General Questions

Disclaimer: The author (me) of this blog is NOT a health care professional.  These are questions I had and answers I received.  The questions and answers another may have and receive could be wildly different.  I just included the ones that I felt were more applicable to the general population.

Post surgery, I had a ton of questions.  Starting with, “What just happened to me”?  Everyone will get different answers for that one.  Any questions I had early on were so specific, they probably wouldn’t help.  Some of the other questions I came up with though I feel will apply across the board.  I’ve presented the questions in two areas, overall and later phases of recovery.  I can’t stress enough, this was my experience.  If someone reading this has any other questions or issues, see a professional.  Also, some of this is what I understand based on a variety of sources.

Overall

Q: Why does the recovery take so long? (I asked this one alot, you would think it would have sunk in sooner).  I just couldn’t get past how two little bitty scars had such an impact. 

  • Surgery – Any surgery itself is traumatic on the body. 
  • Distraction – (Dislocation Lite) of the femur from the pelvis.  That’s the big one. It takes your body awhile to settle down and put everything back in place
  • Osteoplasty – They are grinding on bone in there.  The body isn’t real thrilled about grinding instruments inside of it
  • Tenotomy – This had it’s own distinct ‘flavor’ of discomfort and issues, these resolved before the issues from the Distraction and Osteoplasty though.

Q: What are my chances of arthritis significantly increasing going forward?

A: Depends on the person.  Some people have had their entire labrums removed with no ill effects, others get arthritis all by themselves without ever having issues with their labrums. 

Q: Any idea what landed me on the operating table?

A: In my case, bad luck.  The neck on my left femur had developed a bit too much bone. This may or may not show up on my right hip some day. 

Q: How do you know the osteophyte will not come back?

A: By shaving down the femur, that reduces the contact surface for impingement.  It has happened rarely, but that is often a result of the surgery not being performed properly the first time.

Q: Post iliopsoas tenotomy, will I have to worry about tendonitis going forward.  How about something like snowshoeing?

A: Once through recovery period of six months, I’m as statistically likely to get tendonitis as anyone else.

Later in Recovery when ROM and abilities are returning (about three months)

 Q: I still have a bit hard of a time lifting leg on affected hip to cross knee when sitting (like tying a shoe).

A:  Me and nearly everyone else that has this surgery.  Keep working on exercises it and it will pass.

Q: Front of hip it feels like something is ‘loose’ when I move to turn a corner sometimes, not in the hip joint itself, but in front.  It doesn’t exactly hurt, it just feels weird.

A: The hip capsule where they went through to do the surgery (capsulotomy) is still healing.  That will clear around six months.  Nothing to worry about.

Q: I’ve still got pain in my hip in places I didn’t have before the surgery.

A: Hip distraction, femoral neck osteoplasty, iliopsoas tenotomy (that’d pretty much cleared up by 12 weeks).   Oh yes, now I remember.

Q: Early in the morning and late in the evening, my hip feels ‘loose’ in the socket.  Kind of like it’s rattling (yes, it feels as disgusting as it sounds).

A: Muscles are either still asleep and need to get worked in, or they are getting tired and it’s time for a break.  This is normal at this phase.  I didn’t notice this before because the swelling was so pronounced that there was no chance of extra ‘play’ in the joint.

Q: Now that a portion of my labrum is gone, will that lead to total system failure for the rest of the labrum (think of a ring, which can take load from all directions, remove a chunk of the ring & the ability to take load is essentially neutralized)?  According to some studies, the labrum takes over half the load of the femur going into the socket. 

A: The failure of the labrum to take load is linear.  For example, if a quarter of the labrum is removed, the remainder will now only absorb seventy five percent of it’s previous ability (pre-osteophyte).  A band of fiborous scar tissue will form completing the ring of the labrum.  It will never have the load capabilities of the original, but it keeps the rest from failing.

Q: The post op report mentions ‘actetabular articular delamination’.  Why didn’t this land me in the microfracture category?

A: Microfracture is used as a last resort, when the articular cartilage has worn through.  The delamination was minimal overall and I had enough articular cartilage remaining that microfracture would have probably hurt more than it helped.

Q: Is there anything I need to stay away from regarding activity moving forward?

A: Don’t do too much of any one thing.  You will get into repetitive action trouble.  Keep all muscles worked and flexible.  Oh, and treadmills.  Treadmills will push the femoral head into the acetabulum unnaturally, leading to premature wearing.  Apparently on normal people with solid labrums, it’s alright, but when that part of the system is impaired, a treadmill is a recipe for a new hip a few years down the road.

Q: Any exercises that will help avoid (more) arthritis?

A: For me, kneeling psoas stretch and figure four exercises are the big ones, as well as the standard stretch and strengthen exercises.

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