FAI sharp bone regrowth

[SplashDad]

I am no medical expert here, just a Dad trying to help my teenage son. So forgive my very un-precise language.



My son an avid athlete/soccer player was diagnosed when he was 14 with FAI.  The ball of his femur bone was not rounded correctly and so it was causing pinching and tearing in his hip.  The doc said he would have to wait for his growth plate to heal before surgery was an option.  For about 2 years we managed with PT, ice and anti-inflammatories.  

About a year and a half ago he underwent surgery on his right hip.  The doctor said he was able to shave down the bone, and repair the tear and said after pt and healing he should have no more trouble.


After 6 months of PT and time to heal, he was still in just as much pain as he was before.  Doctor said he just needed to stretch the muscles better.  He said there was nothing 'structurally' wrong with his hip any more and said it would just take time.  6 months turned into a year which turned into 18 months.  Doctor eventually said there was nothing more he could do that it was up to my son to do his stretching and PT to get it to heal.

We got a referral and took him to another Orthopedic specialist.  This was yesterday.  He took a set of X-rays and then showed us that the bone that was supposedly corrected had a sharp point on it again.  He said an MRI would be needed for further conclusions but he said based on the Xray that either it was never corrected properly (which was implied) or it regrew.  I asked how likely that was and he was very evasive.  It seemed he was reluctant to throw another doctor under the bus.

So my question is if this turns out to indeed be a 'structural issue' that should have been corrected in the initial surgery is there something here that I should have legally investigated.  Does anyone know how quickly bone can reshape itself.  We were told by his first doctor/surgeon that this surgery would take care of it for good.  

Now my son is looking at surgery to fix the exact same problem that was supposed to fixed 18 months ago.  I will have more information to share as we investigate further with the MRI's.  Anyone have any similar experiences, thoughts or advice?

[Ben_Friedman]

I was diagnosed with FAI in both hips when I was around the same age. I had my right hip done a couple years ago, then had my left hip done a little more than a month ago (I am 18 now). Although I'm not a doctor, I do know a lot about it.

Just from reading what you said, it could be a few things. 1) the surgeon wasn't very good and did a poor job 2) The surgeon missed a few things. FAI can cause other things too like torn labrums, loose bodies (bits of torn cartilage floating in the joint), and synovitis (joint capsule inflammation). It's possible that he got rid of the bone deformity, but didn't fix the other thigns. In addition, there are two types of FAI: cam and pincer. Pincer is a deformity on the acetabulum (socket) and cam is a deformity on the femoral head (ball). It's not uncommon to have both kinds, and it's possible the surgeon only fixed one of them, and not both. 3) since you mentioned how you got another x-ray showing the bone that supposedly was gone had come back, it's possible that your son has "heterotrophic ossification" which is just a fancy way of saying that the bone was shaven in the hip, but it grew back. Although not common, it does happen after some FAI surgeries.

My advice is find the best sports medicine surgeon you can and get and MRI arthrogram of your son's hip. The MRI is much more advanced than an x-ray. Sometimes, x-rays will not pick up on FAI, as was my case. In addition, MRI's will see any soft tissue damage, and the "arthrogram" part is a dye they inject to see if there's a torn labrum.

Best of luck, let me know if you have other questions.