Should I push for hip preservation opinion?
Sorry, this is long, but I didn't know other people had these same issues or that it could be more than something I just dealt with forever until very recently. I'm 38f and was recently diagnosed with mild acetabular dysplasia (Tönnis 0) after about 8 years of progressively worsening right hip and groin pain and honestly hip issues my whole life that I didn't think were more than temporary issues or I wrote off for whatever reason. I got an MRI and it showed:
My MRI showed:
- Mild acetabular dysplasia
- Borderline CAM-type FAI
- Mild glute med/min tendinosis
- Synovitis
- Some hamstring/adductor tendon changes
The orthopedic surgeon said that if I ever needed surgery it would be a PAO rather than a hip replacement because I have no arthritis. However, his recommendation was to modify activity, do PT, consider a cortisone injection, and only follow up if things worsen. He also said there was "no urgency" because surgery is based on pain and quality of life.
The problem is that my quality of life already feels significantly affected. My hip hurts every time I walk. I've had to stop or significantly modify most of the exercise I enjoy. Sitting for long periods at work or in the car causes sharp, shooting pain in my hip and groin. I have been doing hip and pelvic floor PT off and on for the last 5 years, and I did get a series of trigger point injections to the pudendal nerve last summer that decreased pain for several months but it did come back.
I wanted a second opinion from a hip preservation specialist, but I've hit a roadblock:
- One specialist doesn't accept my insurance.
- Another requires a referral, and I'm worried my current orthopedist won't refer me unless I complete PT first.
I'm not opposed to PT, and I am already scheduled to start again in a few weeks which was the earliest I could get in. I just don't want to spend months delaying a consultation if I'm already an appropriate candidate for hip preservation surgery.
For those who have been through this:
- Would you push for a referral now, or complete PT first?
- Did anyone have "mild" dysplasia with severe symptoms?
- Did your surgeon recommend PAO based more on your symptoms than your imaging?
- Any advice on advocating for a referral to a hip preservation specialist?
I'm just trying to figure out whether it's reasonable to seek a specialist's opinion now instead of waiting. Thanks in advance for your thoughts!