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Any Canadians with/had a hip labral tear here?
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Hi, I am looking to see if anybody on ST is under the canadian healthcare system and has had/has been diagnosed with a hip labral tear. After 2 years of searching for answers and seeing docs of all sorts and a 6 month wait for a MRI (no contrast) I am finally heading somewhere. Results of MRI show that there is a small subchondral pit defect in the left femur and head/neck junction; however, this means nothing and ultimately I need an MRI with contrast to determine if it is indeed a tear. So, I am being passed on again from my physiatrist to a hip orthopedic surgeon. I am concerned which surgeon I get as I understand this procedure is not that common and relatively new. I was hoping to get some feedback from anyone who has had this done in Canada. I am in Victoria BC, but am willing to travel. Also, has anyone had this done privately? If so, would you mind sharing numbers on the costs?
thanks
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Re: Any Canadians with/had a hip labral tear here? [soya] [ In reply to ]
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"I need an MRI with contrast to determine if it is indeed a tear."

Really not much that you can do at this time until the MRI confirms it. I'm not familiar with the procedure and since I'm a chiro and not an ortho surgeon I couldn't offer you much any ways.

There is a med school at the U of Victoria so you're in an area where there should be some high quality ortho people who would be familiar with the latest procedures.
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Re: Any Canadians with/had a hip labral tear here? [cerveloguy] [ In reply to ]
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Hi, in order to get a MRI with contrast, only an orthopedic surgeon can order this. So before I wait another 2-3 months for an ortho surgeon that doesn't have a lot of experience with this, I'd rather get it right the first time. Thanks for the info though, good to know UVic has a med school, at least it's close to home!
Thanks
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Re: Any Canadians with/had a hip labral tear here? [soya] [ In reply to ]
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bump
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Re: Any Canadians with/had a hip labral tear here? [soya] [ In reply to ]
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the university of victoria does not have a medical school, the closest one is UBC.
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Re: Any Canadians with/had a hip labral tear here? [soya] [ In reply to ]
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Soya - if I had an uncommon problem, I'd ensure that the person caring for me was the one other physicians sent their patients...an their families to. Simply ask the hip orthopedic surgeon how many hip arthroscopies he/she does per year and it it's less than, say 30 - 50, find some one who does. In the US, Tom Byrd in Nashville seems to be among the leaders in hip arthroscopy and may give you the advice you seek. Good luck.

John H. Post, III, MD
Medical Advisor, TrainingPeaks
Ironman Certified Coach
Contributor, IRONMAN.com, LAVA digital
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Re: Any Canadians with/had a hip labral tear here? [johnpostmd] [ In reply to ]
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I'm a practicing orthopedic surgeon and if it was my hip I'd see one of the following:

In Western Canada: Nick Mohtadi (Calgary) or Mike Gilbart (Vancouver)

In the US Marc Philipon at the Steadman Hawkins clinic in Vail.
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Re: Any Canadians with/had a hip labral tear here? [soya] [ In reply to ]
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Hi - Dr. Paul Kim at Ottawa Hospital resurfaced my left hip February 23, 2009. I am extremely pleased with my result and conversations with him left me with the impression that his area of expertise is restricted to hips & knees. I understand he is extremely busy so would see many cases. He would have my vote for any sort of hip assessment or treatment.

Ian D. Toms
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Re: Any Canadians with/had a hip labral tear here? [soya] [ In reply to ]
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Had a tear, had it arthroscopically repaired in Calgary a couple of years ago, all is well so far. An MRI with contrast is the way to diagnose, but anyone should be able to order that -- not just an orthopod. Victoria is a satellite medical school to UBC, not a full academic center like oh say Vancouver. There's a few around who do the arthroscopic stuff but not many.
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Re: Any Canadians with/had a hip labral tear here? [Seth] [ In reply to ]
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Thanks Seth! That was very helpful, was also wondering if anybody knows anything about another orthopedic surgeon called Dr Brian Day in Vancouver BC?
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Re: Any Canadians with/had a hip labral tear here? [soya] [ In reply to ]
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Veterinary here so sideline story.
Took some time of work to train for triathlons and went along to specialist orthopeadic vet in my spare time to watch. Scrubbed in an assisted him with a hip labral tear surgery and will never forget. He just diagnosed it by x-ray and when he showed me the x-ray I could barely see it.

Holding all the instruments for him to access it through all the muscles I saw the little flap which he removed(then he did some other work on the area affected).
Since I was training for tri's it really made me think; to me it looked like it would be sore most of the time and it would only get worse if not treated.

So I feel for you if you have a labral tear of the hip. Apparently it is also what has put a halt to Emma Snowsill's season.

Am guessing it is harder for human doctors to diagnose as there is even more soft tissue for a basic x-ray to go through making it hard to see.......tricky to diagnose.

all the best.


G.
www.TriathlonShots.com

http://www.TriathlonShots.com
Full event coverage of triathlon/ironman in photos.


Last edited by: triathlonshots: Aug 24, 09 0:59
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Re: Any Canadians with/had a hip labral tear here? [triathlonshots] [ In reply to ]
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I thought I would re-activate this old thread to provide some info. for other athletes in southern Ontario with labral hip tears. I was diagnosed within the last month or so with a labral tear on my left hip and a likely tear on my right hip as well. I am just waiting for results from the second MRI (arthogram on R. hip, regular MRI on left, Xrays on both). Left has pain, right no pain. Apparently, no FAI.
Anyhow, my sports med doc wasn't really familiar with arthroscopy repairs for torn labrums so he referred me to a hip surgeon who didn't even do arthroscopy. I quickly realized that if I wanted things to move forward at a reasonable pace and in the right direction, I would have to do things myself. While I can't post any insight into the surgury experience, orthopod experience, etc., I can post my experience with finding orthopedic surgeons in southern Ontario.

Initially, I had a heck of time figuring out where to start but I think I have made some progress in the past week or so. Essentially, very few orthopedic surgeons in southern Ontario do arthroscopy to repair torn hip labrums. I believe the main reason for this is that the surgery is quite new so the surgeon would have to be trained for this specific procedure in the last maybe 5-8 years, generally less. Dr. Marc J Philippon in Vail Colorado has done the majority of the research with repairing torn hip labrums and he seems to be the foremost expert surgeon in this area. Prior to 2005, it would seem most arthroscopy of the hip didn't repair the torn labrum but just cut off the flap of tissue that was causing the pain, cleaned up the area and that was it. In some cases, that is all the surgeon can do. If the labrum is still in good enough condition than a newer option became available that revolved around repairing the labrum (suturing the labrum back to the acetabulum), not just cutting out the flap (labral tear). I believe early indications suggest that repairing (called a labral refixation) vs. cutting out the labral tear (called a labral resection, debridement) can help prevent early osteoarthritis. There seems to be strong links between a poor functioning labrum and early osteoarthritis, therefore it would stand to reason that there is an advantage to having a labral repair/refixation vs. a labral resection, if the patient's hip is able to be repaired (based on surgeon's opinion). Early results of the refixation surgery suggests that refixations have a better return to performance for athletes and less hip osteoarthritis in the years following surgery. Use Google Scholar to research recent papers online.

Based on the information I have gathered, my thinking is that if I see arthroscopy surgeon that does resections (which has been around for at least a decade) but not repairs/refixations (not many performed before 2005), than there is a 0% chance that my outcome will be a repair, which potentially points me down a path that has a greater incidence of osteoarthritis. If I see a surgeon that is trained with repairs, than, if possible the surgeon will do the extra work and repair my hip versus just resecting it, which lead me to narrowing down surgeons in Southern Ontario that are trained in hip arthroscopy refixations/repairs. There are few. As a patient, you have to figure out who does it, how long their wait times for consults are and how long after will a surgery be scheduled for. As of the spring of 2011, I have heard that 1-2 months is the best consultation time with many appointments being 8-10 months in the future. After that, surgery can be as soon as 1-2 months but other surgeons wait time is an additional 8-10 months. Therefore, some surgeons may be available with 1-2 months for a consult and then 1-2 months for surgery, other surgeons are 9 months for a consult and then another 9 months for surgery. Keep this in mind when getting referred to a surgeon. Do your homework. Call their assistants, talk to them and ask several questions before being referred to just any orthopedic surgeon for your labral tear. Here is my list so far of orthopedic surgeons in southern Ontario that, based on my research, have been trained in hip arthroscopy for labral tears and likely but not guaranteed, are able to do labral repairs, if warranted. Random Order....

Dr. Douglas Naudie, London, Ontario
Dr. Dan Whalen, St. Michaels, Toronto
Dr Gavin Wood, Kingston, ON
Dr. Lucas Murnaghan, Sick Kids/Womans College Hospital
Dr Olufemi Ayeni, McMaster, Hamilton
Dr Rajev Gandhi, Toronto
Dr. Ginty, Oakville
Dr. Veillette or Dr. Ogilvie-Harris, Toronto (same clinic).
Dr. Paul Beaule, Ottawa,

Do your own research, call the surgeons assistant first, talk to your family doctor as you will certainly need a referral, look them up online, look up ratemd type of websites, etc. My research is pointing me towards Dr. Lucas Murnaghan based on a variety of factors (recently trained, able to do repairs, wait times, etc.). I have yet to meet him, I have not had surgery (and may not need it?), and I have not talked to anyone that has.

Check out http://www.orthoillustrated.com/ and look up the hip section. Good video that shows hip labral repair. There is also a good paper by Robert Fry, M.D., and Benjamin Domb, M.D. titled Labral Base Refixation in the Hip: Rationale and Technique for an Anatomic Approach to Labral Repair.

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Re: Any Canadians with/had a hip labral tear here? [Hutch] [ In reply to ]
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Dr. Murnaghan is a pediatric orthopaedic surgeon. He will see up to the university aged athlete. He may be able to give you the name of a surgeon that treats adults beyond that age group.
My high level KOS son has seen him for follow up of an osteochondritis dissecans of his knee. He is a nice guy and has done triathlons himself. Good luck!
edited to add link
http://www.sickkids.ca/...ff%20Profile%20.html
Last edited by: 2tired: May 2, 11 20:16
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Re: Any Canadians with/had a hip labral tear here? [2tired] [ In reply to ]
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Hopefully he has some flexibility with who he accepts as a patient. Besides, I did go to University and I am willing to sign up to take another course :-)
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Re: Any Canadians with/had a hip labral tear here? [Hutch] [ In reply to ]
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Article in Toronto Star on Dr. Murnaghan

http://www.parentcentral.ca/...hopedic-surgeon-busy
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Re: Any Canadians with/had a hip labral tear here? [soya] [ In reply to ]
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soya wrote:
After 2 years of searching for answers and seeing docs of all sorts and a 6 month wait for a MRI (no contrast) I am finally heading somewhere.


I just have to ask with all the talk about health care. Are you happy with taking 2 years of various visits and half a year to get an MRI? My knee blowout from day 1 to post op and done with rehab was faster than your MRI wait time. If you had a total knee blowout would they have put you up to the front of the line? Just want to hear the details from someone actually in the system. Even my non emergent shoulder was a 48 hour deal from doc visit to MRI and into rehab.

With that said I hope you get it all squared away and back on the road asap! Rehab stinks, but it works.
Last edited by: tigerpaws: May 6, 11 5:14
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Re: Any Canadians with/had a hip labral tear here? [tigerpaws] [ In reply to ]
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tigerpaws, where do you live? Wherever it is, I'm moving there!

I just found this thread while researching surgeons who do hip arthroscopy in British Columbia. I've had ongoing hip pain for 6 years and have been getting the runaround all that time. Some days I think I must be going crazy and that it's all in my head. I haven't ridden in nearly 3 years because of the pain, running is bearable most times as long as I keep it to a short, slow shuffle. But the pain is variable, comes and goes, some days it's very bad and some days my hip is relatively good. Sometimes it keeps me awake at night, or hurts so much that I can't sit at my desk, while other times it gives me relatively little trouble even when I've been fairly active.

GP says I'm getting older and should just get used to slowing down. I'm 47 fer cryin' out loud! Sports doc found tendinosis and refuses to look further even though I repeatedly explained that I have other pain that's nowhere near the vicinity of the tendon and is of an entirely different character.

Finally had the good fortune to have my last appt on a PMS day - I suppose the tears helped my cause - and GP finally referred me to an orthopedic surgeon and for a contrast MRI. Both appts are 7 months away, and now I understand that after seeing the local orthopedic surgeon I will likely be referred on to another surgeon who does hip arthroscopy, as it's fairly new and not many docs do it. The one that I know of, Mike Gilbart in Vancouver, has a wait list of 3 years just for a consult, unless I pay privately, then it's only 2 weeks.

If any fellow British Columbians have any insight/advice/suggestions for how to move things along I'd sure appreciate hearing from you!
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Re: Any Canadians with/had a hip labral tear here? [sweetpeach] [ In reply to ]
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Tampa, FL come on down! The doc even let me get my MRI at an Open Tower MRI center which does cash price discounts.....~$275 for the MRI and they did a 'wet read' that day and sent it to the ortho the next morning.

I'm not saying our health care system is perfect, but I'm not saying it's horrible...for *me* at least. I love my health care and don't want anything changed about it whatsoever. Never had a single complaint with my delivery system.

I feel for you and have a business acquaintance from Montreal who came to the states to have his knee done in Greenville, SC done about 2 years ago. He had been kicked around the Canadian system for a couple of years w/o having had any success in getting the knee done. Come to find out he had 2 bucket handle tears in his medial meniscus. He paid cash out of pocket and is as good as new.

By the way that is EPIC. 3 years for a consult and 7 months for a contrast MRI? That is the most EFFED up delivery system, hopefully I won't ever have to endure it.
Last edited by: tigerpaws: May 19, 11 14:00
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Re: Any Canadians with/had a hip labral tear here? [tigerpaws] [ In reply to ]
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Wow, that's about as far away from where I am while still remaining on the continent! Think I'll have to find something a bit closer to home.

There are definitely pros and cons to both the Canadian and American health care systems. Unfortunately, speed of treatment is not one of our advantages it seems. Perhaps it's true that you get what you pay for.

I'm going to see this Dr. Gilbart privately for a consultation to see if he thinks he can do anything for me. Cost is $500 for half an hour, review of my images, and one follow up. Private contrast MRI is another $1,200 if he thinks it's necessary for a diagnosis. If surgery is needed it will be $10,000 - $12,000. Maybe I'd be better off to take a holiday stateside...sounds like it could be the cheaper option, even with travel and a couple night's stay?
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Re: Any Canadians with/had a hip labral tear here? [sweetpeach] [ In reply to ]
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I just came across this forum while doing some research on FAI. I, like many of you have been suffering with pain for years-almost 20 to be exact-and I am 39. After having done every test imaginable, and seeing the local(Ottawa, Ont.)back surgeon-Dr. Chow, more than 5 times-I had no answers. My biggest complaint was chronic back pain, lower, thoracic, and cervical, as well as nerve impingement sypmtoms in my legs, shoulders and hands. I have tried every therapy I could Google, some traditional, and many not, with no results and a slow progression of my pain. Like many of you I had to search for my own answers, and was not impressed with the help I received from the therapist at the time. I was even told I had a low pain tolerance, and that my problem was mostly in my head! They would concead though that I had muscle tightness throughout my body that they couldn't explain, only to say that none of the "traditional" tests showed anything wrong with me. EESSSHH!! The frustrating part was that they would not recommend anyone outside of their area of expertise, and refused to reasess me when their approach didn't work. I wanted someone to help me find the solution-sorry to say I had to do that on my own.

I am athletic playing competitive hockey and soccer, and now men's league hockey only. I used to do the traditional "bodybuilding" style workouts and managed to get to a bodyweight of 225 lbs, with a 34 inch waist at 5'10. All that to say, that those workouts made me worse, and I eventually stopped alltogether at 27 yrs. I have since managed to keep my pain progession to a slow crawl, but it still progressed. One good thing that came out of this process is my determination to find smarter ways to workout. I haven't searched much of this sight, but it appears to be a running based site. I prefer weights, but have moved into cardio circuits with weights. I have found kettlebells, and have been using them for over 8 yrs. now. I have also found that training movements instead of muscles, has changed my outlook on training, making it more effective and efficient. Some great resources to help you help yourself during your search for a proper diagnosis to your pain are as follows:

-Functional Movement Screen(FMS)-developped by physiotherapist Gray Cook-geared towards a systematic approach for assessing faulty movement patterns in a person, and correcting them through exercise-there are certifications with many practitioners Canada
-Magnificient Mobility DVD-Eric Cressey-shows you how to warm-up properly and why stretching before an athletic activity is counter productive
-Core Performance Essentials-this has been a big part of my workout for the past 3 yrs.-it's main goal is to get your body to work properly-this would be even more effective if you had the FMS first, but it's best features are smart exercises with planned progression-ie. if I asked you in 4 months how your workout was coming you would actually be able to tell me how much you improved
-Pain Free by Peter Egosuce-this book didn't fix me but it changed my view on how I could achieve a permanent solution to my pain, and gave me greater insight into how the body works-there's a website also
-read any articles from Mike Boyle, Eric Cressey, Mike Robertson, Gray Cook and Brett Jones-Jones and Cook collaborated on a project using kettlebells and Indian club swinging to restore proper function to your body

Sorry for the long reply, but I wanted to share my experience with pain, and how I increased my knowledge in terms of exercising intelligently to find a lasting cure to my pain. Wtih that being said, my pain still progressed until I was properly diagnosed inn April 2009.

My wife suffered from hip pain, had a labral tear repaired by the famous(now retired) Dr. Fowler in London Ont. The surgery did not fix her pain, and subsequent visits to other "experts" provided nothing. They said good luck with physiotherapy. Finally after another trip to a different doctor, he recommended her to see Dr. Paul Beaule here in Ottawa. He found her problem in 3 minutes, using an x-ray only, on her first appointment. He performed a proceedure called a Bernese Periacetabular Osteotomy(probably spelled wrong), where he cut her pelvis into three peices, adjusted it to fit properly, and screwed it back together. She was back riding a Harley less than 6 months later. She was a national team rower(now a mother of two), and still in great shape. The surgery was a complete success!

I then booked my appointment with Dr. Beaule and was seen April 1/09. It took him less than a minute to find my problem. Femoral Acetabular Impingement-FAI. Music to my ears-my pain wasn't in my head. From all the research that I had noted above, I figured that my hips may be the source of my pain, and now it was confirmed. Beaule stated that improper hip function, will cause back pain. If you read Cook's and Mike Bolye's "joint by Joint" approach to training, they say the same thing.

I got the call for a surgery date 2 weeks ago, and am going in for a bilateral hip arthroscopy on July 21/11-almost 2 yrs. and 4 months later! The wait has sucked big time, and my pain came to a head in late March when I severely pinched my sciatic nerve working out no less. I have been on light duties at work ever since-surgery can't come soon enough!

Things are progressing quickly in the area of hip surgery, especially FAI, and my doctor, who originally told me he could only operate on one hip at at time(I have FAI on both hips), will now be operating on both at once. I am nervous and the reason for my search was an attempt to find anyone else who had both hips operated on at once-I have had negative results so far.

My research has shown that I am very lucky to have Dr. Paul Beaule here in Ottawa, that his last job before coming here was in UCLA, and that he is a leading researcher in the area of hip athroscopy. He chairs many educational seminars(for other hips surgeons), with one coming up in New York this month. From my understanding he specialized in the Arthroscopic proceedure while studying pro athletes with hip pain. Traditional "open" surgeries were to invaisive and the rehab so hard that many pro athletes solved their pain problems, but never returned to play pro. His advancements in the arthroscopic proceedure has brought this number up significantly.

This is a long reply, just venting about my experience, sorry. I would call his office in Ottawa, and ask for a recommended doctor in your area. I would also look at some of the information I provided above to help you along while waiting for your appointments-be proactive. Lots of information about how to train your body to function properly is out there, as well as improved methods to recover after surgery. For any hockey fans out there, Ray Emery(goalie for the Anaheim Ducks) had the same hip disease as Bo Jackson did. He got surgery-I don't know what kind-and rehabed his hip in Toronto with a private trainer named Matt Nicol. I contacted him telling him about my FAI, and he stated that he could help me prepare my body for surgery, and help rehab me afterwards. He also recommended a local trainer-Lorne Goldenberg strength coach for the Montreal Canadians-here in Ottawa. I contacted him and he also offered to help. I never went because I felt that it would be to expensive, but wonder if it would benefit me.

I'll end it here, search lots, stay diligent, keep your spirits up, and keep moving.

Cheers,

Steve
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Re: Any Canadians with/had a hip labral tear here? [sweetpeach] [ In reply to ]
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Hi Everyone. I came across this forum like many of you searching for some answers. Last year I was training for a 5km and was hit by a speeding car while I was crossing in a crosswalk. I sustained several injuries, including a substantial labral tear on the medial and lateral sides of my hip joint. I am a personal trainer and yoga instructor by trade and have not been able to work since and am in daily pain. I cannot walk without the assistance of a cane and some days can't walk at all. I had several MRIs done (went privately, the wait was up to 1yr otherwise), one of which was of my hip, which showed the labral tear. Dr. Gilbart was highly recommended to me, so ended up going privately to see him. Dr. Gilbart wanted a MRI Arthogram (contrast) performed, which I did privately (the wait would have been 18 months) The MRI Arthogram showed the tear is bigger and on both sides of my hip. I am now again waiting to get back in to see him. There is a big hold up going to see him privately and I understand he is the best of the best when it comes to orthopedic surgery, but does anyone know of another orthopedic surgeon in BC? This wait is horrible and I so desperately want my hip fixed so I can have some movement again and then begin to deal with these other injuries. I miss training so much.
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Re: Any Canadians with/had a hip labral tear here? [sasser] [ In reply to ]
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Sasser, I can relate! I've been a dance and fitness instructor for over 25 years but have been stopped in my tracks by this pain. It's so frustrating and I sympathize!

Have you had your follow up with Dr. Gilbart yet, or just seen the results of the MRI? I had my follow up appt a couple of weeks ago and am booked for surgery on August 16th. There didn't seem to be a problem with wait times when I was in...maybe he's taking a holiday or something? The nerve LOL!

Dr. Gilbart came highly recommended to me and I was lucky to get moving through the process relatively quickly, though I went the private route too. It's just not worth waiting any longer after 6 years. I understand his public clinic has a 3 year wait list just to get in for an initial consultation! I was told the wait for surgery through the public system (having already seen him privately and received a diagnosis) is 6-9 months, but only 2-4 weeks privately.

I wish I could help with recommending another surgeon, but hopefully things will be moving again soon at the private clinic. Let us know how it turns out for you!
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Re: Any Canadians with/had a hip labral tear here? [sweetpeach] [ In reply to ]
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A six month wait for an MRI? We need health care reform in the U.S. BAD. I had to wait 2 days for an MRI on a femoral stress fracture. I bet I'd have to wait a week if I needed surgery for something.
Last edited by: Painless: Jul 27, 11 20:22
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Re: Any Canadians with/had a hip labral tear here? [Painless] [ In reply to ]
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anybody have feedback on Dr. Gavin Wood, Kingston Ontario?
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Re: Any Canadians with/had a hip labral tear here? [soya] [ In reply to ]
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Pretty sure a sports specialist doc can order this as well...not just an ortho.
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Re: Any Canadians with/had a hip labral tear here? [2tired] [ In reply to ]
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2tired wrote:
Dr. Murnaghan is a pediatric orthopaedic surgeon. He will see up to the university aged athlete. He may be able to give you the name of a surgeon that treats adults beyond that age group.
My high level KOS son has seen him for follow up of an osteochondritis dissecans of his knee. He is a nice guy and has done triathlons himself. Good luck!
edited to add link
http://www.sickkids.ca/...ff%20Profile%20.html

Surgery is scheduled for Sept 27th with Lucas Murnaghan. He required an X-Ray (Dunn View) to confirm FAI as well as a high powered (3T) MRI to get some more detail of joint, labral tears, etc. I believe I got my referral for L. Murnaghan around April 10th, May 25th was my first appt., 2nd appt in mid July and Surgery is Sept 27. About 6 month total time from referral to surgery. I certainly didn't conclude that L. Murnaghan was my best choice based on his schedule but from everything I have read, that is a pretty short period of time from referral to surgery (in Ontario Canada). I am happy with that.

Dr. Gavin Wood in Kingston was one of my first choices, based on my early research. His location is about 3 hours from me so that was a bit of a deterrent but i was will to travel as it is extremely important to me to get this problem fixed. With some additional research or resources, I decided and concluded that Dr. L. Murnaghan would provide an equivalent level of experience/expertise as Dr Wood (How do you compare surgeons? It is impossible, in my opinion, to say one doc is better than another assuming both are competent and experienced with the specific surgery. Good doctors have surgical failures too). The ability and experience of doing labral repairs/refixations was key for me and I believe Dr Wood is experienced with refixations (as is Murnaghan). As I understand it, refixations is a more complicated surgery vs. a labral debridement (but what the heck do I know, I'm no surgeon). I wanted to know that my surgeon had the skills to both repair the labrum, if possible (assuming my torn labrum is still repairable) or to debride or shave off the scraps of labrum that are un-repairable. As I understand it, shaving off the labral tear is an easier surgery than repairing the labrum and the training involved with learning the labral repair is more specialized. From that (right or wrong) I concluded that whoever had labral repair training was more skilled and experienced at fixing hip labrums.
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Re: Any Canadians with/had a hip labral tear here? [Hutch] [ In reply to ]
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Best of luck with your surgery! You are in good hands!
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Re: Any Canadians with/had a hip labral tear here? [Hutch] [ In reply to ]
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Hi, how did your surgery go? I am waiting to see Dr Murnaghan for similar problem. Can you share your post surgery experience? Thanks
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Re: Any Canadians with/had a hip labral tear here? [EG] [ In reply to ]
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I am 12 weeks post op. I had a labral resection (labrum was shredded too much for a refixation but he can do that, if possible), shaved down femur for FAI (Cam) and since I had chondral damage, he did a microfracture on the hip. The microfracture adds a significant amount of time off of weight bearing and the precautions are a lot more strict. Cross your fingers for no microfracture but if you get it, the results (eventually...) seem to be quite positive.

I did the CPM for 4-8 hours per day post op for 6 weeks. 6 weeks toe touch weight bearing (10 lbs or less on foot) with crutches, almost 2-3 weeks of using a cane after that. I was on my bike within 4 days post op, I believe. (Stationary, not a road bike, no resistance, 25 rpm was all a could handle at first,10-20 min, it is really just like the CPM machine). I was very diligent doing 30-90 minutes of physio type rehab daily plus 4-8 hours on the CPM plus 90 minutes of swimming daily with pull buoys, no wall push off/single leg wall push off/no flip turns for about 6-7 weeks. I have had pretty steady improvements all the way through. No major set backs. I am 12 weeks in 2 days and I can walk without a limp now but I will limp a bit when I am tired or when I initially get going. It is a long road. Be prepared for a pretty significant reduction in lifestyle the first several weeks, especially if you have the microfracture and he won't know until he gets in there for the microfracture.

My biking has improved each week. Where I used to max out at 250w for my avg. half IM bike power, now I can only handle 200w for 1 minute intervals (LOL). My basic power is about 120-150w now. I didn't/wasn't allowed to add resistance until 6 weeks post op. So in 6 weeks I have moved from 50w to 150w steady riding. I am riding outside now...in the snow and cold for up to 90 minutes (staying away from aggressively positioned road or TT bikes).

Dr Murnaghan is great, in my opinion. My wife liked him too but shes a tramp (jokes!!!). I did a ton of research and in the end, I felt very, very comfortable with how he handled everything. He is young but he is a pro. In my opinion, you are seeing the right orthopod in Ontario. His surgical times are reasonable, his appt times are reasonable and he isn't in and out in 2.5 minutes...he will take the time to discuss the specifics if that's what you want (I don't think it matters much because he's going to do the right thing anyways. Make sure he knows your level of commitment before the surgery regarding rehab). Obviously, the most important part is how he performs the surgery, his surgical skill I suppose? That you don't really know until the surgery is done and there are no guarantees. Fortunately, a friend of mine is in the arthroscopy sales field, specializes in hip scopes and equipment, knows all the surgeons with that specialty and felt Lucas M. was the right guy. Not to mention, some of the others had a 9 month wait for an appt, then a few months to get any required tests (ie. MRA or Dunn View X ray) and then 9 months from then for a surgical date. That helped make my decision, as did all the other factors I mentioned.

I have also accepted a couple of things. I probably shouldn't ever run again (I absolutely love running, have done a hundred km running weeks and I did a 1:20 half marathon 6 months before I started feeling hip pain) but it is possible if I want to take that risk, and I have also accepted that this hip surgery isn't my last hip surgery. It isn't a permanent fix. With my activity level, I will likely need my other hip done and at some point in my like, I will likely need hip resurfacing and likely a total hip replacement. I am not scared of either as I know of people who have had terrific results with both. I am 41 years old, 160-170 lbs, 20 years of triathlon, running, cycling, etc. and hopefully more surgeries are many, many years off, especially after going through this lengthy rehab (total hip replacement can have a shorter rehab!!).

PM me and we can communicate via email if you want or just reply here as others may have similar questions?
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Re: Any Canadians with/had a hip labral tear here? [Hutch] [ In reply to ]
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Thanks Hutch for the quick reply. I am glad you are getting better without setbacks. I am also 41 years old. I am nervous about the surgery. I probably need resurfacing in the future, hopefully many years from now. I heard with resurfacing you can do all sports. Who are you seeing for post rehab? Can you recommend him/her? Who else did you see other than Dr Murnaghan? Thanks again.
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Re: Any Canadians with/had a hip labral tear here? [soya] [ In reply to ]
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Hi,

I worked with Dr Mike Gilbart a few years ago as a medical student.
He works out of ubc hospital in Vancouver.

Great guy and one of the few who does hip arthroscopy.
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Re: Any Canadians with/had a hip labral tear here? [EG] [ In reply to ]
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Steve Hill is my physio. He is in Brampton. Kings Cross Physiotherapy 905 796 2000. He is very good. Works with lots of triathletes, elite athletes, etc. I got kind of nervous the days leading up to the surgery. I then just took the attitude, 'whatever happens, happens.' I did as much research and digging as I could. I felt I was in good hands and whatever cards I was dealt post op, than I would accept that. A friend of mine had been in major hiop pain for 9 years with no good diagnosis, torn labrum eventually diagnosed, took another 2 years for surgery (labral debridement), doc (not Murnaghan but a well known, good reputation doc) said everything went fine and within 12 months post op he was in great pain again and now is being told he has extensive arthritis. He is now going through the resurfacing route, likely another year or so before surgery. He is an awesome athlete and has lost his entire 40's to hip pain. I don't want to go that route. So far, so good.

I didn't see anyone else. The only doc that had good experience with hip arthroscopy and a short waiting list was Dr Gavin Wood in Kingston, Ontario. At my last appt with Murnaghan, there was a resident who had trained at Phillippon's clinic in Vail.

At some point, you just gotta get over it because there is no such thing as DIY hip arthroscopy.
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Re: Any Canadians with/had a hip labral tear here? [Hutch] [ In reply to ]
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What is the name of the resident who had a fellowship under Marc Phillippon in Colorado?

I need to find some new hip orthopods in Ontario that can fix my hip. I got FAI that needs a revision, as well as a labral repair.
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Re: Any Canadians with/had a hip labral tear here? [hip_guy] [ In reply to ]
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No idea what his name is. Women's College Hospital is a teaching hospital because Dr. L Murnaghan always has somebody working with him. Why would you want a student doing the work when you could have Murnaghan or others? I included a list of the orthpods in Ontario earlier in this thread that had experience with hip arthroscopy and likely had the skills needed to do a refixation.

There are some good rehabilitation protocols online and I have a good one. PM me if anyone want a copy of it.
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Re: Any Canadians with/had a hip labral tear here? [Hutch] [ In reply to ]
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I already had 1 surgery done by Dr. Murnaghan. 1 year post, he tells me that the FAI came back and I also found out that he didn't do anything to my labral tear. Studies have shown that people who had labral repair had better long-term outcomes than those with labral debridements. My labrum is inn bad shape so I'd rather find someone who knows how to do both a repair and a labral reconstruction via IT band graft like the article Dr. Phillippon posted this year. Therefore, I need to find the fresh hip orthopods that have had their fellowship done with Dr. Phillippon.
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Re: Any Canadians with/had a hip labral tear here? [hip_guy] [ In reply to ]
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FAI came back? The cam on your femur grew back? I wasn't aware that could happen. Repair is better than debridement which is why I choose Murnaghan (and he is a freshly graduated/trained OS) as he is trained in repairs/refixations. Dr Murnaghan said that my labrum was too messed (decarpeted or something like that) up to repair. I trusted his judgement during the surgery. It is my understanding that, currently, not all labrums can be repaired (it sounds like Phillippon is trying to change that?). I have heard about the grafting/labral reconstruction. Perhaps that is something Dr Murnaghan is investigating however I never discussed that with him.

To my knowledge no one in Ontario is doing that kind of surgery but I have another resource and I will check with him.

Question : if all the trouble with FAI, why not just go for the hip resurfacing so you can get back at it and get your life back? If you are way under 40, than I see your logic/thinking. Perhaps I am underestimating the advances that Phillippon is making but it is my impression all that stuff is really new and experimental and perhaps you will miss out on a lot of potentially active years waiting for a solution...which may end up being hip resurfacing in the end. Don't get me wrong, from what I read, I really wanted a refixation/repair (if possible) and I trust that Dr Lucas Murnaghan made the right decision during my surgery. It is my understanding that he has the skills to do a much more advanced surgical repair on my labrum but there was just nothing there to work with or what was there was insufficient for a repair. Hopefully the grafting is a potential game changer to help people in our position.
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Re: Any Canadians with/had a hip labral tear here? [Hutch] [ In reply to ]
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I wasn't aware that FAI can come back either. But the MRI confirmed it on my femur.

I just turned 26 years old and I am fairly active playing basketball, volleyball, and strength training. I only have issues when I play 2-3 days in a row or whenever I go heavy lower-body training (e.g. squats, lunges). I also had microfracture surgery in the scope secondary to an articular cartilage lesion so I know I could get arthritis earlier than expected. But if I get my labrum debrided, I know that would really mess up the long-term health of my hip joint, which is probably why Dr. Murnaghan didn't know anything with the labral tear.

So I'm willing to wait a few years for Canadian surgeons to learn this new labral repair/reconstruction technique that Dr. Phillippon has published this year. I'm just getting a little anxious... heh
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Re: Any Canadians with/had a hip labral tear here? [hip_guy] [ In reply to ]
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hutch and hip guy, I've had both hips scoped this year, and one of the first questions I asked prior to surgery was if the FAI could grow back ? Answer was yes. My surgeon in So. California, Dr. Snibbe, gives his patients a 1 month dose of Naproxen a week after surgery to combat this problem (hope it works). I also had the pleasure of getting the IT Band graft that you are referring to on the second hip surgery. Not fun at all. My labrum was basically not there anymore- it had calcified- turned into the bone on the hip socket. So, they harvested a 2cm x 4cm piece from my IT Band out of my thigh in an open operation during the scope surgery. I have had a much more difficult time healing from the harvesting than the FAI/ labural repair. Its been 4 weeks and just starting to feel normal and the swelling has finally gone away. As for the graft itself, the surgeon said it was the best new procedure available and should be better than ever. They stitch each end of the graft to what is left of healthy tissue, then used 4 anchors to pull it back to the bone. They are also able to do this w/ a cadaver graft if they know in advance (how they know this is very difficult i imagine). So far my Surgeon has only preformed 30 or so of these grafts and learned it from Dr. Phillipon also. Otherwise, if they cannot do a reattachment and only do a debridement I believe the patient will be looking at a hip resurface / replacement a lot sooner than planned. In my case I had no knowledge of this new procedure (and was asleep when the decision was made) but it was the best available plan for my long term recovery. My Surgeon is one of the best in the country and at the forefront of any new technology. I feel very fortunate to have found him (through Slowtwitch) in my home here in Los Angeles. Anthony
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Re: Any Canadians with/had a hip labral tear here? [MAGGBO] [ In reply to ]
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Hi Anthony,

Thanks for the detailed description on your surgeries because that's exactly what I'm looking for in Canada. At first, I was contemplating about going to the States, but I just started my career and I don't want to take an extended break due to surgery until I need to since I have no hip problems with work activities. If you know Canadian surgeons who have done this type of surgery, please let me know. I'd appreciate it greatly!

If anyone asks why I'm so eagered to try this, it's because I'm all about hip preservation. Not short-term fixes.

My 1st MRI showed degenerative tearing of the anterior-superior labrum with CAM type FAI.
My surgery consisted of osteoplasty for the CAM type FAI, microfracture for the articular cartilage lesion, and debridement of a "large actebular rim fracture"
My 2nd MRI 1 year post showed "anterior superior labral tearing" and CAM type FAI again :(

I wonder if anyone in Canada is also in this situation :/
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Re: Any Canadians with/had a hip labral tear here? [hip_guy] [ In reply to ]
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Hello there everyone!

I have a few questions for all you with hip labral tear(s). How big are your tears? What is said about your tear(s) Do you guys use crutches/cane(s)?

About me. Im 26 yrs young female. I have had extreme hip pain since a fall I had when i was 9 months pregnant. ..days away from my due date :( The fall has brought on the worse time of my life. I have just found out that i do have a tear on both left and right hip plus tons of soft tissue damage .. It has been 2 yrs since the fall and i have just gotten answers, however I'm kind of lost. I saw Dr Brain who told me i was severely disabled which wasn't what I was thinking. . .i know i have major problems with movement (walking, running. .etc) however i dont consider myself that bad off. Anyways he said he couldnt help me and that he would send me to Dr Gilbart. I have seen Dr gilbart but he suggested that surgery isn't for me as i have too much soft tissue damage that could become worse. . .if he was me he wouldnt do surgery. However at that point i only knew for sure I had the one tear but now i have both tears and i would like to be fixed. . . i am limited to what I can and can not do. . . .which at 26 with 3 children isnt what I ever had never dreamed off in my life. My one Dr who is not a surgeon but a

Physical Medicine and Rehabilitation said that for my soft tissue to even start to get better is to have the surgery. . .so Now im waiting to

hear back from Dr Gilbarts office. I want

to be normal again. . . i use a cane or crutches when needed. . . i should be using a cane 100 % of the time but its a hard with young

kids. . . Anywho I have found this all vary helpful. . .thank you everyone for posting. Please let me know how big are your tears im just

wondering as im not getting much about sizes of tears.
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Re: Any Canadians with/had a hip labral tear here? [soya] [ In reply to ]
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OK so I'm just creeping this thread. As many of you may know, I'm a knee specialist in the GTA. Couldn't help but comment on hip arthroscopy. The real reason very few Canadians do the surgery (and the reason Marc Phillipon, a Canadian, went to the US) is that the payment here is horrible. We used to get $300 to do the surgery while Marc charges $12,000. Welcome to socialized healthcare!
The pay schedule just changed and Ontario surgeons are now getting up to $1000 for the surgery so more guys are doing it.
The guys with the most experience with hip scopes in southern Ontario are Doug Naudie in London, Femi Ayeni in Hamilton and Mark Ginty in Oakville. I don't know about Dr Murnaghans hip scope training, but he is an overall superb surgeon technically (and he is a nice guy too).
Hope that helps somewhat.
Last edited by: Deak: Jan 25, 12 13:17
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Re: Any Canadians with/had a hip labral tear here? [Deak] [ In reply to ]
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Deak - Thank you very much for the information. Now I understand why there are very few surgeons in Canada that offer hip arthroscopy. If my previous posts seemed like I was bashing Dr. Murnaghan, I didn't mean to. He is a very nice person and even offered to refer me to other hip specialists if I felt that I wanted a 2nd opinion because he proposed to another hip scope to fix my CAM impingement again. Based on the follow-up, he didn't say much about my labrum so I got the impression he had no plans to treat it. I plan to look up and potentially book an appointment to see the other hip orthopods that you mentioned. Do you know if any of them have done hip labral reconstructions too? Thanks again!
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Re: Any Canadians with/had a hip labral tear here? [soya] [ In reply to ]
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soya wrote:
Hi, in order to get a MRI with contrast, only an orthopedic surgeon can order this. So before I wait another 2-3 months for an ortho surgeon that doesn't have a lot of experience with this, I'd rather get it right the first time. Thanks for the info though, good to know UVic has a med school, at least it's close to home!
Thanks

Not true, my wife was referred by her chiro who is a medical doctor for a contrast mri last week, got mri two days ago (where she does indeed have a labral tear) and has an appointment with Jack Taunton this week..............we are lucky we know the right people. Will know a little more after her appointment as to what procedure is and how long recovery.

sean
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Re: Any Canadians with/had a hip labral tear here? [canwi] [ In reply to ]
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There is an MRI machine called the T3. This is a very high resolution machine which is an alternative to an MRI with dye (arthrogram). My daughter reacted to the dye for her first MRI, so for the second one, a T3 was used and it yielded an excellent and clear result. A GP can order an MRI as well (at least in Ottawa that is the case).
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Re: Any Canadians with/had a hip labral tear here? [Hutch] [ In reply to ]
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A few things here...I had a FAI with a shredded labrum. My first surgery was done in 05, a debrisment and microfracture. I then had another debrisment and a osteotomy in 09, where my FAI came back, with osteophytes. In 10 i had a fairly large graft/transplant that didn't work one bit. I am not blamming the surgeon, he did the best he could but once you start working on the hip, it never seems to go back to normal. The longest I was pain free was 1.5 years. I was able to do Louisville but it hurt. Now I am scheduled to have a resurfacing done. My current Dr stated that once you start tearing down the integrity of the hip, it doesn't really work the same. He does both Arthroscopic surgeries and open hip resurfacing and total hips. He has warned me off doing triathlons any more, but say's its my hip and i can do what i want after one year's time. From what I gather, a torn labrum is usually a good fix, and a debrisment and FAI is eventually going to need more surgery or lifestyle change.
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Re: Any Canadians with/had a hip labral tear here? [Deak] [ In reply to ]
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1/ Phillipon must get more than $12k for the surgery. $30k sounds closer especially if rehab is included but what the heck do I know.
2/ Murnaghan/Cdn surgeons must get more than $1k!! If it is even close to that, than it is a crime. I think he did his arthroscopy training out at UBC. Last time I was in to see Murnaghan, there was a resident who had just come through Phillipons program.
3/ Naudie, Ayeni and Ginty were all on my list and have good reputations. Ginty had about 9 month first appt wait, then wait for MRI/xrays, and a follow up appt., then another 9 month wait for surgery, total of almost 2 years. Ayeni is in Hamilton, something was going on with transitioning to a children's hospital and he was only having appt. either 1 day/week maybe even 1/month? Lots of his surgeries were being cancelled due to the transition to a children's hospital (that's what I was told at the time) and I did get in touch with Naudie's secretary but I can't recall the outcome.
4/ I am just over 4 months post op. I am biking daily (30-120 min), still almost entirely under 200w where 200w used to be a long easy ride for me. My swimming has progressed to being able to push off with both feet, but I still try to do >50% on my good leg. Running...mild nausea even thinking about it. Not even close to running probably never should. I can see my biking coming back though. Starting to think about some mild half shots for golf.
5/ Brandt Snedeker has his labrum repaired (not sure of exact details) via Phillipon in early Nov 2011 and about 3 months post op he won a PGA tour event at Torrey Pines last weekend. I believe his other hip was done a year or two ago. Good success story.
6/ Hip resurfacing sounds enticing but I haven't done much research on it yet. I can't picture myself going through another rehab on my other hip, which Murnaghan commented that it is even worse than the hip his operated on but there is no associated pain with it. That being the case, running isn't a great option.

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Re: Any Canadians with/had a hip labral tear here? [rgjhrf73] [ In reply to ]
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Wow, I just came across this thread and it's filled with all kinds of helpful tips.

I have been diagnosed with Femoroacetabular Impingement with a pincer lesion and labral tear or degeneration.


I am a Canadian citizen based out of Montreal working overseas, and thus, will need to be treated privately.

One of the members here was kind enough to compile a list of doctors who can repair labral tears, which is an important part of treating Femoroacetabular Impingement:


Dr. Douglas Naudie, London, Ontario
Dr. Dan Whalen, St. Michaels, Toronto
Dr Gavin Wood, Kingston, ON
Dr. Lucas Murnaghan, Sick Kids/Womans College Hospital
Dr Olufemi Ayeni, McMaster, Hamilton
Dr Rajev Gandhi, Toronto
Dr. Ginty, Oakville
Dr. Veillette or Dr. Ogilvie-Harris, Toronto (same clinic).
Dr. Paul Beaule, Ottawa



This list is good for me as it is in the Quebec/Ontario region, unlike Dr Gilbart who does treat patients privately, but is at the other end of the country.


Does anyone know of any doctors I can contact from Eastern or central Canada who treat Femoroacetabular Impingement privately? I need to re-enter Canada, pay for the treatment, get operated on, recover, and then leave the country as soon as possible.


Many thanks...
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Re: Any Canadians with/had a hip labral tear here? [skatemomrose4] [ In reply to ]
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Thank you for your input.

I just received a reply from Dr Wood, and he told me that private practice is not allowed in Ontario.

He also told me that he thinks Dr. Paul Beaule has a clinic in Quebec, so that would be ideal for me. I have Googled his name and only come up with what seems to be a personal website, but nothing about a clinic here or anywhere else:

http://www.conservativehipsolutions.com

Thanks again, and I will surely ask anyone I do decide to go with if they actually do the repair.
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Re: Any Canadians with/had a hip labral tear here? [Westpoint] [ In reply to ]
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Dr Beaule's name has certainly came up several times in my research, Ottawa region I believe.
Beaulé PE, Allen DJ, Clohisy JC, et al. The young adult with hip impingement: Deciding on the optimal intervention. J Bone Joint Surg Am. 2009;91(1):210-221.
Above is likely one of his recent papers.
pbeaule@ottawahospital.on.ca
http://medicine.tums.ac.ir/...20Labral%20Tears.pdf

http://www.medicine.uottawa.ca/...ery/eng/faculty.html

I would be surprised if he wasn't capable of doing a repair, if possible.

Good luck. Sounds like you need to spend some time to see if you are even eligible to have the surgery completed in Ontario via OHIP.
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Re: Any Canadians with/had a hip labral tear here? [Hutch] [ In reply to ]
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Thanks Hutch...
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Re: Any Canadians with/had a hip labral tear here? [hip_guy] [ In reply to ]
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I had labral tear repair surgery completed by Dr Nick Mohtadi in Calgary. My family doctor recommended that I choose only the very best surgeon to repair my hip and that I travel to that surgeon and sit on a longer waitlist if necessary. I think this was excellent advice. In many cases, medical imaging is not yet sophisticated enough to diagnose hip problems in detail, leaving surgeons without the option to map out the details of a procedure in advance. Very few surgeons are comfortable enough with hip arthroscopy to manage this uncertainty. I would recommend Dr Mohtadi to anyone needing hip surgery in Western Canada. He is a very knowledgable and skilled surgeon. He is based at the University of Calgary Sports Medicine Centre.
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Re: Any Canadians with/had a hip labral tear here? [pelagia] [ In reply to ]
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I'm so happy to read through this thread.. some very good info. I'm a 32 year old woman and was diagnosed with a hip labral tear about 10 years ago by an ortho surgeon in Kitchener. After calling the office for months, I was never able to get a referral to someone who could fix it, so I just gave up. I had even found a doc online (Dr. Day in Vancouver) who did the same surgery for Mario Lemeauix, and gave this doctor's number to the surgeon, and still nothing. The pain in the beginning was mild and only really worsened after a lot of running, or if I sat for too long. These days it aches all the time and I can't sleep on my right side. The day after running around a baseball diamond I am limping! I called the surgeon's office last week and apparently my records have been destroyed.. Yesterday I saw my family doc who is sending me now for a new xray. Not sure what the point of getting an xray first is when I already know an MRI with dye will be needed to see the tear.. but I guess they have their procedures to follow.

I'm grateful for the names of the S. Ontario surgeons who can do hip arthoscopy now.. thanks everyone. I will be sure to pass these on to my doc when I eventually get re-diagnosed. I just hope it doesn't take too long because I'm really struggling this summer. At least my bf is out of commission with an injury as well so we can sit around lazily together!

For those of you who have had the surgery already, did your surgeon give you a referral to a physiotherapist who is familiar with this type of surgery, or did you just go to any physiotherapist? Also, how long did you have to stay off your hip afterwards?

Thx!
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Re: Any Canadians with/had a hip labral tear here? [smann] [ In reply to ]
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Hi,

I just read your post and am fascinated by your story in particular. I've had similar pains and constant muscle tightness and now have a labral tear. I've spent 3 years searching for answers only to get worse. I haven't been able to work out at all since an injury (the tear) 3 years ago and have lax ligaments all over the place. The ligaments are being treated with prolotherapy as is the labral tear - not surgery, but if that does not work, I wouldn't be surprised if I also had a hip/pelvic issue. My hips have never been 'straight', I have slight scoliosis and my pubic symphysis is off. I'm guessing a surgery something like your wife's or yours may be in my near future and if you wouldn't mind communicating with me, I'd appreciate it very much.

My e-mail address is chornitza@hotmail.com.

Thank you,
Jelena
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Re: Any Canadians with/had a hip labral tear here? [Jelena] [ In reply to ]
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This forum and the information contained is a blessing to me. Seriously!

About 25 years ago I was involved in a serious motorcycle accident (slammed into a car at 80 km/hr). While there were no broken bones, there were brain injuries and the seam and stitching on the right leg of my leather trousers disintegrated (almost as if my leg expanded enough to pop the seam completely.) Since then I've been in constant pain with my right hip, getting worse month by month. Each Doctor and Ortho I see sends me off for Xrays, bone scan, ultrasound, find nothing and recommend physio. Been there, done that, no results. I recently asked my GP for a re-assessment and while waiting for the appointment, came across information about Labral tearing. The xrays he ordered of course came back negative and he was not inclined to refer me to an Ortho. Good thing I went prepared with papers on Labral tears, as he knew nothing about it. And now with the information contained in this forum on who can do the proper assessment and repair work, I'm finally feeling hopeful after 25 years of pain and leading a restricted life.

Thank you all for the information shared!!
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Re: Any Canadians with/had a hip labral tear here? [Vapour] [ In reply to ]
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I hope you will get the surgery and please let us know how it goes for you.
I am scheduled for labral repair in about 10 months with Dr Beaulé in Ottawa.
After compensating on the right hip for so long, the latter is also falling apart now but I keep a smile on.

25 years with the same pain is incredible. It has 'only' been 2 years for me and the agony is hard to describe at times.
You are brave and suffered long enough.
Now win that 649 and go to Vail Colorado to meet Dr Philipon!
We need more Hip labrum surgeons in Canada.

By the way, that is what caused Lady Gaga to stop her tour.



Only fools never change their minds and I'll never change my mind about that.
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Re: Any Canadians with/had a hip labral tear here? [Westpoint] [ In reply to ]
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I am in Toronto, Ontario, and have been reading this entire thread with great interest. Looks like I will need to get a surgical opinion and probable hip arthroscopy or other hip surgery to deal with FAI. The consensus seems to be that Dr. Lucas Murnaghan is the best doctor locally for this type of surgery, and many of you have been to see him. Yet he is listed as a pediatric surgeon who does not see patients above college age. Are any of you who have seen this doctor above college age? I am 46 and thus far out of this range, but if this doctor does in fact see older patients I would love to know.

I would also be very interested in your commentary on wait times for this doctor and for possible alternative surgeons in the area. I am also considering asking for a referral to either Dr. Christine Young, Scarborough Hospital; Dr. Rajiv Gandhi, Toronto Western Hospital/UHN; Dr. Sebastian Rodriguez-Elizalde, Humber River Regional Hospital; or Dr. Mark Ginty, Oakville Trafalgar Memorial Hospital.

Many thanks, in advance, for any information you may be able to provide--I'd be most grateful.
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Re: Any Canadians with/had a hip labral tear here? [soya] [ In reply to ]
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I am seeing Dr Ackerman in Kamloops BC. I have had 2 sets of x rays and will be getting a MRA, in other words a MRI with the dye. He seems very thorough. I feel really good under his care. However, he prefers open surgery but told me when we reach the decision making phase that if I really want arthroscopic that he will recommend me to someone. Does anyone know much about which is better? Open or arthroscopic.
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Re: Any Canadians with/had a hip labral tear here? [Loretta] [ In reply to ]
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Hi there, just wondering if anyone has had surgery with Danny Whelan at St. Mike's and know how many surgeries he has done for hip FAI and labral tearing? Also, if anyone has traveled to the US to have it done, and who is best there and what is the cost usually? Thanks
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Re: Any Canadians with/had a hip labral tear here? [msm84] [ In reply to ]
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Well add my name to the list of Canadians that need hip surgery. I have been referred to Dr. Naudie in London and have just received a call for surgery date. July 2014. That is 11 months away and I can barely walk now. I have talked to the local MP about trying to get some assistance if I can find another surgeon that will be willing to take me on as a patient and have an earlier surgery date. I am in the process of looking to find another surgeon but after reading these posts it sounds like I might have a good surgeon already and the wait time will be about the same. I am feeling a little overwhelmed by the thought of doing nothing for another year. Any help from you forum posters on what I may also be able to try?
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Re: Any Canadians with/had a hip labral tear here? [Mrman] [ In reply to ]
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Sorry about that but I recently had a Hyaluronic acid hip injection (product is called Synvisk) to relieve my labral tear + femoral head necrosis.
People refer to it as viscosupplementation. Read about it as opinions are diverging.

As for me, I went from no sports at all after IMFL to swimming, biking and jogging (not running yet) again. Not race fit though but livable, bearable and much easier on the joints (at least for 6 months...)

Not covered by Ohip, $500 (ouch) and performed by an MD with an ultra-sound technician guiding him.
Super long syringe (ouch again) and 2 days of pain then... labral pain GONE.
I am a believer but as always, I assume results vary and it may not yield the same results for you.

Let me know if you are interested and want more info. I only know that one doctor in Ottawa (Dr Gauvreau) but I trust him. I do not know about other doctors performing that injection in Ontario.



Only fools never change their minds and I'll never change my mind about that.
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Re: Any Canadians with/had a hip labral tear here? [Bancarel] [ In reply to ]
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Thank you very much. If anything it gives me something else to research. I will ask my doctor more on it aswell. Thank you again.
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Re: Any Canadians with/had a hip labral tear here? [Bancarel] [ In reply to ]
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Have you tried Durolane? It costs about $350 ($280 at Costco) and is similar to Synvisc.

I had this injection done at the hospital by doctor referral. I had Durolane filled by my pharmacy ahead of time (as it needs to be ordered in). A radiologist did the injection under x-ray guidance and told me about the cheaper price at Costco. From what I understand you don't have to be a member to use Costco's pharmacy but you do need a prescription.

Early in 2013 OHIP decided to no longer pay for the procedure and hospitals are now charging a fee to have it injected on the premises. This makes me mad as OHIP will still pay to inject cortisone into your hip but not viscosupplementation.
Last edited by: barbis9: Sep 20, 13 1:39
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Re: Any Canadians with/had a hip labral tear here? [Mrman] [ In reply to ]
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It takes 9 months to get in to see Dr. Ayeni and then there is a 2-3 year wait for surgery. You can get your hip replaced sooner than having it repaired in Ontario.
Last edited by: barbis9: Sep 20, 13 1:10
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Post deleted by barbis9 [ In reply to ]
Re: Any Canadians with/had a hip labral tear here? [msm84] [ In reply to ]
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Hello,

I have just met with Dr Whelan at st mikes 2 weeks ago. His assistant did all the work and ran the appointment, Danny came in at the end said 3 words told me he is booking 9 months out for surgery and walked out... Arrogant to say the least. His assistant Brian was very good knowlegable and has had the surgery so that was assuring. Was told i could go home that night does anyone on hear know if that is true and if so a good idea?

Thanks
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Re: Any Canadians with/had a hip labral tear here? [barbis9] [ In reply to ]
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just reviewed this forum again now that I am actually set to have the surgery.
I was diagnosed almost 3 years ago with a labral tear by my reuhmatologist but had to see 3 other doctors before a final yes that's what it is and we'll operate diagnosis.
Finally, I think I'm set for surgery in November with Dr. Ayeni in Hamilton. He came highly recommended to me so I hope the 1 1/2 year since consult will be worth it.
For the person who was asking about East Cost doctors who do this surgery....Dr. Wong moved from Hamilton to Halifax last summer and set up his practice (I think he works with Dalhousie University now). I saw him before going to see Dr. Ayeni.
I'm seeing lots of wonderful post-surgery stories on here which gives me great hope for a full recovery. I'm wondering what it's like right after surgery though...ie weight bearing, pain level, mobility level. I am planning for quite an extended time off work (I do childcare). Just wondering what to expect in the first few days/weeks.
Any thoughts??

Thanks
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Re: Any Canadians with/had a hip labral tear here? [Westpoint] [ In reply to ]
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Dr. Wong moved to Halifax from Hamilton last summer and I believe has set up practice with privileges through Dalhousie.
He was highly recommended to me before he left and seemed very knowledgeable and friendly in during the one consult I had with him.
Hope this helps!
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Re: Any Canadians with/had a hip labral tear here? [barbis9] [ In reply to ]
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I have been suffering with hip pain since the birth of my first child in June. I have seen several therapists - chiro, physio etc. but it was my osteopath that suggested a labral tear. After researching the symptoms etc. i'm afraid that is what i am dealing with on both hips. I am a yoga teacher and pretty terrified that i will not be able to return to my yoga practice. It is pretty disheartening to hear of the wait times for a consult and then the procedure. Unfortunately, i am not in a financial position to go to the US but that seems to be the only way to get this done any quicker. Thank you for the information on Drs. in the area. I will begin the process of trying to see someone! I am 33 and would like the option of repair vs. debridement if possible. I am hoping to hear from those of you who have undergone the procedure and how recovery is going. Thank you, thank you for all the posts - i feel better hearing all this anecdotal information vs. just clinical facts.
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Re: Any Canadians with/had a hip labral tear here? [hip_guy] [ In reply to ]
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Hutch, wondering if you would feel comfortable to know how you are doing currently? It sounds like you are very active and would represent a good outcome!
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Re: Any Canadians with/had a hip labral tear here? [Nancathia] [ In reply to ]
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I had surgery almost exactly a month ago and am doing well. I had a labral tear (almost torn in two) in my right hip. They were able to repair the tear and shaved a bit of the bone (to make sure the problem that caused the tear does not return). My surgeon was Dr. Ayeni out of Hamilton and he was wonderful. It was a long, frustrating wait...6 months for the consult and over a year for the surgery (I know the waits are longer now), but in hindsight worth it. I am now in physio and am recovering well. Had 2 1/2 weeks on crutches (no weight bearing), and over the past weeks have progressed from one crutch to just a cane. I still get stiff but am not experiencing anywhere near the pain I had previous to the surgery. I am not back to work yet (i work in childcare). I was worried like you that I had an issue with my other hip as well but after having an MRI with dye done on it, my surgeon has said that although there may be something there, it is not surgical at this time and he thinks with strengthening, it will not cause me much trouble. Hope this information helps you.
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Re: Any Canadians with/had a hip labral tear here? [Nancathia] [ In reply to ]
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I had a mosaicplasty (think bone graft) on my femoral head, labrum got cut (repair was not possible) and cam impingement got fixed.

9 weeks later I can swim, bike without resistance, I cannot run nor jog yet. Swimming helps a lot, rowing works as well.

I had it done abroad ($10000 altogether, in debts for years...), better timing would probably had it covered by OHIP but decisions had to be made quickly to go back to normal and somehow 'salvage' whatever would be left of my 2014 season .

Your labrum fix could also be covered if you can have 2 or 3 surgeons stating they cannot operate before a 'reasonable' amount of time.
Be super patient though and get cracking on the paperwork asap if you are considering out of province surgery.

Labrum turned out to be the least of my worries and since surgery the pain is almost completely gone (the labrum one that is).

Rebuilding my quad is a painstaking process, 4 weeks without load-bearing positions on my left leg did some serious damage.

Hyaluronic acid provides relief until surgery (good for 6 months) It is about $400 (not covered) but it worked for me and allowed me to make it in more or less one piece till surgery.

Voilà,
if you have any questions don't be stranger.



Only fools never change their minds and I'll never change my mind about that.
Last edited by: Bancarel: Dec 6, 13 18:12
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Re: Any Canadians with/had a hip labral tear here? [blondie 44] [ In reply to ]
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How are you doing now post op? I too, have been diagnosed w Labral tear after Several months of hip pain/stiffness. Set up for a cortisone shot next month as I await patiently or more impatiently to see dr yanni in Hamilton. I understand the wait to be long and surgery longer...no cycling; minimal running :( sucks
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Re: Any Canadians with/had a hip labral tear here? [Jenham] [ In reply to ]
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I'm doing really well!! Hope the cortizone shot works for you...they told me it would last 3 months and it felt great at first - no pain at all for a month but that was it.
I did wait quite a while for the surgery with Dr. Ayenni in Hamilton. In hindsight, it was worth the wait! I am now about 7 weeks post surgery and feel wonderful!!! I still get achy but the pain is nothing compared to the stabbing I used to feel beforehand. I have been in physiotherapy since the end of November and my therapist says I am doing very well...I now only use my walking stick outside (due to the snow), inside I don't need it anymore.
You're right about no running for a while but I do use a stationary bike every day (when I can). I have already been able to do somethings that I have not been able to do in years (since the pain began) like squat down and not need help getting up...a small thing but exciting to me!
I know how frustrating the wait is, but now, post-op, I can honestly say hang in there! it is worth the wait!!
The surgery itself was ok...painful right after but the recovery has been much quicker than I expected!! I was told initially that it could be up to 6 months before I go back to work (childcare), now they are thinking more like less than 3.
Hope this info helps...feel free to ask me anything else...
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Re: Any Canadians with/had a hip labral tear here? [blondie 44] [ In reply to ]
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6 months? geez - I was hoping for 6 weeks!!! I get a lot of pinching but mostly down the hamstring and sitting cross legged I get very stiff. I can still run but minimal amounts per sports doc - small tear and he said the benefits outweigh the risks. For sanity sake, I need to do that minimal amount! I thought the cycling would aggravate it more, but I will get my bike on the trainer and see. Are you in Hamilton? I'm travelling from Mississauga and am currently doing physio but not sure I'm at the right place. I'm glad to hear you are recovering quite well and I hope that I can get in sooner rather than later but we know the healthcare system and with the few doctors that perform this surgery, I think that may be wishful thinking. thanks for the info on the cortisone shot - I thought it would last right through - again wishful thinking :) Did you do much research prior - on both the injury and the doctor? Any sites you would recommend? thanks so much for your feedback!
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Re: Any Canadians with/had a hip labral tear here? [Jenham] [ In reply to ]
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I believe they tell most patients 6-8 weeks up to 12 weeks...I think they told me longer because of what I do...childcare.
I had a fairly large tear that they were able to fully repair and they shaved some bone to try to make sure I would not get a recurrance.
I use the upright stationary bike (as opposed to the recumbant(?)) I find that when I use the recumbant style, I get more of a catch in my hip.
I am up in Barrie but have family in Mississauga...where do you do physio? I know people in health care down there and can maybe check around for you.
Dr. Ayenni has told me that the weight is getting longer, his receptionist has said that the wait just keeps getting longer as more people are diagnosed than ever before and because the former top doctor for this procedure in Ontario (Dr.Wong) moved down east and recommended Dr. A to all his patients.
I did do some research on Dr. A before surgery and was very happy with what I found. He is very nice though very soft spoken. I did not research the surgery much as I felt I didn't need the graphic.
Here is the site for his profile at McMaster:
http://macortho.com/...le=47&popup=true
I'm sorry but I deleted the other sites I had used for research.
I know I looked a lot of injury/surgery info up on WebMD. I also seem to remeber reading an article or two on Dr Ayenni but can't remember where I found them.
I may be worth trying the corizone...I know I said it only lasted me a month but it was worth it. I was told it could last 3-6 months. Also my GP told me that they will only give you so many of these so use them sparingly. It could be worth it to get you back to a semblance of normal for a while.
I know how you feel about doing the minimal that you can...I felt the same, even if it hurt, I just needed to so something!
Any other questions...fell free!
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Re: Any Canadians with/had a hip labral tear here? [Hutch] [ In reply to ]
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Hutch: Don't know if you are still here, since it is 2 years since your post on Orthopods doing hip labral repairs. I am in the same vortex of trying to get to the surgical solution. Had the MRA and clearly indicated macerated labral tear. Lots of pain and immobility and restriction. According to my second Ortho, I am being referred to Dr. Ayeni in Hamilton, (6 weeks ago and no indication of any appointment yet...), but was advised of his long wait times; 8-12 months for the consult. I have been suffering for over a year already. I need a solution sooner rather than later. Gaining weight because I can do very little, and losing muscle mass at a ferocious rate.... Biggest issue for me is that I am older and my research indicates that I am likely to get resected not repaired because of my age; that means a likely hip replacement within a couple of years after the resection....Not a good prognosis.
I would like to reach out to you for your experience over the past couple of years, and get any new info you may have on which Dr. are doing hip arthroscopy and who is good / available.
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Re: Any Canadians with/had a hip labral tear here? [jhlett] [ In reply to ]
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Dr Philloppon (spelling) has done a lot of research on labral tears. I have a bunch of research papers on .pdf
You have to be assertive, flexible and try to approach doc directly. Tell them you can do a cancellation. I had my surgery 9 months after I felt the first pain. That is very quick as it took the first 3-4 months just to get diagnosed. PM me to chat via email
Last edited by: Hutch: Feb 19, 14 8:30
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Re: Any Canadians with/had a hip labral tear here? [Hutch] [ In reply to ]
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Thanks for the reply. Glad you recovered well. I have lots of research papers that I have read, and would certainly like to receive the ones you have. I don't know what you mean by "PM me..." to chat....
I pulled up ratings on several of the Orthopods you listed 2 years ago, and have a short list of 5 that I guess I need to pursue.
Who did your surgery?
Thanks.
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Re: Any Canadians with/had a hip labral tear here? [jhlett] [ In reply to ]
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Lucas Murnaghan. 10/10
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Re: Any Canadians with/had a hip labral tear here? [Hutch] [ In reply to ]
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I'm going through the whole hip arthroscopic surgery process in Canada as well, in the sincere hope that I can get back to work and some semblance of an active life again.

I have a wonderful sports medicine physician who was able to spot the problem and get the 3T-MRI imaging ducks in a row in 2 months flat. I've now been diagnosed with a large anterior complex labral tear and a smaller posterior one with some mild FAI. There is no sign of hip dysplasia or acetabular anteversion or retroversion. I'll need arthroscopic surgery for this so I have been looking at my options.

My first choice is to stay in Eastern Ontario to see either Dr. Paul Shim, Dr. Gavin Wood or even Dr. Lucas Murnaghan in Toronto (thanks, Hutch). Dr. Murnaghan's father is near retirement and sometimes they get confused with each other on paper so bear that in mind when searching for information. Dr. Paul Beaule has too long of a wait so he's not on my list.

I can't work at this point because of this injury, so seeing Dr. Michael Gilbart in Vancouver via private route might be an option. He does primarily arthroscopic surgery in a variety of joints (knees, hips, elbows, shoulders). He was enthusiastically recommended as well by my sports medicine doctor. The waits privately are far shorter and I have relatives who can put up with me while I recover to the point that I can comfortably fly home. I've been quoted 11-13K for surgery (all in) plus $750 for the pre-surgery consult and imaging reviews. Doing the same in the US would cost quite a bit more. My provincial plan can cover a small part plus it can jump in with both feet if I have to be transferred to a public hospital or have to visit an ER for complications, thanks to interprovincial health agreements. This surgery is considered day surgery so fingers crossed I won't have to deal with that.

I'll post a bit more as things progress to help anyone who has the same issue in Canada.
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Re: Any Canadians with/had a hip labral tear here? [PumpkinEater] [ In reply to ]
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How old are you?
How do you think you tore labrum? One traumatic event or chronic FAI?
Did you have an 'Dunn View' xray?
Surgery can have a relatively fast recovery assuming you don't need the microfracture technique which I don't think they know they have to do until they get in there.
Has this Van dock every done microfracture, FAI type surgeries? As I recall, there was someone out there that had a good reputation, perhaps it was him?
Sitting on a plane seat would be a bit uncomfortable but at least you could get the wheel chair assistance (perhaps hard on ego?) through the airport.
2.5 years post-op. Shaved down labrum debris. Shaved down FAI on femur. Did microfracture in acetabulum. Surgery took less than 90 min. 99.5% pain free. Can bike 2-3 hours at whatever intensity I want pain free. Can run short distances pain free (haven't really tried anything longer...not worth it).

Hutch
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Re: Any Canadians with/had a hip labral tear here? [Hutch] [ In reply to ]
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Hi Hutch, if you still have that rehab protocol and could send it to me, that would be great. I'm so glad that you've gotten most of your mobility back.

To answer your questions, I'm under 40 and sustained at least the anterior part of the tear thanks to hyperextension in beginner-level "triathlete" yoga under load and the idiotic instructor who instructed us to do so. There was no pop, no twinge, just a vague soreness the next day. It took me two classes to figure it out as I thought it was a irritated psoas issue. The injury was further exacerbated by an even more idiotic physiotherapist who didn't like that I wasn't extending my hip. I had good reason not to.

Yes, Dr. Gilbart is the one you're thinking of. He ordered the Dunn (45) and the cross-table xrays for me. I was provided with copies of all of my scans and Dr. Gilbart will be going over them in a few days to see if I'm a good candidate. He is an assistant professor at UBC and does a fair amount of research with labral tears and FAI. I hope he can repair the labrum instead of removing the damaged parts but it's anyone's guess with a complex tear. The MRI report says the cartilage looks mostly good so maybe I can avoid the microfracture.

If surgery is a go, I will fly on over for the consult and hang out with the relatives until the surgery. I'm not looking forward to the flying bit, and it's the sitting that will do me in. I can't bring any sort of ice pack on board unless I can MacGuyver one from the food court in the secure zone. On the ground, the airport folks are pretty good as soon as they see someone with a cane or crutches. I'm in too much pain to give a hoot about my ego; they can bring on the wheels.

Dunn xray for uninitiated:
http://roentgenrayreader.blogspot.ca/...02/dunn-view_08.html

Why yoga is evil incarnate:
http://www.nytimes.com/...ty-in-yoga.html?_r=0
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Re: Any Canadians with/had a hip labral tear here? [PumpkinEater] [ In reply to ]
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Sounds like you have a better than avg chance of full recovery or fully functioning normal person. I am fully functioning and very fit. Can't run 1:20 half marathon anymore but feel just as fit. I only took 1 pain pill. After 1st day, I was good as long as I wasn't stupid. Plane should be fine.
Hutch
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Re: Any Canadians with/had a hip labral tear here? [Hutch] [ In reply to ]
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Hi all!

Can anyone comment on Dr Ivan Wong or Dr. Danny Whalen?

I had my initial consult with Dr Whalen in December. He initially told me if I was not going pro then I should probably reconsider and not get the surgery (large labral tear, FAI). Before the injury I was running approximately 120 kms per week. His assistant also told me that the success rate is low with this type of surgery. That being said, my sister is a physio therapist in Halifax and has seen many of Dr Wong's patients post op who have had a lot of success so I am considering inquiring about getting an initial with him instead. I have recently re located back East and no longer live in Ontario. If anyone has had labral tear surgery with any of these two doctors, or have any information, it would be greatly appreciated! Thanks!
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Re: Any Canadians with/had a hip labral tear here? [Adams83] [ In reply to ]
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Hi All:

I am not an athlete but I have been practicing yoga for 10 years and have always pushed myself as opposed to "gentle" yoga. I'm fit and in my
early 50's. I've given up yoga but swim and power walk as the intense hip pain only occurs during certain movements.

For the last 3 years I've had painful "snapping" in my right hip/groin area. I had a hip x-ray which was negative. Had another hip x-ray a year
later which was also negative. This year had my third hip x-ray which showed minimal degenerative change. I tried physio which helped
with muscular tension relief but the unbearable snapping nerve pain has never subsided. I'm now being proactive and researching my
options. I'm searching for an orthopedic surgeon that performs hip arthroscopy in Toronto and the GTA. I assume I'll need an MRI or MRA.

Can anyone recommend a surgeon that has experience with FAI and tear repair?
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Re: Any Canadians with/had a hip labral tear here? [Adams83] [ In reply to ]
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Adams83 wrote:
Hi all!

Can anyone comment on Dr Ivan Wong or Dr. Danny Whalen?

I had my initial consult with Dr Whalen in December. He initially told me if I was not going pro then I should probably reconsider and not get the surgery (large labral tear, FAI). Before the injury I was running approximately 120 kms per week. His assistant also told me that the success rate is low with this type of surgery. That being said, my sister is a physio therapist in Halifax and has seen many of Dr Wong's patients post op who have had a lot of success so I am considering inquiring about getting an initial with him instead. I have recently re located back East and no longer live in Ontario. If anyone has had labral tear surgery with any of these two doctors, or have any information, it would be greatly appreciated! Thanks!

Hi there

I also have a large labral tear and FAI. I had my appointment with Dr Whelen last week and I was told the same thing (i.e. the success rate is low and it will not help with the pain or my inability to generate as much force by my right hip than my left). Have you got a second opinion ? What are you doing to manage ?
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Re: Any Canadians with/had a hip labral tear here? [Jessec22] [ In reply to ]
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Jessec22 wrote:
Hello,

I have just met with Dr Whelan at st mikes 2 weeks ago. His assistant did all the work and ran the appointment, Danny came in at the end said 3 words told me he is booking 9 months out for surgery and walked out... Arrogant to say the least. His assistant Brian was very good knowlegable and has had the surgery so that was assuring. Was told i could go home that night does anyone on hear know if that is true and if so a good idea?

Thanks

I had the same experience with Dr Whelan. He came in the room for 30 second, told me the surgery wouldn't help me and left. How big was your tear ? did you end up getting the surgery ?
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Re: Any Canadians with/had a hip labral tear here? [sweetpeach] [ In reply to ]
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I called the office in Vancouver and they no longer take public clinics...this office now only does private care. :(
I have been waiting 10 years to see someone...
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Re: Any Canadians with/had a hip labral tear here? [Hutch] [ In reply to ]
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Hi,
I'm Canadian living in Montreal. I will go through the labral tear surgery in 2 weeks. The doctor told me I should use a cpm machine for 28 days after the recovery, but I'm having trouble finding one. I saw on this thread that some of you used it too. Would you know where I could rent one, in Quebec, or in Ontario, for the time of my recovery? He also recommended a DVT-pump, so I'm also searching to rent one of those... Did you ever experience it? Thanks!
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Re: Any Canadians with/had a hip labral tear here? [mpl] [ In reply to ]
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Update 3.5 years post op
Dr L. Murnaghan did an awesome job for me. Now I am biking 1000km/mo and I have seen >600w+ a few times during intense intervals. Doing 275w intervals for 5-10 minutes at a time, several reps. I haven't had any problems with my biking or swimming.
I do not run anymore. <Sigh>.... I have tried shuffling around a few times, 500m, 1-2km here and there but I almost always have some minor discomfort the next day, sometimes in my non-op hip, so I am no longer a runner. Just not worth it, I have decided. My other hip is still pain free and I would like to keep it that way.
Aside from not running, I am 100% back to pre-op fitness.
I can't say enough good things about Dr. Lucas Murnaghan and upon checking his recent tri results online, he seems to have picked up his triathlon training/racing a bit. He is getting pretty fast for a guy who likely lives in the city, has a real job and likely works a lot.
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Re: Any Canadians with/had a hip labral tear here? [mpl] [ In reply to ]
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I did not use a Cpm machine but had already researched them before and that name had come up a few times:

http://www.cpmrental.ca/

Just found this one:

http://www.diamondathletic.com/...amp;-Dynamic-Splints

What you might also want to look into is an Aircast cryo-cuff with the hip attachment like this one:

http://www.worldtohome.net/...fsjcUCFYzMtAod1jAArA

I bought one just before my surgery (mosaicplasty) and it helped a lot for the next 2 weeks.
Cheap and efficient, easy to use (you might need some help to load and empty the cooler).
Kept everything cool which made a difference with the swelling.

Good luck



Only fools never change their minds and I'll never change my mind about that.
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Re: Any Canadians with/had a hip labral tear here? [Jenham] [ In reply to ]
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1 yr to the week Post op FAI/micro fracture [70% tear in labrum/cam & pincer - basically my R hip ws f-ed up!]
:)
anyway - I too initially saw Dr whalen - he felt the surgery was counter productive because of the size of the tear [too large], plus the onset of osteo-arthritis; he thus felt it was not worthwhile, also noting there was only a 40-60% chance of any marked improvement.
he wouldn't do the surgery but did refer me to Dr Femi Iyeni at McMaster - he specializes as well in FAI.

http://macortho.com/...1&viewprofile=47

Long wait to see him, longer wait to have the surgery - big wait list - but, Great surgeon and [pretty much] successful surgery - while recovery was/is long and continuing, much better ROM. Was on crutches for nearly 10 weeks with total non weight bearing for 8 weeks - that sucked. used a CPM and it really helped.

I have no plans/likelihood to race an Ironman or marathon ever again, and haven't raced any triathlons/road races since the surgery, but I can run 45 min and ride/swim fine. May go back and do the odd Sprint just because I could.
Like Hutch, since the surgery, I am noticing the wattage on the bike is steadily getting higher/better. Sold the TT rig post surgery and now ride my road bikes exclusively - they fit better and the Q angle on my hips is more adaptable to the road position. Took months to feel "comfortable" that I could stress the surgical hip, but now, no worries at all.
Bottom line:
The surgery was worth it - just realize it may not be the magic bullet you are hoping for; go easy after, and DO YOUR PHYSIO/REHAB! Don't let the hip get stiff and tight; you will pay for it down the road.
Lastly, while Dan Whelan is a very good surgeon, he was/is just too busy to spend the time with each patient - and so, I can't recommend Dr Iyeni enough - he was not only an excellent surgeon, but thoughtful [he called me the day after the surgery to make sure I was doing ok!], funny, caring and approachable.
Which is a good thing, because, f me, I have to do the other hip this summer [major tear in the L hip labrum - sigh - there goes 2015...]
Last edited by: runjohnrun: Apr 25, 15 14:46
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Re: Any Canadians with/had a hip labral tear here? [Bancarel] [ In reply to ]
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Ok, thanks a lot for all those info. hHe surgery is in a week, I'll arrange everything and... hope for the best! With a lot of physio, of course!
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Re: Any Canadians with/had a hip labral tear here? [Adams83] [ In reply to ]
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I saw Dr. Whalen for a consultation (fall 2014) for a hip labral tear with Cam Impingement. At the time I was on Dr. Beaulés' surgical waitlist, Dr. Beaulés' receptionist recommended a few Dr.'s closer to me in Toronto who would also be able to perform the surgery - likely much sooner than Dr. Beaulé . I felt my visit with Dr. Whalen was a waist of a day, I did not get a sense from Dr. Whelan that he was competent in diagnosing hip impingement or at performing hip arthroscopy. He said that he only performs the surgery on the cases that he feels will have the best possible outcome (1 in 10 patients) - I took this to mean young adults (<25) with acute labral tears. I had the surgery with Dr. Beaulé 5 weeks ago, I'm 42 and have had hip issues my whole adult life - from hip impingement as I understand now.

Dr. Beaulé was very confident he could correct the issue during my consult and during my post operative meeting he was very happy with the surgical outcome. At 5 weeks post-op my hip is feeling much better than before surgery. My advice to anyone with ongoing hip paint is to make sure you get an answer to what is causing the problem. A hip labral tear can be hard to diagnose, I was negative on the impingement test but MRI with contrast confirmed a "complex labral tear", this was only after every other possible cause was ruled out!

Dr. Beaulé, is a very competent Hip specialist, he confirmed CAM impingement just by looking at my X-Ray. His wait is very long: 1 year for consult plus 27 months later for surgery. I've followed this thread for a while and it looks like the Dr. at McMaster is also very good at hip arthroscopy.

If you have hip impingement with a labral tear and you can't get it under control surgery is available on Ontario, but you have to see the right surgeon and unfortunately the wait is long...but worth it!
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Re: Any Canadians with/had a hip labral tear here? [CWM] [ In reply to ]
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Hey Everyone,

Thank you so much for this thread - reading all of your posts has been helpful in reducing some of my anxiety and directing my research. I am lost on next steps though and was wondering if anyone can suggest what I have should prepared as I wait for a consult.

I have been dealing with limited mobility and constant pain in my right hip for about a year. I was being treated by a rheumatologist for misdiagnosed Bursitis but at my insistence to my GP that things were not improving (after rounds of meds and a cortisone shot) I was finally sent for an MRI which showed a large labral tear, severe tendonitis and something else in the glute area. The rheumatologist has informed my doctor that these tears "sometimes just repair themselves (!)" but I insisted on being sent for a consult with ortho surgeon after finding this thread. Based on the wonderful list here, I was able to get my GP to send a referral to Dr. Femi Ayeni in Hamilton. The rheumatoligst also sent a referral to Dr. Dan Whelan (of who I am not sure about seeing based on the feedback here), as well as to a local ortho in my area, Dr. Bertolia at Southlake Hospital. I have just learned of another in Richmond Hill, Dr. Anthony Marchie (his admin told me that he recently returned from specific training on these injuries in Europe) so I will be doing some research on him to see if I should request a consult. I have not yet heard back from the previously listed 3 surgeons and its been about 6 weeks since the referrals went out....... All of this is a time sensitive matter for me as I am turning 37 in a few months and would like to have another baby. I can't imagine being able to carry a pregnancy let alone going through labour with this type of pain and restricted mobility. I need to get this sorted out and on a list for surgery soon if that is a viable option for me.

My question to all of you is - is there any preparation that I can do while waiting to cut down on the run around once I have a consultation? As I have just had a regular MRI, I asked my GP to send me for a T3 or one with the dye so that we have more info for the surgeon as I anticipate that will be the first thing I will get sent for and then will have to wait for follow up. The GP said he is not able to request that... Would a physiotherapy clinic or chiropractor be able to do this? (I think I recall reading that in previous posts?). Has anyone begun a modified physio program to increase strength in prep for a possible surgery? Although its progressed to the point where some days I can't even lift my daughter or walk for longer than 5 min without a break... can't imagine exercise :)
Last edited by: teewee3: Jul 16, 15 9:11
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Re: Any Canadians with/had a hip labral tear here? [soya] [ In reply to ]
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One of my former age group athletes (40+) had surgery a few years ago and is in great shape. But he did take his time recoverying and did all the rehab work to ensure he was properly ready to go back to exercise. It took some time, but he is great. Where do you live/where is the surgery occurring.
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Re: Any Canadians with/had a hip labral tear here? [coachbarrie] [ In reply to ]
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No surgery date yet and still have to meet with a surgeon to hear about my options (I want to do the repair but don't know if surgery is even an option yet)..... I live in Aurora, Ontario
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Re: Any Canadians with/had a hip labral tear here? [CWM] [ In reply to ]
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10 week update on my recovery...my experience has been similar to most, the recovery from hip arthroscopy is a rollercoaster - I do my exercises and stretching as directed by my PT; there are days where I can't believe how good my hip and body feel and there are days where my hip is sore, tight, and I feel lousy. Overall I'm very happy I did the surgery, I've learned that when my hip feels lousy to stop...rest, elevate (and take NSAIDs if its really bad), after 2 or 3 days I seem to get back on track. I'm looking forward to progressing to dynamic PT in the next week or 2 :).

The restrictions from Dr. Beaulé don't seem to be as strict as I'm seeing from other peoples experience, don't know if this is good or bad, but I thought I would share. His instructions are 3 weeks TTWB (toe touch weight bearing) and then wean off crutches to weight bearing as tolerated. I was full weight bearing at 4 weeks, I felt good, then I walked TOO MUCH at the end of week 4 and had to go back to 1 crutch and NSAIDs for a week...then I felt I was back on track. Dr. Beaulé did a 2 portal approach for me, I think that is his standard, maybe but not sure if this allows weight bearing earlier on?
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Re: Any Canadians with/had a hip labral tear here? [teewee3] [ In reply to ]
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My routine to adapt/cope with my hip condition before I had surgery: I stretched everyday (about 30 minutes); aerobic exercise 4 to 7 times/week - especially the bike with pedal straps to help with hip flexion strength; core strength exercises; Chiropractic ART (Active Release Therapy) on the Hip (Piriformis, IT, TFL, Hip Flexors) and low back . I also got some relief from Durolane injections (my work health plan covered them - each injection costs $400). For me Durolane provided about 10 weeks of 50% relief, but I've heard some people get longer relief, my hip was sore for a week after each injection. The injections are done in the hospital by radiologist under fluoroscopy.


Best of luck!
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Re: Any Canadians with/had a hip labral tear here? [teewee3] [ In reply to ]
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Has anyone heard of or had dealings with Dr. Aaron Nauth in Toronto? Just found the Athletic Edge Sports Medicine (AESM) Clinic online and they advertise that their orthopaedic surgeons do hip arthroscopy and labral repairs. Getting desperate for a consult after my leg locked 2 weeks ago and I fell. The pain has changed and I worry that I might have hurt myself further.
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Re: Any Canadians with/had a hip labral tear here? [runjohnrun] [ In reply to ]
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Hey John,

Thank you for the comments. I'm on deck with Dr. Ayeni too. I met with him in April and go back in October for a follow-up. I have a hip labrum tear, apparently not small, and in two places. At this point, I know it's surgical but that's about it. Thanks for yours and the other's comments as my list of questions is growing quickly!

Things are little more complicated unfortunately as I have severe OA in my knees and am currently rehabbing a lateral patella release and am waiting on confirmation about the other knee. Talk about a write-off of a season, more like the last two years. But I'm hopeful that after surgeries I can get back on the wagon and do the work necessary to get me back to the triathlon world (even if it means walking the run).

Question for everyone who has gone through this already, knowing now...what questions would you ask your surgeon pre-op?

Thanks!
Mandy
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