Damage Over Time

I met with the new surgeon this morning and had myself ready to plead my case for bilateral surgery and a dual recovery. As soon as he stepped into the room he started asking questions about how long the pain has been happening, if there's been a sudden change, if I'm doing anything drastically different in the past few months. After answering several variations of this he had me go through a series of movements testing my strength and flexibility and we settled in to go over all of the imaging.

In theory your socket should cover most of your joint.

                             Mine is short by more than 7 degrees on the outer edge alone. 

He explained that because my sockets don't form completely around the ball joint of my femur that my labrum (the cartilage in the socket) has grown outward to compensate. Also because I'm not formed quite right, the movement has rubbed against that labrum and begun to peel it away from the socket it should be attached to. Normally they would go in, place plastic anchors in the socket, and sew the labrum to them. The problem in my case is that the tear didn't happen all at once or even quickly with a change in activity, it's damage over time (insert joke about tank and healer here) which means that surgery is much less likely to be effective long term. The surgeon could make a perfect repair and the cartilage would continue to deteriorate leaving me with months of recovery for limited relief. At this point the wisest thing to do would be to wait for the pain to catch up to me and have the procedure then so that I get the most out of it.

This is the MRI of my right side. 

The white is the space in the joint showing anterior labrum peeled away. 

In the meantime I've learned that I'm in the beginning of osteoarthritis, which may be the cause of some of my pain. I'm also too far past the point where they can do a repair on the joint itself, so with no chance for an osteotemy we'll be moving straight to a replacement when the time comes.

                                                 The surgeons illustration of my situation.

All of that aside, he said that I should do what I can while I can and that moving is essential to keeping the cartilage healthy. I'm still barred from high impact like running, jumping, or lifting my knees above 90 degrees, but walking, hiking, and pilates are all in. In fact, he said that pilates is one of the best things that I can do given that it strengthens your core and can be modified to accommodate my hip needs. He also said that I should absolutely not miss out on The Camino in April because there will come a time when I can't make those plans anymore, and this trip sounds amazing. He's not wrong.

Training starts Monday.