurt my hip. I was fine, the only damage as the grass stain on my white leggings!
So now i am home! It is such a great feeling! I can focus on my rehab and returning to work, no later than a week from tommorrow!
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