Ignoring the Problem Didn't Make it Go Away

The pain and limited range of motion in my left hip became too much to bear earlier this year. So I went back to my orthopaedic surgeon, fully intending to go in for arthroscopic surgery to repair my torn labrum, shave down the bone spur, and be on my way. Of course, because I had waited a couple of years, I needed new MRI images. Back to the lab to have dye injected in my hip again, which was worse the second time because I knew exactly how uncomfortable it was going to feel.

Armed with my new MRI images, I went back to my surgeon, who had some bad news: the new MRI had shown that my real pain wasn't from a torn labrum. Rather, it was from a combination of avascular necrosis and osteoarthritis -- a double whammy.

Let's take osteoarthritis first, as it's more common. Generally speaking, osteoarthritis of the hip refers to the narrowing of the space between the ball of the femur and the hip socket. Left untreated, the two bones ultimately could end up rubbing against one another every time the affected person puts weight on their leg. At this point, though, the osteoarthritis in my hip wasn't my surgeon's main concern.

My MRI also showed evidence of stage 2 avascular necrosis. Simply put, avascular necrosis is a condition in which the bone tissue begins to die due to a lack of proper blood flow. In hips, there are four stages, with stage 1 referring to the beginning indications of the disease and stage 4 referring to a hip that has essentially collapses due to bone death.

My surgeon was pretty blunt with me that day in May: you're going to need a hip replacement at some point in the next ten years, in all likelihood. But he was much more concerned with the necrosis than he was with the arthritis, which he thought wouldn't progress nearly as quickly.

So we agreed that I would have an outpatient surgical procedure called a "core decompression" done on my hip to try to slow the advancement of the avascular necrosis. While it sounds fancy, all it really entails is having a drill inserted through your outer thigh and into the top of your femur to: 1) drill out as much dead bone as possible and 2) create scar tissue, which creates new blood vessels, which, hopefully improves blood flow to the affected part of the bone for some time.

My doctor advised me going into the procedure that the odds were only about 60% that the core decompression would work well enough to put off a hip replacement for ten years. But he argued it was low risk, fairly easy recovery, and was strongly of the view that somebody my age should put off a total replacement for as long as possible.

And so I signed off on a core decompression on my left hip this past June.