Hip Dysplasia Surgery in Young Adult

[plansrme]

I haven't been on the Chat Board in forever, so forgive this interruption, but as I've been trying to find more BTDT information on this topic, I thought this might be a good place to check.

My 19 yo has been diagnosed with hip dysplasia in both hips.  She has an MRI scheduled next week, and the dr. will not give her much information on prognosis and recovery until he sees the MRI.  All she's gotten out of him so far is 3 weeks on crutches (non weight-bearing, I assume) and a longer rehab.  This is per hip, so two surgeries, two rehabs.  

She is a college swimmer, and his refusal to either tell her she has a future in her sport or she does not is frustrating.  If anyone has any experience, i would love to hear it.

And if anyone wants to come help me track down the orthopedist who blew me off as a stupid mom, with no x-rays, no nuthin', when I took her for a hip dysplasia evaluation when she was 2 because I thought she had it then, grab your pitchfork and torches and come on down.

[prairiewindmomma]

I'll come with my pitchfork. I can even bring my manure fork in case we need to switch tactics.

My knowledge about hip dysplasia is somewhat limited, but I think a lot will come down to whether she has any necrosis, bone spurs, bursitis and the degree of her arthritis in her hips. Are they thinking of doing PAO, arthroplasty or resurfacing? If she's a competitive swimmer I would make dang sure to get her with a sports med surgeon who has done a lot of athlete work. 

 

[MysteryJen]

Well, that is super frustrating. I am so sorry for everything. 

We have been through the mysterious hip pain, the non-helpful suggestions, the crap-tastic MRI which at first showed nothing amiss. 

And the out-of pocket second opinion which showed, indeed, a torn labrum and FAI (impingment of the hip bone and socket).

Basically dd2's hip bone and socket were grinding together every waking minute of every day and wearing a tear in her labrum.

Two years from first complaint about hip (age 15 years 4 months) she had surgery.

Surgeon found- yes a torn labrum (pain wasn't quite as imaginary as they said it was) and more bone issues than they could see on the MRI and multiple xrays.

She had surgery at the beginning of June- and is currently off crutches, kicking "gently" (insert eyeroll) and basically will be back to full training the beginning of September and should be competition ready for December (high school season).

And all this was going on during recruiting. She went on 4 OV's gritting her teeth and downing Advil like candy. She told the coach of the program she wanted before she committed and he said we want you anyway, you are young and tough and we want you here. She committed at NMSU and had surgery two weeks later.

So- hip surgery is both as bad and as good as advertised. It was pretty miserable for a while, but she is pain-free now.

My older daughter had knee surgery at VT. Great experience, good outcome- should have done it earlier. Coaches and athletic departments want their athletes fixed and working. She can probably red-shirt and get both hips back 18 months if she does it soon. I wouldn't hesitate to use the recommendations of the athletic department.

[plansrme]

2 minutes ago, MysteryJen said:

 

And the out-of pocket second opinion which showed, indeed, a torn labrum and FAI (impingment of the hip bone and socket).

Basically dd2's hip bone and socket were grinding together every waking minute of every day and wearing a tear in her labrum.

Two years from first complaint about hip (age 15 years 4 months) she had surgery.

Surgeon found- yes a torn labrum (pain wasn't quite as imaginary as they said it was) and more bone issues than they could see on the MRI and multiple xrays.

She had surgery at the beginning of June- and is currently off crutches, kicking "gently" (insert eyeroll) and basically will be back to full training the beginning of September and should be competition ready for December (high school season).

And all this was going on during recruiting. She went on 4 OV's gritting her teeth and downing Advil like candy. She told the coach of the program she wanted before she committed and he said we want you anyway, you are young and tough and we want you here. She committed at NMSU and had surgery two weeks later.

So- hip surgery is both as bad and as good as advertised. It was pretty miserable for a while, but she is pain-free now.

My older daughter had knee surgery at VT. Great experience, good outcome- should have done it earlier. Coaches and athletic departments want their athletes fixed and working. She can probably red-shirt and get both hips back 18 months if she does it soon. I wouldn't hesitate to use the recommendations of the athletic department.

Thank you.  That is very reassuring! She is transferring schools, due to start in two weeks at the new college. I am also thinking a red-shirt season might be in order, but we need the surgeon to talk to us about scheduling options.  The sports med dr originally thought she had FAI but sent her to the hip specialist to confirm.  Hip specialist is the one who diagnosed HD.  She doesn't seem to be hurting badly enough for this to be what it is, but he is the hot-shot hip guy around here.

Best of luck to your daughter at NMSU.  Hope this is but a distant memory by the time her freshman season rolls around.

[PinkTulip]

This is a topic I am unfortunately well-informed on. My oldest DS had PAO surgeries on his hips when he was 16 and 17. It was a brutal year of surgeries, crutches, physical therapy etc. for recovery. He was a high-school swimmer at the time and missed his entire junior year of swimming  

But the good news is that he recovered remarkably well, and has had had very few issues in the mean time. In the year after his second surgery, he skied all winter, swam at the state meet, ran a 6-minute mile. His walk is completely normal, he has zero pain (except a little twinge when the weather is changing), and you would never know he had hip surgery unless you see the 6-inch scars on both hips. 

There is a very short list of surgeons I would trust to do a PAO on my family member, so do your research there. Also, there is an amazingly supportive Facebook group that is super helpful. 

Feel free to PM me with any questions- I’m happy to support you and your DD through this! 

(I’m at work today and will be at at event tonight, but I’ll check my PMs tomorrow morning!)

Edited August 2, 2019 by PinkTulip
Typo

[plansrme]

1 hour ago, PinkTulip said:

This is a topic I am unfortunately well-informed on. My oldest DS had PAO surgeries on his hips when he was 16 and 17. It was a brutal year of surgeries, crutches, physical therapy etc. for recovery. He was a high-school swimmer at the time and missed his entire junior year of swimming  

But the good news is that he recovered remarkably well, and has had had very few issues in the mean time. In the year after his second surgery, he skied all winter, swam at the state meet, ran a 6-minute mile. His walk is completely normal, he has zero pain (except a little twinge when the weather is changing), and you would never know he had hip surgery unless you see the 6-inch scars on both hips. 

There is a very short list of surgeons I would trust to do a PAO on my family member, so do your research there. Also, there is an amazingly supportive Facebook group that is super helpful. 

Feel free to PM me with any questions- I’m happy to support you and your DD through this! 

(I’m at work today and will be at at event tonight, but I’ll check my PMs tomorrow morning!)

I will PM you.  Thank you.  

[Storygirl]

We didn't get to the point of considering surgery with DD17, who was a ballet dancer, so I can't offer many details. She didn't have hip dysplasia but instead has a labral tear. She was not recommended to have surgery, except as a last resort, because the doctor warned that the surgery may produce scarring that could cause new problems, and that could not be predicted. I would be sure to ask about that.

DD17 does not have pain during daily activities, only during certain movements in dance.

I would definitely get a second opinion and look for someone who works with high level athletes.

I'm sorry they didn't believe you when she was younger. That is super frustrating.

[kbutton]

I know next to nothing about this problem, but what I do know is that you probably want to know WHY she has the problem. I hear about it commonly occurring with other problems since our family has been thrust into the world of connective tissue disorders. It's definitely possible to have as a solo problem, but since connective tissue disorders are commonly under-diagnosed (and some CTDs have serious complications, such as heart or aortic involvement), I thought I'd mention it.

https://journals.lww.com/jbjsreviews/Citation/2019/04000/Developmental_Dysplasia_of_the_Hip_in_Patients.9.aspx

 

[plansrme]

3 hours ago, kbutton said:

I know next to nothing about this problem, but what I do know is that you probably want to know WHY she has the problem. I hear about it commonly occurring with other problems since our family has been thrust into the world of connective tissue disorders. It's definitely possible to have as a solo problem, but since connective tissue disorders are commonly under-diagnosed (and some CTDs have serious complications, such as heart or aortic involvement), I thought I'd mention it.

https://journals.lww.com/jbjsreviews/Citation/2019/04000/Developmental_Dysplasia_of_the_Hip_in_Patients.9.aspx

 

 

I will keep that in mind.  She was adopted from China at 15 months, so my working theory is that it is related to early malnutrition, but I also means I know nothing of her genetic history.

[mamakelly]

On 8/2/2019 at 1:27 PM, Storygirl said:

We didn't get to the point of considering surgery with DD17, who was a ballet dancer, so I can't offer many details. She didn't have hip dysplasia but instead has a labral tear. She was not recommended to have surgery, except as a last resort, because the doctor warned that the surgery may produce scarring that could cause new problems, and that could not be predicted. I would be sure to ask about that.

DD17 does not have pain during daily activities, only during certain movements in dance.

 

This is exactly my daughter's story!!! She is 17 and was a dancer practically from the time she could walk. She got more serious about ballet at about age 7. She danced her final Nutcracker 3 years ago and was in so much pain. She was diagnosed with a small labral tear was well.They said her tear was too small for surgery but it caused her terrible pain to the point that she couldn't even stand in line in the store. She was also diagnosed with a "slight under covering of the femoral head" meaning, slight hip dysplasia. They only suggestion they would give us for the pain was a cortisol shot, which we opted not to do for various reasons. We ended up doing PRP on her hip, they took her blood, spun out the platelets and injected them into her hip. Within a few weeks she was nearly pain free. She's back to dancing, but she's taking an adult class that is way less intense. 

 

OP I'm so sorry no one listened to you about your daughter. I really wish someone had caught my dd's issues earlier as well. It would have saved us so much heartache. 

[itsheresomewhere]

36 minutes ago, mamakelly said:

 

This is exactly my daughter's story!!! She is 17 and was a dancer practically from the time she could walk. She got more serious about ballet at about age 7. She danced her final Nutcracker 3 years ago and was in so much pain. She was diagnosed with a small labral tear was well.They said her tear was too small for surgery but it caused her terrible pain to the point that she couldn't even stand in line in the store. She was also diagnosed with a "slight under covering of the femoral head" meaning, slight hip dysplasia. They only suggestion they would give us for the pain was a cortisol shot, which we opted not to do for various reasons. We ended up doing PRP on her hip, they took her blood, spun out the platelets and injected them into her hip. Within a few weeks she was nearly pain free. She's back to dancing, but she's taking an adult class that is way less intense. 

 

OP I'm so sorry no one listened to you about your daughter. I really wish someone had caught my dd's issues earlier as well. It would have saved us so much heartache. 

I could hug you for posting about PRP.   I am looking into it for myself and don’t really know anyone who has done it.  Thank You.  

[alewife]

On 8/2/2019 at 2:05 PM, plansrme said:

I haven't been on the Chat Board in forever, so forgive this interruption, but as I've been trying to find more BTDT information on this topic, I thought this might be a good place to check.

My 19 yo has been diagnosed with hip dysplasia in both hips.  She has an MRI scheduled next week, and the dr. will not give her much information on prognosis and recovery until he sees the MRI.  All she's gotten out of him so far is 3 weeks on crutches (non weight-bearing, I assume) and a longer rehab.  This is per hip, so two surgeries, two rehabs.  

She is a college swimmer, and his refusal to either tell her she has a future in her sport or she does not is frustrating.  If anyone has any experience, i would love to hear it.

And if anyone wants to come help me track down the orthopedist who blew me off as a stupid mom, with no x-rays, no nuthin', when I took her for a hip dysplasia evaluation when she was 2 because I thought she had it then, grab your pitchfork and torches and come on down.

I am sorry to read this.  

My son began having major hip pain at the beginning of the fall season last year.  It was maddening to see him continue to play and watch him down Advil like candy. 

X-rays and MRIs showed hip impingements and torn hip labrums. He had surgery on both hips simultaneously the beginning of June.  The first few days post-op were extremely difficult, but he is happy that he had both hips done at the same time.  He goes to rehab three times a week and is gradually regaining his full range of motion.   The summer has not been fun, but he is now completely pain-free.  The surgeon is very pleased with his progress and  expects to clear him to play competitively by December.  

When I was researching surgeons, it was recommended to me to make sure I find someone who has a lot of experience with young athletes.  If you are in the Midwest and want recommendations for both my son's surgeon's name and the name of a surgeon who my friend's daughter regrets using, send me a pm.

Good luck to your daughter!  Hopefully she will be back in the water swimming pain-free soon!

 

[MysteryJen]

Alewife, sorry about your son's hip troubles. I am glad he is doing better.

I absolutely second the recommendation to use someone who works primarily with athletes. Both for surgery and PT. 

Because they understand the stakes and the probability of them doing too much too soon and do not judge them for taking sport seriously.  

We passed on a couple of surgeons because they suggested stopping competitive sport and waved off her concerns about recruiting as not very important. 

[alewife]

3 hours ago, MysteryJen said:

(snip)

I absolutely second the recommendation to use someone who works primarily with athletes. Both for surgery and PT. 

 

I agree 1000%.  Selecting the right PT is extremely important and almost as important as selecting the right surgeon.  My older son had Tommy John surgery when he was in high school.  I spent a ton of time researching surgeons and ended up selecting a doctor that was 5+ hours from home.  However, I didn't realize that I needed to be as diligent in selecting a PT.  

When I took my older son to his first post-op appt 5 days after his surgery, I thought the surgeon was going to blow a gasket.  He was furious that the PT had not followed proper protocol, (and I was too trusting that the PT was able to follow written instructions).   Luckily, no permanent damage had been done.  But I learned a valuable lesson that day.

My experience taught me not to assume that PT practices associated with a "big-name" hospital employ competent therapists.  You really need to do your due diligence up front because not all PTs are created equal.  

@MysteryJenI hope your daughter has a great, pain-free  swim season!

[plansrme]

12 hours ago, alewife said:

 

When I was researching surgeons, it was recommended to me to make sure I find someone who has a lot of experience with young athletes.  If you are in the Midwest and want recommendations for both my son's surgeon's name and the name of a surgeon who my friend's daughter regrets using, send me a pm.

 

 

Not in the Midwest, but if you know someone in the Southeast, let me know. 

[mamakelly]

On 8/3/2019 at 5:47 PM, itsheresomewhere said:

I could hug you for posting about PRP.   I am looking into it for myself and don’t really know anyone who has done it.  Thank You.  

 

It was truly a miracle for our daughter. I'd be happy to talk with you about it, if you want more info, either by pm or a new post...