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Dr.Sawhney
Dr.Sawhney, Orthopedic Surgeon
Category: Orthopedics
Satisfied Customers: 6823
Experience:  More than a decade of post qualification experience
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I'm 29 and was recommended p arthroscopy surgery,

Customer Question

I'm 29 and was recommended for a hip arthroscopy surgery, other than a cam impingement I have a possible Laberal tear. Would I benefit from having the birmingham hip resurface done, or would the arthroscopy be my better choice?
Submitted: 1 year ago.
Category: Orthopedics
Expert:  Dr.Sawhney replied 1 year ago.

Hello

I am an orthopedic surgeon and I would be happy to help you today.

Can you tell me your symptoms and since how long have you been having these symptoms?

Thanks

Customer: replied 1 year ago.
I have been having these problems for almost 2 years. I got the cane around 2 months ago, my va dr told me initially it was because I'm overweight. I'm 270lbs and 76" tall. I have a grinding on the outside of my hip and inside of my groin, along with sharp pain on the inside of my groin. My lower back has been going numb along with my thigh as well. I get no relief from pain killers, I was on percocet earlier this year and was d/c and given orthotic insoles and 800mg ibuprofen. Currently I'm on 1200mg of gabapentin, 2400mg ibuprofen and 1000mg of Tylenol
Expert:  Dr.Sawhney replied 1 year ago.

I am busy with an emergency. Shall answer shortly. Please bear with me.

Expert:  Dr.Sawhney replied 1 year ago.

Thanks for your cooperation.

I would try to explain the nature of your disease and treatment decisions emanating from that .

Femoroacetabular impingement progress from impingement to arthritic changes in hip gradually. There are different treatments available for each stage of disease and there is no "one solution fits all" treatment.

Impingement first of all involves the labrum in the area of impingement. If left untreated delamination of the marginal cartilage of acetabulum occurs. This delamination can progress gradually to involve ever greater areas of acetabular cartilage as well as cartilage of head of femur. This ends as arthritis of the hip.

In the initial stages of labrum tear or marginal cartilage involvement arthroscopic treatment is successful and should be done. If labral tear or marginal cartilage involvement is diffuse and not focal open treatment in form of surgical dislocation of hip and osteochondroplasty can be done.

Reconstructive procedures like Hip resurfacing or total hip replacement considered only when there is arthritic involvement of the hip joint .In younger patients resurfacing is the preferred treatment especially if acetabulum cartilage is relatively better.

Considering that duration of a symptoms is only 2 years and your age is only 29 you should be undergoing arthroscopy in preference to reconstructive procedure like resurfacing.

Feel free to ask any follow-up question.

Customer: replied 1 year ago.
The 2 years is how long the pain has been intense to the point where it's debilitating. I have noticed since at least 2011
Customer: replied 1 year ago.
Sorry I have noticed the pain since at least 2011
Expert:  Dr.Sawhney replied 1 year ago.

Still I would advise you to undergo arthroscopy because you are too young to consider reconstructive procedures as primary surgery before exploring other options. Reconstructive surgeries like hip resurfacing have a finite life and that factor must be considered .

Moreover your surgeon would be able to assess the state of cartilage in hip joint during arthroscopy and have a better idea regarding the need for resurfacing now or later.

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