Hip preservation

[Aboutmeabouttime]

My DH has suffered with chronic hip joint pain for years, had scans, physio all of it. He lives on ibuprofen which is terrible as he also has Crohns, sleeps badly, can’t concentrate. I feel like now it’s affecting his personality, short tempered, copes poorly with decision-making or when things don’t go smoothly…. (We have two teens!)

Finally decided to see a private hip specialist in hopes of getting some kind of diagnosis and treatment. Looks like that might be hip preservation? Was not something I had heard of, wondering if anyone has any lived experience they might share. Appointment is in a few weeks - anything we should be asking?
Thanks

If he has had scans etc what was the diagnosis? If he has been in chronic pain and had earlier hip scans did they not say what was wrong?

I have had tears repaired and hip preservation, hip reshaping etc, but the preservation surgery has not fixed the deformity and the NHS surgeons have now decided it is not worth doing more of that type of surgery.

As you are seeing the consultant privately I would be a bit worried that they will recommend preservation surgery that won't be a long term solution if he has arthritis.

I would be asking what the benefits of preservation surgery will be rather than hip replacement. Most new hips last 15 plus years so he may be better waiting for that rather than having preservation surgery.

Has he had hip steroid injections to see if they resolve the pain? Most surgeons won't do lots of injections cos they increase the risk of problems when the hip is replaced.

If he has not had a back scan and there is no clear hip diagnosis it may be worth asking for a back MRI cos a lot of hip pain can be referred from the back and spinal issues because of the gait issues.

Reading with interest as I am in the same boat and have just had a big row with DH as he is pisssd off with me talking about my hip. Pain is running my life.

In my case they’ve offered injections but I didn’t want them because they are not a cure.

@wonkywalker do you know why your surgery didn’t work? How many surgeries have you had? What are you going to do now?

@garlictwist i am an odd case as my hip surgeries did not improve my gait as my underlying problem is femur deformity so hip preservation surgery just tinkered at the edges to see if they gave any more stability. A hip replacement will potentially destabilise my leg further and may mean I will go from a wonky walk to no walking so I have morphine plus hip injections and keep going - although at a crawl on crutches.

You may find it good to have one hip injection to see if it brings a lot of relief and then it may help you realise that you are ready for a replacement?

If DH is pissed off at your mention of your hip pain, I suggest getting a rat to naw at his hip joint or take a sledgehammer to his joint and see if he mentions pain.....

@Wonkywalker Thanks for your reply. I think I'm at the stage where I might try the injection. They won't give me a replacement as I'm only 42 and don't have arthritis, "just" labral tears and mild dysplasia.

How do you keep going through the pain? I really struggle to enjoy life when I am in pain, it's literally all I can think about and my anxiety is through the roof. Tbf, I can see why DH gets annoyed as I can't be easy to live with. I know I need to find a way to carry on more postively if I'm in this for the long haul which it seems I am, but I just don't know how.

@WonkywalkerThank you for replying. The medical professionals theories have changed over time, last MRI suggested maybe labral tearing which can be surgically repaired I believe but obviously if there is a structural cause maybe not? He’s 45 if that makes any difference? He had a round of injections some years ago but that was temporary relief… yes private as god bless the NHS but not sure we can wait any longer.

He has a prolapsed disc but manages this through Pilates and not suffered any flare up from that since last summer. He also has tinnitus which is believed to be linked to the chronic pain so generally something needs to change.

@garlictwist
sorry you are also suffering - DH and I periodically sleep in separate rooms to try and safeguard sleep but appreciate you might not have that option x

Does he have structural issues such as hip dysplasia? Or just labral tears?

I have both and was hoping to have the preservation surgery but my age (44) and condition of my hip means that’s not possible so it looks like I’m going straight for a hip replacement.

If there is a structural issue with the hip then surgery is generally the only option longer term as physio and injections just mask the issue for a short while.

@Aboutmeabouttime it sounds as if he needs scans of both hip and back as if there is something structural with his hip it may just tear again if repaired and although he may not be feeling pain in his back it may be referred back pain in his hip. Sometimes they try steroid injections in either hip or back to try and work out if it is hip or referred back pain.

At 45, if he has no arthritis, he may be a candidate for hip reshaping or resurfacing plus tear repair but it sounds like lots of scans are needed to try and work out the cause of the tears - if it is something structural the preservation surgery may do more harm than good.

Although physio won't sort out structural issues it may be worth exploring to try to improve his back and leg muscles, followed by Pilates if he is fit enough for that. I have found physio helpful to get surgery ready.

@garlictwist if you are only 42 and don't have arthritis but are in a lot of pain , I would recommend as much physio and Pilates as you can cope with to safeguard your back as walking with hip pain really affects it. I try to do more physio after an injection - if you do get an injection I would book a holiday as I regret not travelling more but when I was 42 as I thought I would be able to travel later in life.

He also has tinnitus which is believed to be linked to the chronic pain - has he discussed the tinnitus/ibuprofen with anyone? Ibuprofen can cause tinnitus so it may be another good reason to stop taking it.

@Greybeardythe ibuprofen is a problem on many levels but this is the thing - no practitioner looks at him holistically to try and solve the root cause. He has seen an audiologist about the tinnitus, had a head scan even, nothing they can do apart from offer ‘living with tinnitus’ support.

Stopping ibuprofen without another plan to manage the pain isn’t an option…

Update - saw private consultant who examined, looked at all the scans and took history….mild deterioration in the hip, no structural abnormalities etc.

Opinion is most consistent with a condition called greater trochanteric pain syndrome, which includes trochanteric bursitis and gluteal tendinopathy.

Plan in the first instance is hip joint injections to see if they are contributing to the pain but if not probably a sports/hyper mobile pyshio specialist to work on rehabilitation of the tissues - can be a slow process…

Sadly no silver bullet but something… looking at costs for injections privately