Did labral tear surgery reduce your PN/pelvic/perineal pain?

[Jax87]

Hi Everyone,
I'm 3 weeks out from my FAI/labral tear surgery with Dr. Kelly at HSS. So far, so good. The surgery was really easy and I went home the same day. My mom and my aunt alternated taking care of me for the first three weeks, but now I am on my own and doing fine. I stopped taking the Percocet 4 days after surgery due to constipation and the fact that I really didn't have enough pain to warrant it! I am on NSAIDs now. I just graduated to using only one crutch outside and no crutches inside. It is amazing what a few days makes in terms of recovery. I went to PT the very next day after surgery and I am going twice a week for PT and ART. My muscles have seized up some after surgery, but my PT says that is normal, and they will eventually relax to a point that is better than the were before and hopeful let up on all my pelvic nerves. Thanks to the Lyrica and Cymbalta, I don't have much pain day to day, but a true structural solution would be a Godsend. I have been told that it takes 4 weeks for the soft tissue to heal and 6 weeks for the muscles to heal from the traction (50 lbs!) that the surgeon put on me during surgery, so I just need to be patient and keep on with PT. I can definitely tell that my PN symptoms and hip are connected, so I think this surgery was the right choice for me. Dr. Kelly told me after surgery that the impingement in my hip (like a bone spur) was literally crushing my labrum, so I know it was necessary. No wonder I've had muscles dysfunction!

Anyway, hugs and love to you all.

Jackie

[Karyn]

Hi Jax,
I'm happy to hear your surgery was successful and that you're feeling better!

I went to PT the very next day after surgery and I am going twice a week for PT and ART.

I wonder why some of these surgeons prescribe PT and others don't. Does it depend on the surgical approach?

Dr. Kelly told me after surgery that the impingement in my hip (like a bone spur) was literally crushing my labrum, so I know it was necessary.

So, your labrum was crushed, but not torn? Do you know what exactly the impingement was? I have bilateral OS Acetabuli, which is also like a bone spur. Has your surgeon ever mentioned this term to you?

I have been told that it takes 4 weeks for the soft tissue to heal and 6 weeks for the muscles to heal from the traction (50 lbs!) that the surgeon put on me during surgery,

OUCH!!!!! Can you please describe the traction process? I thought they dislocated your leg from your pelvis to gain access to the surgical site, but why do they add weight?
Best wishes for continued recovery, Jackie!
Hugs,
Karyn

[helenlegs 11]

and they will eventually relax to a point that is better than the were before and hopeful let up on all my pelvic nerves. Thanks to the Lyrica and Cymbalta, I don't have much pain day to day, but a true structural solution would be a Godsend

Here's hoping and I know that you are giving it the very best chance to allow exactly that. Well done so far, looking forward to your progressive recovery posts .

Take care,
Helen

[Jax87]

Hi,
Thanks for all the well wishes! Karyn, I'm now sure what bilateral OS Acetabuli are. I think it is related to FAI, but I'm not sure. I had a CAM impingement, which means there was too much bone on the femoral head of the hip. I think all surgeons prescribe PT after arthroscopic surgery, or at least any of the reputable ones. Are you on the Hip Chicks website? It's really great because you get to hear from lots of different women with hip issues and their treatments. Anyway, PT is essential with the arthroscopic surgery because of the traction. The weight is used to open the hip just enough to get the tools in to do the work inside. They used to have trouble, ironically, with the traction because it would harm people's pudendal nerves, but now that they are better at the surgery patients are in traction for less time and therefore there is less of a risk to the nerve. My surgeon only kept me in traction about half an hour and I had no numbness or pain in my vulva or groin, thank God! You have to have PT to recover the muscle strength lost during the traction experience and to realign your muscles. I'm not an expert on hip surgeries, but from the Hip Chicks site it looks like people who get PAOs and hip replacements also have to have PT.

I just joined Nutrisystem to try to lose all the weight I have gained during this lovely ordeal/law school. I figure it would be good to have less weight on my joints/pelvis too, right? Have any of you had any weight loss success? I know a bunch of us struggle with weight issues due to PN.

[alexm]

Hi guys and girls,
This is a message for all of you who have had FAI & labral tear repair.
I saw the surgeon in Paris a couple of days ago and he seems very capable. He has done close to 1000 Fai/labral repairs and has been doing between 100 and 150 for 5 or six years. Over here they use an arthroscopic technique which necessitates only 10 to 20 minutes of light traction. So that came as a pleasant surprise. He has already operated on some PN sufferers but didn’t want to speculate on any possible links other that saying that it was possible.
The only thing that I found a bit worrying was that he does not give any PT for the first month apart from a kind of mini exercise bike which he claims I can use almost lying down. Here’s a link to the kind of thing I am talking about:
http://www.comparestoreprices.co.uk/exe ... e-bike.asp
What kind of Pt did you guys do after the operation? I am willing to do as much as is necessary. I was also considering continuing with my osteopath. What do you think?
Also, he said I would need to be up and about after a couple of days and that I would be on one crutch after one or two weeks and then try to wean myself off completely. Does this sound abut right to you?
I would really appreciate any help you can offer, as I’m a little freaked out by the whole after care thing.
Also, does anyone know how to contact Lernica? I cannot get the private message system to work at the moment.
Much love,
Al

[Elmwood]

Hi Alex.

Good luck with your upcoming surgery.

It seems that different surgeons do different things and you just need to find somebody that you're comfortable with and who is capable. If your surgeon has done that many surgeries it would be easy enough to find out if he was capable and I'm guessing he is if they continue to let him practice. As for PT, crutches etc. it seems to vary. I was on crutches for 6 weeks and my surgeon did not prescribe me any physical thereapy. Lots of people on this site who get the surgery here in the states seem to be on crutches for 2 weeks or so and then do some physical therapy.

As for Lernica, she seems to check this site regularly so hopefully she'll be in touch with you soon.

[alexm]

Hi Elmwood and thanks for your kind words. I guess I'll have to rust a guy who has done nearly 1000 FAI/Labral tear operations. It's just a bit odd how the post-op varies so damn much.
Much love
Al

[kathyd]

Hi Folks
I just wanted to check in regarding the labral tear surgery I had in 2009 with Dr Struan Coleman at HSS in NYC.
Dr Coady my pelvic pain gyn at the time, was doing a study in which they found that some womens' vulvar and pelvic pain improved after the surgery. Im sure you are familiar as this has been discussed a lot. Quite a few of us had this surgery. I had no hip pain or clicking etc. when Dr Coleman did the pre-surgical check,so this made me quite skeptical about doing it.
My main symptoms at the time were IC/ urinary urge/pressure and urinary hesitancy and sit bone and mild right side perineal pain that was gradually worsening. Since IC protocol treatments hadn't helped and PTs couldn't seem to find any reason why my sit bones hurt (other than a "skinny butt"), I was anxious for pain relief and
I had the surgery reluctantly. The surgeon said he found significant damage to my labrum and that I had really needed the surgery. He also lengthened the psoas muscle
How I had gotten a labral tear in the first place I'll never know (unless its just from the natural wear and tear one's body sustains by middle age.
THe recovery was pretty easy... I was mainly on 1 crutch and soon I really didn't need one.
I did the necessary PT protocol for recovery (a few months of weekly visits and in between I did all the exercises.) I healed fine.
But I saw no improvement in my issues.. I wasn't told about what actually happened during the surgery; I didn't know about the traction, you guys are discussing, but would like to know more?
I hope that this traction didn't worsen my PN issues ;If I knew there was any risk from that I would've probably not done it.
I had the surgery in Nov 2009. By Spring 2010 around the time I finished post-surgical PT,
the sit pain had become bad enough that I was cutting back on driving ..
From then on things gradually got worse etc.
BTW Ive heard from the surgeon's office this year. They wanted to re-examine me and see how I was doing and possibly get an MRI of the other hip. I explained how much pain I was now in and said that unless this exam could do anything to help me find the source of my pain and reliev it, then I saw no point in coming in. They were basically doing a follow up on those who had been in the study I assumed..

Was anyone else part of this study?.. and did you go back recently for a re-check?
I think Dr Kelly is Dr Coleman's colleague, but I'm not sure.
Thanks.

[Jax87]

Hi Kathy,
I wasn't part of Dr. Coleman's study, but I am a patient of Dr. Kelly who is his colleague. Dr. Kelly hasn't mentioned anything to me about the study though, I think they work pretty independently. Anyway, I was properly informed about the traction before my surgery. It is about 50 lbs of weight applied to your leg so that the surgeon can get into the joint. There is a small risk of PN damage, so I talked to my PT about it before my surgery because I wasn't going to do it if it was going to make me worse. My PT has worked with Dr. Kelly for over 10 years, since the arthroscopic surgeries began. He said in the beginning they had more trouble with groin and genital pain/numbness after surgery due to nerve issues because of the length in time in traction. However, as the surgery improved, they had to leave the patients in traction for less time and therefore had fewer nerve problems. Additionally, even though some people had pain/numbness, NONE of them had long-term PN problems as a result of the surgery with Dr. Kelly. (obviously some of them may have still had their existing PN pain, but that's different than damage from surgery)

So, hopefully that makes you feel a little bit better about your decision to have surgery at HSS and in general. We can only try to do different surgeries and treatments and see if anything helps through trial and error. I hope you find relief from your pain soon.

Hugs,
Jackie

[Elmwood]

Hey everyone.

I was not part of the study Kathy (I'm a male anyway) but figured i'd chime in with my 4 month post op update. But don't let me side track other people from the topic if they were planning on responding to Kathy and Jax.

So I have FAI and labral tears in both hips and in January I had my left hip operated on. I've definitely felt relief in the left side buttocks pain and don't seem to have it anymore. As for PN relief, I'm leaning towards no. Let me explain. Before I had the surgery I never paid much attention to which side of my scrotum, perineum, penis etc. was bothering me. But after the surgery on the left hip I decided to pay more attention and I've noticed that my right side (for the scrotum anyway) is usually worse. But I don't necessarily think that having the hip surgery has given me relief on the left side because sometimes I still get the pain on both sides or just the left. And when I get the pain on both sides it often comes as one wave of pain encompassing the whole scrotum. If my hips were causing me the pain why would both sides bother me at once since each side of the scrotum (I think) has its own branch of the Pudendal Nerve.

Anyway, I hoping that in fact the surgery has given me relief but tough to say until I get the other one done.

On another note; I had a pelvic varices embolization 2 days ago but am not finding any relief from that either. Thats a real bummer to say the least because my Potter MRI said "very prominent varices effacing pudendal nerve." But it wasn't a real shock because it doesn't seem that anybody on this site has found much relief getting their varices treated.