3 days post hip arthroscopy (again)
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0 days post hip arthroscopy (again)
Day of Surgery
Once inside, Dr. Mei-Dan found an area of cartilage damage with underlying subchondral bone defect. He performed small micro fracture to promote cartilage healing and smoothed out the cartilage in the area. This defect was not picked up by any of my imaging studies and the only reason he found it was because he was "searching" for it based on my clinical presentation and a slight artifact on CT. He believes this defect is most likely the root cause behind all of my symptoms. However, just to be safe, he fixed all other structural abnormalities while he was in there since I have tended to be a bit of an enigma throughout all of this. Interestingly enough, he found that a portion of bone on the acetabulum (socket portion of joint) had actually grown under and around one of the previous anchors, leading to a protrusion of bone and labrum. This protrusion may have been acting like a pincer-type irritation of the surrounding tissues- but especially the labrum, as there was evidence of peripheral tearing/fraying. As such, the anchor was surgically removed from this site, the extra bone growth was shaved down and the labrum repaired. I also had a bursectomy of the iliopsoas bursa due to chronic inflammation and, to finish, he closed the anterior hip capsule and tightened this closure to make up for my inherent collagen laxity and to prevent me from over-stretching it (I was a dancer and figure skater... I can't help it!). All in all, he seemed quite pleased with how things went! So fingers crossed this is the last time this hip finds herself up on an operating table :)
10 months post core decompressionPart of my evaluation in Utah included a CT scan for 3D reconstruction of my hip. This is such amazing technology that allows surgeons the ability to see the bones of the body in their full and actual shape/orientation within the body. (Make sure to take a peek at the slideshow below!) This study, unfortunately, did not offer much diagnostic value for me. There were some signs of FAI, but this abnormality did not match my clinical presentation. Plus, FAI was previously resolved in the first surgery I had, which made this even more unlikely. Imaging can be a wonderful tool for diagnosing pathology that we are unable to see with the naked eye. HOWEVER, it is so important to correlate radiographic abnormalities with the patient's symptoms. Just because something is structurally abnormal, it does not necessarily indicate SYMPTOMATIC pathology. In my case, for example, if FAI was the driving factor behind my symptoms, I would expect the majority of my pain to be associated with sitting and squatting activities. My chief complaint, though, was pain with prolonged standing and walking- both of which are inconsistent with the diagnosis of FAI. Because of his mismatch between diagnostic imaging and clinical presentation, FAI should not be considered in the differential. As I was in the process of moving back to Colorado, I decided to continue this evaluation back home. Dr. Mei-Dan has been with me through all of these hip shenanigans and, at the end of the day, I wouldn't want anyone else operating on me. I forwarded him imaging done out in Utah and he placed orders for another MRI out in Colorado. Between these imaging studies, consideration of my past medical/surgical history and current symptom presentation, we came up with a few scenarios that may be contributing to my pain. However, because all of these imaging studies were only suggestive of various pathology (not conclusive or diagnostic), the upcoming hip scope is going to be somewhat of an "exploratory" procedure. Surgery set for September 25th... wish me luck! |
AuthorJust a physical therapist and her journey being on the other side rehab. Categories
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