My journey started over 2 years ago when I started getting right sided groin pain after playing netball. I've always been active and enjoyed running, gym classes, and netball. I thought it was a strain so I rested but the pain kept coming back. I self referred to physiotherapy but after 3 months of doing specific strengthening exercises, I still couldn't get back to running or netball. I didn't have pain in my normal day but I was frustrated I couldn't exercise.
I was referred to an orthopaedic hip consultant and had an X-Ray which revealed "mild dysplasia" (basically, a shallow hip socket) and an MRA (Magnetic Resonance Arthogram). This is the gold standard investigation for detecting labral tears. The labrum is a ring of cartilage that surrounds the hip socket. For an MRA a dye is injected into the hip socket before an MRI scan to allow "contrast imaging" and therefore better visualise the joint. In all honesty, I found the injection very uncomfortable and I was hobbling around for a week afterwards. From this moment, my pain started to gradually get worse and slowly starting interfering with day to day activities.
The scan revealed a labral tear and my consultant offered me a corticosteroid injection, which I had under general anaesthetic in April 2015. By this time I was struggling with pain that much I was off work and using crutches. The injection gave me excellent relief but for only two weeks. At my follow up, I was offered an arthroscopic (keyhole) labral repair.
As a physiotherapist, I was aware of what dysplasia was and was concerned it could affect my post op success. My consultant told me it was mild so I should be okay but that I could potentially re-tear again in the future. I wasn't happy consenting to a surgery when the outcome sounded questionable so I sought a second opinion privately from Mr McBryde in July 2015.
This is the first time the surgery "Peri-acetabular osteotomy" was mentioned as an option. This is a complex operation involving breaking the pelvis to realign the hip socket and therefore give better coverage of the femoral head (the ball) in the acetabulum (the socket). It takes 9-12 months for the bones to heal fully and involves a lengthy and tough rehabilitation!
I was obviously devastated hearing that this was what was recommended, especially as I was told my dysplasia was classified as "mild" so I didn't see it coming. I was transferred to his NHS list and saw him again in September where we discussed at length the pros and cons of either an arthroscopic labral repair or an open pelvic osteotomy.
My consultant was honest and said he didn't know which surgery would give me the best outcome (without having a crystal ball!) He explained that as my dysplasia was borderline, I may have success with a labral repair but on the other hand, it could potentially make me worse. This is because the labrum provides stability to the hip joint by deepening the socket so by messing with the tear this could "de-stabilise" my hip and cause me more pain. He further advised me that the labral repair may only give me short term relief and if I were to re-tear later down the line and perhaps had developed arthritis, I would not be as good of a candidate for the PAO as I am now.
Taking all this into account, I decided to be listed for a Triple Pelvic Osteotomy (the version of PAO my consultant does). The arthroscopic labral repair was definitely appealing as it is less invasive, has a reduced chance of post op complications, and faster recovery time, however I felt I would be taking too big of a risk as the post op success was uncertain! After doing my own research online and speaking to people on the Facebook groups, I've discovered there are many people with dysplasia who have had failed labral repairs. My consultant also feels, by addressing the dysplasia, the labral tear will settle down as I will not be abnormally loading it anymore.
I think it has taken me most of 2015 to really accept that this is the best decision and it will fix me. I'm now two weeks away from my surgery and trying to stay as strong and positive as possible (see My Surgery Preparation).
Good Luck to everyone else in their own journeys.
Love, Andrea X
I was referred to an orthopaedic hip consultant and had an X-Ray which revealed "mild dysplasia" (basically, a shallow hip socket) and an MRA (Magnetic Resonance Arthogram). This is the gold standard investigation for detecting labral tears. The labrum is a ring of cartilage that surrounds the hip socket. For an MRA a dye is injected into the hip socket before an MRI scan to allow "contrast imaging" and therefore better visualise the joint. In all honesty, I found the injection very uncomfortable and I was hobbling around for a week afterwards. From this moment, my pain started to gradually get worse and slowly starting interfering with day to day activities.
The scan revealed a labral tear and my consultant offered me a corticosteroid injection, which I had under general anaesthetic in April 2015. By this time I was struggling with pain that much I was off work and using crutches. The injection gave me excellent relief but for only two weeks. At my follow up, I was offered an arthroscopic (keyhole) labral repair.
As a physiotherapist, I was aware of what dysplasia was and was concerned it could affect my post op success. My consultant told me it was mild so I should be okay but that I could potentially re-tear again in the future. I wasn't happy consenting to a surgery when the outcome sounded questionable so I sought a second opinion privately from Mr McBryde in July 2015.
This is the first time the surgery "Peri-acetabular osteotomy" was mentioned as an option. This is a complex operation involving breaking the pelvis to realign the hip socket and therefore give better coverage of the femoral head (the ball) in the acetabulum (the socket). It takes 9-12 months for the bones to heal fully and involves a lengthy and tough rehabilitation!
I was obviously devastated hearing that this was what was recommended, especially as I was told my dysplasia was classified as "mild" so I didn't see it coming. I was transferred to his NHS list and saw him again in September where we discussed at length the pros and cons of either an arthroscopic labral repair or an open pelvic osteotomy.
My consultant was honest and said he didn't know which surgery would give me the best outcome (without having a crystal ball!) He explained that as my dysplasia was borderline, I may have success with a labral repair but on the other hand, it could potentially make me worse. This is because the labrum provides stability to the hip joint by deepening the socket so by messing with the tear this could "de-stabilise" my hip and cause me more pain. He further advised me that the labral repair may only give me short term relief and if I were to re-tear later down the line and perhaps had developed arthritis, I would not be as good of a candidate for the PAO as I am now.
Taking all this into account, I decided to be listed for a Triple Pelvic Osteotomy (the version of PAO my consultant does). The arthroscopic labral repair was definitely appealing as it is less invasive, has a reduced chance of post op complications, and faster recovery time, however I felt I would be taking too big of a risk as the post op success was uncertain! After doing my own research online and speaking to people on the Facebook groups, I've discovered there are many people with dysplasia who have had failed labral repairs. My consultant also feels, by addressing the dysplasia, the labral tear will settle down as I will not be abnormally loading it anymore.
I think it has taken me most of 2015 to really accept that this is the best decision and it will fix me. I'm now two weeks away from my surgery and trying to stay as strong and positive as possible (see My Surgery Preparation).
Good Luck to everyone else in their own journeys.
Love, Andrea X