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Acetabular labral tear (Hip socket cartilage tear)

post #1 of 12
Thread Starter 

Anyone have experience with this injury, rehab, or the arthroscopic surgery to repair it? What I thought was a groin pull (Sartorious muscle strain) from an awkward ski fall back in late February just seems to be getting worse.After consulting Dr Google, I'm convinced that I have torn cartilage in the hip socket. I've got all the classic symptoms: weight bearing pain (limping alot), clicking noise when I lift my leg, and impingment(reduced/painful range of motion). I'm just starting the slow process of seeking help thru my HMO. I've got a good Doc that's on my side but he can't just order an MRI. I have to go the x-ray and rehab route first before I can see an orthopedic surgeon or get an MRI. Needless to say, very frustrating. If I had the surgery tomorrow, I'd be good for the next ski season !  ;) Thankfully, I can still ride a bike, though not with any real power and I can paddle my kayak. Will update as things change. Don't hold your breathe...


Edited by xcsteve - 8/2/11 at 10:40am
post #2 of 12

I am sorry to hear that you have been in such pain.  I do have exp in rehabing these & work w/ an orthopod who has has the repair done & does the procedures.

 

First, forget dr. google.  (sorry)

 

Next, do the rehab & work w/ a therapist w/ strong manual skill.  They can often help / route you in the correct direction.  Get the MRI if it is approp & go from there.  There are many other issues that may present the same way.  I hope that this is not as dr. google diagnosed, yet regardless wish you well.  I am suprised to hear that your HMO is making you hope hoops, yet CA is always been more aggressive than the rest of the nation.

 

best wishes

post #3 of 12
Thread Starter 

Sounds like good advice. Yeah, I could be wrong with the self-diagnosis. My wife rolls her eyes when I tell her I think I figured out what my problem is from doing a google search. Anyway, I'm going to keep an open mind about the physical therapy. Thanks for your input. 

post #4 of 12

I've got experience with this as well - both personally and professionally. I had surgery for femoro acetabular impingement (FAI), and a labral tear in Jan 09 after 20 years of improperly diagnosed hip problems. I'm also a strength coach and have trained a lot of clients with either FAI or labral tears, or both. I've trained some post-surgery, and others as part of conservative measures to avoid surgery.

 

I'd definitely agree with the recommendation to train/rehab as though you won't have surgery, as you may have something completely different, and if it is a labral tear and/or FAI, you may be able to avoid surgery with the right training/rehab approach. But at the same time, I'd suggest going through the process to find out what's up. If you see an orthos who recommends an MRI, make sure it's actually an MRA - Magnetic resonance arthrogram. MRIs don't cut it for hips, and if a doc or surgeon is suggesting one, then they are not experienced with hips and you want to move on to someone who does. 

 

Good luck!

 

Elsbeth

post #5 of 12
Thread Starter 

Evaino,

Your comments are rather timely to say the least at this point.Completed three weeks of physio a month ago, didn't help at all.I had an MRI last week and the tech immediately told me my MRI was abnormal.I went back the next day for a CT scan. My doctor who is a family physician then called me in and said there's nothing conclusive yet but did say he has ruled out cancer. I'm scheduled to get another MRI with contrast this coming Wednesday.Is that what you are referring to as an MRA ? Just a wild guess but I'm thinking I fractured something, didn't know it and necrosis developed.If that's the case, the BIG question I suppose will be how far along it is? The initial ski fall was back at the end of February, thought I had recovered and was back to skiing six weeks later, no problems, all seemed good. Ski season ended, started doing some serious road bike riding and then rather suddenly had a relapse.Anyway, at this point it seems whatever it is, it ain't going to be good.I'm 58 and have always been very active, so feeling a bit bleak about the whole thing.Checkers anyone ?

post #6 of 12

I wouldn't jump to the necrosis assumption. But I would go see a specialist. Does your hmo allow you to go see an orthopedic specialist? You're wasting your time with the family physician. The MRI with contrast may be the MRA - not sure. Hips are complicated - go see someone who knows them. And the world of hip orthopedics has been on hyperdrive for the last 10 years - another good reason to skip the family doc. Do they have sports medicine physicians down there? If so, that's where I'd suggest you go. I'm not a fan of going to an orthopedic surgeon for assessments because they're surgeons and some of them will have the "I have a hammer so everything looks like a nail" approach, but it would be the way to go if you don't have access to a sports med md.

 

Also, what's your PT doing? There are some great PTs out there, but there are also a lot of terrible ones. If you're going in for a few minutes of manual therapy and the rest of your session is getting hooked up to machines, then you are seeing one of the latter, and the fact that it's not working may reflect that. And is the PT stretching you aggressively? Particularly into hip flexion or rotation? If so - that's also a bad sign. If you do in fact have FAI, then they're stretching you into bone on bone and that's going to make you worse, not better. 

 

Good luck! 

 

Elsbeth

 

post #7 of 12
Thread Starter 

I do have an appointment coming up with a sports medicine doctor in a week. I am not doing any P/T at this time, however I am doing some light biking. Spinning, no pressure. Figure it's good for circulation and maintaining strength.Have also been doing some flatwater paddling but may cut back on that as it uses leg pumping and core rotation.I am trying to keep off it now as much as possible.Fortunately I only weigh 150 lbs. Thanks for your insight, I really appreciate help, Elsbeth.

post #8 of 12
Thread Starter 

Well, at this point this doesn't have much to do with skiing but perhaps it will be helpful to someone, somehow. After two MRI's, a CT scan, a few more doctors and being relegated to crutches, it seems that I may have a tumor in the pelvic bone that has fractured the illium above the hip socket, thus the crutches. Was rushed to surgery last week for a biopsy of the pelvic bone and am now waiting for the results which will take 7-14 days. I'm optimistic but realistic, that said, I don't think I'll be skiing this coming season! What's interesting is that the pathologist doesn't think that the initial ski injury (February) had anything to do with it. In fact everything seemed good until I went for a bike ride in June that involved 7000' of climbing. The next day I was in pain, which  makes me think that may have been when the fracture occurred. On a lighter note, I feel lucky I didn't break anything skiing this past season. I had some really crazy days skiing in close to zero visibility where I would find myself plastered up against a snow bank or crash landing onto a service road unexpectedly.

post #9 of 12

heres to wishing you the best!

Hopefully its something benign.

 

When people break bones with mechanisms of injuries that are too minor to usually break these bones, these breaks are called "pathological fractures".

 

After which docs usually go looking for a reason for the fracture.

 

Ya, your primary concern right now is to hope that this isn't something bad that cannot be treated easily.

 

However, most of all, I'd recommend not looking towards Dr. goggle for possible diagnosis at this point, you will freak yourself out. trust me.

 

Good luck!

post #10 of 12

 

Quote:
Originally Posted by xcsteve View Post

Well, at this point this doesn't have much to do with skiing but perhaps it will be helpful to someone, somehow. After two MRI's, a CT scan, a few more doctors and being relegated to crutches, it seems that I may have a tumor in the pelvic bone that has fractured the illium above the hip socket, thus the crutches. Was rushed to surgery last week for a biopsy of the pelvic bone and am now waiting for the results which will take 7-14 days. I'm optimistic but realistic, that said, I don't think I'll be skiing this coming season! What's interesting is that the pathologist doesn't think that the initial ski injury (February) had anything to do with it. In fact everything seemed good until I went for a bike ride in June that involved 7000' of climbing. The next day I was in pain, which  makes me think that may have been when the fracture occurred. On a lighter note, I feel lucky I didn't break anything skiing this past season. I had some really crazy days skiing in close to zero visibility where I would find myself plastered up against a snow bank or crash landing onto a service road unexpectedly.


Sorry to hear that and also hoping it is a benign tumour. Best wishes for a speedy recovery.

 

Elsbeth

 

post #11 of 12
Thread Starter 

Turned out to be Bone cancer in the pelvis.I am in the first of three cycles of chemo at UCSF right now to shrink the tumor. Going well, no problems.Then surgery probably in Feburary.The surgery will be a major turning point in my life. Hard decisions, no guarantees, and a slim chance at avoiding leg amputation.More later...

post #12 of 12
Quote:
Originally Posted by xcsteve View Post

Turned out to be Bone cancer in the pelvis.I am in the first of three cycles of chemo at UCSF right now to shrink the tumor. Going well, no problems.Then surgery probably in Feburary.The surgery will be a major turning point in my life. Hard decisions, no guarantees, and a slim chance at avoiding leg amputation.More later...



Oh ! That truly sucks. Thoughts and prayers to you, keep us informed. 

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