Saturday, August 20, 2011

Recap on my Conditions

I know my condition is difficult to understand and probably most of you have never heard of it before.  I will give a brief recap on my condition for those of you who have not been following my blog from the beginning.  Shame on you.  You should all be on the edge of your seat waiting for me to publish my next post about what I bought at Target this week.  Hehe, just kidding.  My blog is just to keep my friends and family updated on my hip and on my life since I am so far away from all of you.  So here it goes, my conditions.

First is my Femoral Acetabular Impingement also known as FAI.  The head of my femor is grinding against the rim of my acetabular, or pelvis, and in the process grinding away at the tissue in between and causing painful inflammation of the joint.
I have a mixed impingement

My FAI must be addressed with surgery, there are no ifs, ands, or buts about it.  The surgery that treats FAI is a surgical dislocation and debridement.  This can be done either arthoscopically, or with an open surgery.  I am trying to decide whether to have an arthoscopic surgery or an open surgery to treat my FAI.  With an arthoscopic surgery, two or three small incisions are made, the size of a dime.  With an open surgery, one long incision is made across the top of the thigh. I will use Megan Fox to demonstrate where the incisions will be.  Her right thigh is an arthoscopic surgery and her left would be an open surgery.

My next condition of my hip is hip dysplasia.  This is when the hip socket is shaped too shallow to support the femur.  A subluxation is when the femur comes part way out of the hip socket, so that it does not fit tightly.  My hips feel loosy goosy.
Dysplastic hip.  Not mine.
The surgery required for hip dysplasia is called a periacetabular osteotomy also known as a PAO surgery.  With this surgery, a very long incision is made along the underwear line, or at the top of the thigh. Again Megan Fox will model the location of the scar. The pelvis is then broken and moved to a better location.  Then pins are inserted into the pelvis to hold it back together.  I heard one person describe it as putting the hat back on top of the head.  Many months or years later the pins are removed with another surgery.  I am trying to decide whether or not I need this dramatic surgery.

Before and after PAO surgery

The third condition I have is arthritis of the hip.  This is a deterioration of the cartilage from years of having my bones pinching on the cartilage and from years of inflammation of the joint.  Because of my arthritis my chances at having a successful Impingement or PAO surgery decline dramaticly.  However, if I can have even a 30 % reduction in pain and delay a hip replacement, I would consider that a success.  Right now I rarely leave my house because of how much pain I am in.

arthritis of hip
I think most of you know what surgery is required for arthritis.  A total hip replacement (THR).  With a total hip replacement the diseased joint is removed and an artificial joint is put in its place.  The problem with a THR at my age is that there needs to be a revision every 10 to 20 years.  With each revision surgery more bone is removed and each surgery becomes more difficult and more likely to have complications.  Every surgeon I have talked to has been very adamant about me not having a hip replacement in the next 15-25 years.  It would be much better for me to be managing my pain for the next 20 years with strong medication than to be in a wheel chair when I am 55.
Total hip replacement

I know I have a long road ahead of me and I am very lucky to have the support of my friends and family.  The decision as to what surgery I proceed with is ultimately my decision alone.  I tell the surgeon what I want to do, not the other way around.  You know what they say, when life gives you lemons, you make lemonade.  And in my case, I think I will add a shot of Tequila to my lemonade.

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