So I had my appointment with the hip doctor today. He was really nice, and very detailed in telling me everything that's wrong with my hip. I have a tear in my
labrum (cartilage).
Labral tears are typically the result of some underlying etiology, whether it be bony or traumatic. In my case, it's the bony etiology. I have a cam and pincer lesion, which are bony abnormalities on my femur and pelvis bones that make up the hip joint. I also have femoral
retroversion.
Here's my orthopaedic lesson for the day:
Femoroacetabular impingement (
FAI) is a condition in which the femoral head,
acetabulum, or both are shaped somewhat abnormally. The ball and socket do not fit perfectly, causing friction during hip movements, resulting in damage within the hip joint. The damage can occur to the articular cartilage (smooth white surface of the ball or socket) or the
labral cartilage (soft tissue bumper that surrounds the socket).
Impingement can occur as a result of femoral sided impingement (Cam impingement),
acetabular rim impingement (pincer impingement), or a combination of both which is the case in the majority of patients.
CAM Impingement: During motions such as
hyperflexion and internal rotation of the hip, the Cam lesion is able to fully engage within the joint. This results in cartilage loss over the femoral head and corresponding dome (
acetabulum), as well as
labral tears. CAM lesions predominately affect the cartilage within the hip joint, resulting in a characteristic peeling of the cartilage off the bone. Cartilage wear is the definition of arthritis, therefore, this type of impingement is considered a
pre arthritic condition.
Pincer: The second category of
femoroacetabular impingement is the "pincer" type lesion, referring to the "over coverage" of the
acetabulum in respect to the ball (femoral head). The "extra" bone of the
acetabulum repetitively hits upon the femoral neck resulting in the pinching of the
labrum in between.
Combined (what I have): CAM lesions often coexist with pincer lesions. CAM lesions lead to articular cartilage injury first, whereas pincer lesions crush and tear the
labrum first.
Femoral
Retroversion: refers to how posterior (facing back) the femoral neck is.
Due to the anatomy of a
retroverted femur, when the hip is internal rotated, the femoral neck hits the
acetabular rim earlier than it would with a normal femoral neck. This results in crushing of the
labrum, and many times more posterior (back) pathology in the joint.
I know I'm a geek, but this is how I tore my labrum without actually having an injury!
While I look like a good surgical candidate, he wants me to try 6 weeks of physical therapy, since I really haven't had any conservative treatment. Obviously PT won't fix the tear or lesions, but will build up my hip strength and possibly decrease the pain I'm having. That being said, only 10% of people have a decrease of pain. When he told me he wants me to do the PT first, I totally made a face! He said, "You don't look very happy."
I said, "Well I just feel like it's a waste of time to do PT if it won't actually fix the problem." However he said he wants me to try it. I can also schedule surgery while I do the PT because right now he's scheduling surgeries in October.
So I'm going to call his office on Tuesday (not sooner, so I don't seem like a psycho) to try to pick out a surgery date, and then will do PT during my lunch breaks at the PT place where I work.
The good news is that I should only have to wear a hip brace and be on crutches for about 2 weeks! However I'm on my feet a lot at work, so I don't know if I'll be able to jump right back into things.
Two things that I'm thinking about:
1) With the surgery, the MD said he'll tighten my hip capsule. This means I'll lose some of my flexibility. This isn't really a big deal since I don't dance anymore, but my flexibility has been "a part of me" my whole life! It's kind of depressing to have that change!
2) It scares me whether the same thing could eventually happen to my other hip!
He’s slowly starting to say words!! Every time he says something I’m amazed! It’s the best feeling! Some of his words include: on, good, no, nana (banana), Liley (Riley), good job
Caleb dropped one of his toys, and the giraffe’s head popped off. He picked it up, tried to put the head back on, and kissed the giraffe’s face! So stinkin cute!! He also kisses his OSU football player nightlight.
When we feed the dogs, I point my finger and say, “eat your food!” If Caleb sees dog food still in their bowls, he points his finger and “tells” them to eat their food!
He gives us hugs when we ask for"tight squeezes" and now gives kisses with his lips closed :o)
His favorite foods are blueberries, cheerios in milk, cucumbers, tomatoes, teddy grahams, peaches, cheese, and of course, Daddy’s German pancakes.
He’s starting to be a little stinker with brushing his teeth, and we have no idea why! It’s like he won’t stand or sit still to let us do it!
He LOVES Mickey Mouse Clubhouse and Team UmiZoomi even more than before. I only let him watch two shows a day, and he is totally enthralled. It kind of creeps me out how he zones out, but I use those times to run around the kitchen and get stuff done. He sits on the couch with his Disney characters and other stuffed animals so they can all watch!
I'm realzing that these play dates are just as important for us Moms, as well as for the kids to socialize! It feels so great to have another Mom say the exact same things I think and feel!
