Hip microfracture for FAI with 3 cm2 lesion, 4 months post op ADVICE PLEASE :)

11-10-2013, 02:07 AM

Hi Everyone,

This is my very first post on any online forum so forgive me if I miss anything or drone on too much!

I am now 16 weeks post op from a microfracture operation to treat a 3 cm2 grade IV full thickness articular cartilage damage, involving the roof of my acetabulum. This was caused by many years of sporting activity with FAI in both hips. I understand from online sources that 3 cm2 full thickness is a very large defect and some sites even state it's too big to attempt microfracture?!

I guess I was hoping that by now (4 months post op) I'd be a bit more advanced with my recovery than I am. So what I'm trying to do is get in touch with people who've been treated for a similar amount of hip damage and make sure I'm at the appropriate stage of rehab.

I have followed rehab procedure strictly (6 weeks 0% weight bearing. 4 further weeks 25% weight bearing. CPM machine 3 hours daily for first 6 weeks. Physio work concentrating on core and glutes etc.).

SO... THE STAGE I'M AT NOW IS: I am walking without crutches but not for distances of more than maybe 10 minutes before I start limping slightly so need crutches again. I am able to use a static bike and exercise for around 15 minutes on a medium intensity. I often experience a dull strong pain in my hip joint at night and first thing when I wake. My hip regularly pops/twinges/clicks (not sure of correct term, but a bit like when your knee or elbow pops/clicks when you stand up or sit down) - when this happens it's painful for a split second but then settles down again.

MY QUESTION TO FELLOW HIP MICROFRACTURE PATIENTS IS... IS THIS NORMAL AT 4 MONTHS POST OP?

I have read some website that say I should be walking much further distances or even be 100% pain free by now and completely without crutches.

Another question is... how many years should this microfracture give me before a THR may be necessary? I've totally given up running, football, tennis and other impact sports.

Another thing I should say is that I am also being treated for a herniated/slipped disc in my L5 lower back - most likely as a result of using crutches for so long - and certainly not helping with my hip recovery

YOUR HELP AND ADVICE IS HUGELY APPRECIATED. Please let me know if you require any further information or indeed if you feel I can help you in any way at all,

Kindest Regards,

Liam

11-10-2013, 10:55 PM

Sorry if this posts twice:

Hi there, welcome!

I had a similar procedure, though the microfracture area was smaller (surgery #1 = labral trim and microfracture 1 mm). Post-surgery, I was not told about the microfracture, so I was weight-bearing up stairs before my stitches were out. Needless to say, my rehab process was not successful.

I would recommend using a walking-assistance device as long as needed, whether crutches or a cane. I did NOT do well using one crutch. I also had a reconstructive surgery (#2) to fix the FAI which the first surgeon did not recognize. Finally, surgery #3 served to lift up the flap of cartilage that had separated from the acetabulum, perform microfracture under the cartilage, then pin the edges using plastic pins. The last surgery took about two years to reach maximum recovery; I mention this length of time to let you know that you may continue to improve well past the initial six months of rehab.

Treat your back well; I have had to have an L4-L5 fusion, likely due to stressing the disc to baby the hip. Some helpful tips: if you can locate and afford a saddle chair, consider purchasing one. It is like sitting on a horse or bicycle saddle, with your knees lower than your buttocks. I found that mine also forced my to sit up straight and maintain good posture. If you can find a pool to walk in, do so. Practicing good gait is helpful for recovery. I still have loud (audible to others across the room) popping, which is usually preceded by sharp pain and the popping process relieves the acute pain.

Good luck with your recovery! If you have specific questions I might have missed, please respond and I will try to answer.

11-11-2013, 08:29 AM

You might want to have a neurosurgeon take a look at your back. Your gait prior to hip surgery could have been bad and now the new hip straightens out your skeleton (gait) which could cause some irritation to the sciatic nerve complements of L5- Good luck and take care

Hip microfracture for FAI with 3 cm2 lesion, 4 months post op ADVICE PLEASE :)

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