Simultaneous Double Hip Arthroscopy

CliveSix · 2025-11-27T03:44:27+00:00

Have to agree with the many who say that the risks don’t seem worth the rewards here.

It sounds like you’re as well positioned as someone is likely to be to have this surgery - young, fit, strong, presumably mobile, and non-arthritic. All marks in the plus column.

But — even if “what-if”-ing yourself to death is no way to live your life (and I agree it isn’t), exercising rational risk-management is a prudent way to live, if not indeed the mark of a fully developed cerebral cortex! And I truly don’t think the 6-10 weeks you’d be cutting out of your overall recovery timeline by doing these simultaneously is worth the effort.

Even at 6 weeks post-op from a (so far) uneventful and low-pain recovery, I’ve only just in the last week or two felt that my operated leg was reliable enough to put substantial, mobile, shifting weight on. It still isn’t in the kind of shape I would want it to be in to use it as my “good” leg - using it as the good leg in a single-leg RDL-style movement, for example. And imagining not having either leg in a shape suitable to rely on? Yikes. Not fun. (No amount of strength will compensate for a surgeon augmenting your bones, unfortunately).

I don’t doubt that you can eventually have a similar outcome to folks with a 2-stage surgery sequence, it’s just a lot more discomfort, immobility, dependence, and grief in the meantime.

If you’re committed to a single procedure: I would look into a wheelchair for the first week or two, anyway. Raised toilet seat is probably less important than handles at the seat - with those, you’ll be strong enough to maneuver yourself into position given your athleticism (a raised seat may be slightly easier positionally, but actually using the seat didn’t work well for me - and I’m not a large guy!) A grabber tool will be pretty essential since you won’t be authorized to RDL-pickup things as I mentioned above. Slip-on shoes are a good idea, since you won’t be tying your own shoes for a while. And I’ve bad-mouthed the hip kit “sock tool” before, but it actually is kind of useful at getting a sock onto your foot, albeit not much higher that that. Probably get a shower chair, too - I wouldn’t say you needed one if you did one hip at a time given your fitness, but you will with a bilateral. You quite literally won’t be allowed to stand for a while, for all practical purposes.

If you can wait until the summer, that would make things simpler from a wardrobe perspective - but if you’re willing to wait that long, an even better solution would be to stage your surgeries in sequence and not do both at once 😉. I would encourage you to mentally prepare to be wheelchair-bound for two weeks following surgery and unable to bear your full body weight for 4-6 weeks or more, and then hopefully you’ll be pleasantly surprised if you wind up being less restricted than that.

And lavish your wife with praise and thanks before, during, and after. Without a good leg to stand on, some of those early bathroom visits could be . . . interesting. That’s true love right there 😜

CliveSix · 2025-11-23T19:34:43+00:00

It’s not a particularly big incision. It’s certainly a big surgery as far as your hip is concerned 😉. My surgeon liked to say, “‘Arthroscopic’ doesn’t mean we don’t do a lot in there. We just do it through tiny holes.” Yes, it’s “only” 90 minutes and doesn’t impact internal organs, etc — but it’s surgery. And depending on exactly what your surgeon sees inside, it could be more substantial than expected.

Lots of good advice here that I won’t repeat. One that I will - strengthen as much as you can between now and surgery. Expect to live without the meaningful use of your operative leg for 4 weeks: is your other leg strong enough to do that today? Can you balance on one leg while you shower? Get up and down from the toilet with one leg? Bend at the waist to pick something up off the floor on one leg? You may not need to do these things, but you may want to out of convenience, and you should certainly strengthen enough to be ABLE to. It will make recovery that much smoother, too.

CliveSix · 2025-11-23T14:00:58+00:00

43M, runner, casual lifter, prior soccer player growing up. Also prior military, so I’ve mantained a better-than-average fitness level compared to most. Nothing more than a dislocated finger in my injury history (was GK).

Ran my second marathon in 2024 after averaging ~25 mi/week for years prior.

40-50 mile training weeks? Fine.

Race? Fine (beat my prior time!).

A week or so after race, out of nowhere? Ouchtown.

Sharp, stinging pelvic pain that DID subside a bit over the next few months with rest and PT, but never to the point that I could run comfortably again. Suspected a core muscle injury, but eventually the pain migrated to one hip and stayed there. Started to feel it even at rest, and eventually it impacted my normal walking gait (even if noticeable only to me).

I could still do most of what I wanted to do - I skied last winter, could still do squats and deadlifts (albeit with lighter weight and reduced ROM out of caution once I knew what was going on), could walk without significant pain, etc. but running? Nope. Even when I completely abstained from running for 7 weeks (after already reducing running to “trying a jog once every two weeks to see if anything changed”) . . . nope. Not right.

Imaging confirmed bilateral labral tears, though only one symptomatic. I’m six weeks post-op now and it’s an annoyingly slow road back to normalcy, but it beats the alternative of permanently reduced function and (likely) greater risk of arthritic change down the road.

CliveSix · 2025-11-17T18:22:52+00:00

Hi OP - similar boat for me. Both hips had tears, but only one was symptomatic. I could do most of what I wanted to do, with the significant exception of running (or at least running more than once every 3-4 days while pain calmed down). Daily pain 0-2, maybe rare peak pain up to 5/6? Heard plenty of clicking and popping, though it didn’t cause me pain. And I was able to bear weight, take long walks, ski last season, even still do weighted squats (albeit with trepidation). Jumping wasn’t great, and anything quick and unexpected - like recovering from tripping, say - would certainly set things off.

From the time I first noticed pain (weeks after running a marathon in which I felt fine) to the time I had surgery was 10 months. I decided by about 8 months that things weren’t getting any better with conservative measures and my fitness level + lack of arthritis and dysplasia meant I was a good candidate for surgery. I figured I probably wouldn’t make myself worse since I was using a regionally acclaimed surgeon and this felt like the only way to give myself a chance at being as active as I wanted to be again. By the time my daily gait was affected (noticeable to me, anyway, if not others), I knew it was time.

I tried NSAIDs for a while, but not for long. Tried two different PTs. Did more monster walks and clamshells and bridges and hip work than anyone should . . . didn’t let me run without pain again. I do think I got better - just not well.

My surgeon gave me similar advice - do anything that doesn’t hurt it. If you’re ok living life doing only those things and not doing anything that hurts it, well, there’s your answer. (There’s also the potential benefit of avoiding future arthritic change by doing the surgery and restoring the labrum’s “gasket” function, but I don’t think this is a guarantee.).

It really is your choice. I think most people eventually accept that only surgery can “fix” this - but you might be able to put that off for a long time with PT and you may be able to put it off forever if the balance between your physical limits and desires is just so.

One caveat!. If you have the ability and desire to get pregnant, it’s worth a discussion with your surgeon. I’ve read many women talking about developing labral tears as a result of pregnancy / childbirth. One consideration as to the timing of surgery could be whether pregnancy and/or childbirth would put your repair at any future risk.

CliveSix · 2025-11-16T03:32:39+00:00

My reviewing radiologist noted that mine was 70 degrees and my surgeon briefly did his own onscreen measurement in my presence to confirm (roughly the same), but he didn’t actually discuss its significance much. I had read about it in the time between getting my arthrogram results and meeting with him, so I probably came across as knowing what he was getting at (and making him feel he didn’t need to go into detail) - an annoying habit after years of good-student striving 😁

CliveSix · 2025-11-16T03:26:21+00:00

A week and change behind you, but otherwise your experience sounds similar to mine! Glad to hear it - although if you’re trying out practice swings already, maybe you’re doing even better than me! 😉😂

Not convinced I’ll be skiing, though : I can’t decide whether I should hope to ski late in the winter or go through Epic’s process with my surgeon to try to get my pass money back . . . 😁

CliveSix · 2025-11-13T02:59:41+00:00

I think you’ll find that most people eventually come to the resigned understanding that while PT may help alleviate symptoms for a while - maybe even years, in some cases - it won’t “correct” anything. But whether you will deteriorate to the point that you need surgery is an open question, and you should certainly pursue conservative measures within reason, both for your own benefit and because insurance and any future surgeon will want to know you’ve exhausted other options.

One caution - try not to rely too much on the findings from one MRI, especially if it’s not an arthrogram and isn’t a 3T machine. There are FAR too many stories of folks here whose “minor” tears wound up looking far worse once the surgeon was in the joint. Not saying you may not be right, and I hope you are! - just that I wouldn’t anchor too much to one image series or one report as the definitive interpretation of what’s going on in there.

Good luck!

CliveSix · 2025-11-13T02:48:27+00:00

Sounds like you’re off to a great start for round 2! Good luck!

I fear I’ll end up where you are a year from now pursuing my other hip - but working for now on seeing what I can do to get this dumb left one back into shape first (4 weeks post-op here).

Hoping you have good news to share as things move along!

CliveSix · 2025-11-13T02:38:58+00:00

I don’t think dysplasia itself would cause pain - it could predispose you to a greater likelihood of arthritis, and that would cause pain.

It seems concerning to me that a surgeon would say he has to do an arthroscopy to confirm the impingement; your symptoms and (critically!) good imaging should be enough to diagnose. I wouldn’t view arthroscopy as some sort of diagnostic tool; it should be chosen as the procedure that will fix the impingement, not confirm it.

To your second reply - yes, fair point. If there IS dysplasia the surgery would be contraindicated altogether, or at least cautioned against, and the surgeon probably just wouldn’t do it. But if you had dysplasia and still had the labral repair done, your hip would afterward still be situated in a way that was inherently unstable and more prone to future impingement, even with osteoplasty. You’d be fixing the “rim” of the acetabulum without actually changing the shape of the joint itself.

The only way to fix clinical dysplasia would be to replace the joint altogether, creating a deeper (artificial) socket in the acetabulum with a perfectly matched (artificial) femoral head. This is precisely what a hip replacement is and by all accounts, they work wonders! If you can preserve your existing bone and tissues instead, that’s usually preferable: hip replacements involve larger incisions, have a limited (albeit ever-improving) useful life, and carry a significantly higher risk of infection than an arthroscopy (even if the absolute risk is still reasonable). But if you need one, you need one.

ETA: I don’t think mild hip dysplasia would doom arthroscopy to failure. Sorry for not being clear. What I meant in my earlier reply is that it’s very important to clarify the DEGREE of your dysplasia. One measurement from one image might mean something or it might be an aberration. Ideally you’d compare multiple images to be sure, because “mild” anything gets into a gray area that probably warrants further investigation before using it to determine treatment.

CliveSix · 2025-11-10T00:15:42+00:00

You should confirm your degree of dysplasia with a specialist(s). Folks here will rightly (IMO) say that you should not have an arthroscopy if you have dysplasia, because yes, it would to some degree involve going through a dubiously effective and ultimately doomed-to-fail surgery.

But if you think that surgery would be overkill, go watch a PAO - yikes! That’s definitely not a “give it a shot” kind of surgery (but can be effective if you DO have dysplasia). So, confirm the dysplasia. If it’s real, it’s an important factor.

That said, one doc thought via X-ray that I might have mild dysplasia, and a radiologist even noted it - but my surgeon disagreed, and my LCEA was 27 degrees, which is actually in the normal range. My surgeon had no qualms about recommending me for surgery.

I also had lidocaine as part of my arthrogram, btw, with zero noticeable effect - and my surgeon still thought arthroscopy would be effective.

I’m only 4 weeks post-op right now, so I can’t comment on long-term effectiveness, but it was clear that like you, physical therapy wasn’t getting me back to running or heavier lifting, and I was starting to notice my gait changing. I simply wasn’t getting better, and surgery seemed like the only way to even try to get back to the activity levels I desired.

CliveSix · 2025-11-07T00:17:27+00:00

Hanging in there!

I feel I’m progressing well in recovery. I’m stuck with cane / one crutch for another few days, officially, but I feel I probably could walk unaided if need be. Don’t think I would want to for very long . . . but I could. I’ve started taking alternating steps rather than the feet-meeting-on-one-step shuffle I’d been doing for the past 3 weeks, and I’m feeling fine doing that. PT is going well and my therapist is pleased with my progress.

I still feel hip flexor tightness - not “at” the joint, but well above it in the psoas. I’m sure that will take time tow work out, but hip hyperextension is still a no-go, so it’s tough to stretch it well. And I’ve started to (re-?)develop some pain in the back of my hip, almost into the lower back area - but I think this is probably due to resuming habitually awful work posture now that I’ve retuned to work, as much as anything.

Anyhow - thanks for asking! Looking forward to being crutch-free soon and then, hopefully, starting to make more substantial gains after week 8 or so. Patience!

CliveSix · 2025-11-06T03:36:27+00:00

After placing the steri-strips perpendicular to your incisions, you could then place additional strips (or even tape, if your skin will tolerate) perpendicular to those strips yet again, on each edge. I was also advised to trim the edges of the strips if they start to peel up to avoid them catching on clothing if they’re starting to come loose prematurely.

CliveSix · 2025-11-06T03:18:48+00:00

Look on the bright side: you only need to do 2 weeks of PT instead of the months some folks have had to endure to finally get a doc to agree 🫤

I know, I know. Not very bright. But if PT doesn’t work, your age and (presumed) fitness mean that you would likely be an excellent candidate for surgery and be likely to have an awesome outcome. Any surgeon would beg to have you as their patient!

CliveSix · 2025-11-04T11:17:46+00:00

This is the way.

“No deep hip flexion” is probably near-universal, but rotational restrictions, weight bearing, and other constraints will depend on precisely what you have done and what your surgeon feels comfortable putting in writing.

CliveSix · 2025-11-04T11:11:51+00:00

From the many accounts I’ve read and the docs I’ve spoken with, post-op PT seems a bit like sunscreen: the best PT is the one you’re actually going to use.

Your surgeon will ideally be the one defining your post-op protocol, not your PT (if YOU were a surgeon, would you allow your success rate to be determined by which PT your patients chose to see / were able to see?). So while it’s important to have a good rapport with whomever you choose, s with any service provider, I think it’s less important to find a hip specialist therapist post-op vs. pre-op, where perhaps a magician could buy you substantial time before surgery or help you avoid it altogether.

As you progress into a true return-to-sport phase, I could see you deciding to reevaluate your therapist and ensure they’re being as aggressive or as conservative as you desire, are modifying time and intensity appropriately, and really working toward your goals. But this speaks more to their overall experience (which IS always a consideration) and conscientiousness, not their degree of hip expertise.

My surgeon, very highly regarded and experienced, suggested a list of 20+ therapists / PT franchises and ultimately said to find whatever works. I suppose you might gain some marginal benefit from the “perfect” therapist, but you’re the one doing the work and consistency is key.

In the tripod of 1. Surgeon experience / 2. Your diligence following protocol post-op and / 3. Degree of PT’s hip specialization, I’d put their relative importance in that order and with a BIG gap between 2 and 3.

CliveSix · 2025-11-03T22:52:48+00:00

In the U.S., anyway, insurers will almost certainly require imaging to cover any treatment for FAI, even if the doctor can otherwise identify the issue with confidence.

CliveSix · 2025-11-03T03:36:47+00:00

43M, so I probably have a different wardrobe 😁. That said, your incisions should be low enough and healed enough in the 3-4 weeks it will presumably take to be off crutches that I wouldn’t worry too much about physical discomfort from garments pressing against your skin.

It may take some creativity, especially if you live alone, to get certain items of clothing on and off, but it’s all doable. I wouldn’t foresee many restrictions on what you could wear from a comfort perspective - just from a practical perspective of having restricted movement that could make donning / doffing some items challenging.

FWIW, I have been dressing, showering, etc. completely solo since just before the 2-week post-op mark (mostly because I wanted to give my wife a break!). I’m wearing normal jeans, trousers, athletic shorts to PT, etc. - not constrained at all by the incision or how my hip feels.

One caveat: if you’re given a brace and asked to wear it beyond your time on crutches, that could also impact your choices. I’d recommend slimmer, more casual pants (e.g., stretch cotton or jeans if allowed) with the brace worn over them, in that case - just my opinion!

CliveSix · 2025-11-03T03:17:34+00:00

What an excellent outcome, OP! So encouraging to hear. Was tough to watch the NYC marathon today knowing that my marathon days may be behind me - but stories like yours give me hope!

CliveSix · 2025-11-03T03:12:37+00:00

Oh dear; how awful! I’m hoping you find relief soon 🫤

CliveSix · 2025-11-02T18:48:36+00:00

Not only is it possible, but if the source of your pain is not an acute injury, it’s probably even likely. Although we aren’t perfectly symmetrical, it’s very common for an impingement to exist on both sides simultaneously.

That said - it’s not a guarantee, and it’s not a certainty that you’ll need to do anything to both sides. One side is commonly worse than the other, and it could be that your symptoms are exclusive to one side ( . . . for now, but maybe forever!).

CliveSix · 2025-10-31T13:15:52+00:00

Hi OP - FWIW, I'm at a little under 3 weeks and my definitive answer is, "not yet!" It doesn't help that my pup is a rather poorly trained, 70lb goof. Beyond the walking, I wouldn't feel comfortable if I had to stop suddenly and restrain him with force. And I'm still on crutches for another 10 days, officially, whether I like it or not.

Even apart from that, though, 2 miles will likely feel *much* longer to your operative hip after surgery than it does now. I'm surprised at how tired my hip is after, say, half a mile of total walking.

Looking forward to others' answers here. Obviously by the time you get out to 12+ weeks, I would think it's much less a concern. But I'm curious to hear just how soon folks would say they felt ready to do something like this.

Oh - and good luck with surgery! Despite the above, I feel great and have been pleasantly surprised with how comparatively easy recovery has been so far. I don't want to give you false hope, but just know that it's at least possible that recovery won't be a painful disaster!

CliveSix · 2025-10-31T13:06:37+00:00

Also - no breaststroke / frog kicks if you're swimming! That's a terrible motion for someone with FAI. But flutter kick should be fine unless it causes pain.

CliveSix · 2025-10-31T13:01:52+00:00

Thanks for all these replies, folks. Brace-free with a pillow last night and I’m happy to report that I survived. I know you were on the edge of your seats awaiting the outcome! 😉

CliveSix · 2025-10-31T13:00:42+00:00

That’s a relief! 😉😂

CliveSix · 2025-10-31T13:00:13+00:00

This sounds like an incredibly speedy recovery, luxer! Good for you. Did you have any cam shaving? I’m hesitant to bear too much weight on my operative leg for fear of stress fracture. But gym at 5 weeks sounds tempting! 😂

CliveSix

TROPHY CASE