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TDF
Hip Labral Tear surgeon in the Boston area? 3/28/2011 4:31PM Reply | Return to Index | Report Post
Any recommendations for an experienced surgeon in the Boston area to repair a labral tear in the hip?
Skeptical and cautious
RE: Hip Labral Tear surgeon in the Boston area? 3/28/2011 7:21PM - in reply to TDF Reply | Return to Index | Report Post
In my observational experience this is a moderately risky low yield procedure. The equivalent rest , recovery and rehab period of non surgical care yields similar or better results. Don't talk yourself into surgery if you can help it.

Your experience may differ. Good luck.
Archimedes
RE: Hip Labral Tear surgeon in the Boston area? 3/28/2011 7:53PM - in reply to Skeptical and cautious Reply | Return to Index | Report Post

Skeptical and cautious wrote:

In my observational experience this is a moderately risky low yield procedure. The equivalent rest , recovery and rehab period of non surgical care yields similar or better results. Don't talk yourself into surgery if you can help it.

Your experience may differ. Good luck.


I'm not sure a Labral tear can heal on its own. The area has a low blood supply and would likely just never go away. I do agree with keeping away from surgery at all costs though.
ouch my hip!
RE: Hip Labral Tear surgeon in the Boston area? 3/28/2011 7:59PM - in reply to Archimedes Reply | Return to Index | Report Post
my friend and excellent distance runner had her labral repair done by dr scott martin? at a hospital in forest hills? cant recall the name of the place. he was excellent and had done quite a few in the past. would recommend.
BillCarr
RE: Hip Labral Tear surgeon in the Boston area? 3/28/2011 9:45PM - in reply to ouch my hip! Reply | Return to Index | Report Post
Don Reilly at the New England Baptist is an excellent hip surgeon. However, there may be a difference between those who specialize in hip replacement versus labral repair . . . I'd give a call to the Baptist to get a proper referral.
TDF
RE: Hip Labral Tear surgeon in the Boston area? 3/29/2011 9:42AM - in reply to BillCarr Reply | Return to Index | Report Post
Thanks Ouch and Bill,

I have also found these names. Does anyone have experience with any of these doctors?

Dr. Peter David Asnis; Boston, MA
Mass General Hospital

Dr. Brian D. Busconi; Worchester, MA
U Mass Memorial Medical Group

Dr. Mininder Kocher; Boston, MA
Children's Hospital Boston

Dr. McCarthy; Boston, MA
Mass General Hospital
ceg
RE: Hip Labral Tear surgeon in the Boston area? 3/29/2011 10:10AM - in reply to TDF Reply | Return to Index | Report Post
I haven't had the surgery, but I saw Dr. Asnis for two different hip injuries over the years - each time he ruled out a labral tear. He's pretty knowledgeable on hip injuries, specifically labral injuries (I was told by another sports ortho that he was "the hip guru"), so it might be worth a consult. I think it's difficult to get in to see him though because he spends a majority of his time working with the Bruins.
Wisco Fan
RE: Hip Labral Tear surgeon in the Boston area? 3/29/2011 2:41PM - in reply to TDF Reply | Return to Index | Report Post
Asnis is at MGH. He's a great guy and straightforward professional. He cleaned up my meniscus three weeks ago. Also, he is the ortho guy for the Bruins and helps the MGH team provide coverage for the Red Sox.

TDF wrote:

Thanks Ouch and Bill,

I have also found these names. Does anyone have experience with any of these doctors?

Dr. Peter David Asnis; Boston, MA
Mass General Hospital

Dr. Brian D. Busconi; Worchester, MA
U Mass Memorial Medical Group

Dr. Mininder Kocher; Boston, MA
Children's Hospital Boston

Dr. McCarthy; Boston, MA
Mass General Hospital
bfullem
RE: Hip Labral Tear surgeon in the Boston area? 3/29/2011 4:20PM - in reply to TDF Reply | Return to Index | Report Post
Go to NYC and see Dr Bryan Kelley. When Mike Lowell was with the Red Sox, he had Dr Kelley do his hip.

He is located at Hospital for Special Surgery
Neliah2507
RE: Hip Labral Tear surgeon in the Boston area? 3/29/2011 4:32PM - in reply to Skeptical and cautious Reply | Return to Index | Report Post
[quote]Skeptical and cautious wrote:

In my observational experience this is a moderately risky low yield procedure. The equivalent rest , recovery and rehab period of non surgical care yields similar or better results. Don't talk yourself into surgery if you can help it.

Your experience may differ. Good luck.[/quote

As much as I can appreciate you being skeptical about surgery, labral tears do not heal without surgery. They simply don't. Especially anything that is significant. Also, MOST labral tears are caused by impingement (which is a bone deformity) and obviously will not heal without surgery. No amount of rest or PT is going to change the shape of your bone. If you don't do something about it, you are setting yourself up for not only continuous/slow damage from any activity involving hip flexion, but also an ugly case of arthritis and chronic pain further down the road which will DEFINITELY not be easily fixed by that point. Surgery is not for everyone, nor is every doctor good at what he does. But if you are willing to do the research and find someone you can trust and have some faith in, it's not always the negative experience it's made out to be.

Hip arthroscopy is much less dramatic than needing a full hip replacement 20-25 years later. Which would you rather recover from? Or I guess you could just live in pain and discomfort on a daily basis. I guess that's also an option.
Neliah2507
RE: Hip Labral Tear surgeon in the Boston area? 3/29/2011 4:33PM - in reply to TDF Reply | Return to Index | Report Post

TDF wrote:

Any recommendations for an experienced surgeon in the Boston area to repair a labral tear in the hip?


I do not know of anyone in particular in the Boston area but I do know of a great guy in central NY. He's done over 1500 surgeries involving hip resurfacing and arthroscopy and has been doing research on the topic in numerous publications. If you'd like his contact info I wouldn't mind posting it.
Skeptical and cautious
RE: Hip Labral Tear surgeon in the Boston area? 3/29/2011 6:15PM - in reply to Archimedes Reply | Return to Index | Report Post
I apologize for the negative response. It can be quite successful. It is dependent upon patient selection (is this tear worthy of surgery) and an experienced skilled surgeon.
I've seen too many marginal outcomes from not adhering to the above criteria.
Ned Schneebly
RE: Hip Labral Tear surgeon in the Boston area? 3/29/2011 7:06PM - in reply to TDF Reply | Return to Index | Report Post
I have experience with Dr. Kocher, he was a really knowledgable guy and he's definitely a hip expert, he told me he had performed over 500 labral tear procedures. He gave me a cortizone shot as a diagnostic, meaning if it made the pain go away then the problem was in the hip joint, suggesting a labral tear. Not only did it make the pain go away, it basically cured me for good (in addition to a lot of hip strengthening with a focus on abductors and glutes). So luckily, I didn't actually have surgery to repair a labral tear, but I recommend Kocher nonetheless.
Been through it
RE: Hip Labral Tear surgeon in the Boston area? 3/29/2011 8:31PM - in reply to TDF Reply | Return to Index | Report Post
I had the surgery in September of 2009 for a relatively large anterior labral tear (about 1 cm long). My surgeon was Dr. Scott Martin at Brigham and Women's Hospital - one of the best orthopedic surgeons for hip scopes. I've heard horror stories of people getting the surgery done and then having to go back in months later to have the scope re-done because the first procedure was unsuccessful or simply ineffective. Since my surgery I have had a few setbacks in my recovery but I have not had to go back in for another surgery. My joint was a mess because of all of the running I had done in my first two years of college but Dr. Martin did an amazing job. I HIGHLY recommend him if you can get an appointment with him. I also heard that Dr. McCarthy at MGH is very good as well. Be very careful with who you chose for this surgery. Hip scopes are pretty uncommon and most surgeons are very inexperienced.

The cause of my tear was femoroacetabular impingement (pincer). I have it in both hips but it was much worse on the left side. Dr. Martin shaved the bone down ever so slightly to prevent re-occurence of a tear which is key.

I'm going ot be honest.. the surgery is a tough one. Since it is rare most PTs dont know how to properly rehab patients that undergo repairs. But if you are debating on whether or not to do the surgery in general I would 100% say that you should go for it. Cartilage is (for the most part) not vascularized and relies on simple diffusion to obtain nutrients for tissue repair. As a result the tear will not heal on its own. You can get an intra-articular cortisone injection to get rid of the inflammation in the joint but the tear will still be there and when you start running again the pain will simply come back (of course the severity of the pain depends on the extent of the tear).

In terms of rehab, it is ridiculously slow - I won't lie. You also need to expect a few setbacks here or there. In general though, the things that I have learned are to really stick to your strengthening program. If you slack AT ALL in your strengthening you will sincerely regret it. I am proof of that.

let me know if you have any more questions. I've learned a lot in the past few years battling this injury and I'd be happy to share more of my experience or to give advice.

Good luck!!!
TDF
RE: Hip Labral Tear surgeon in the Boston area? 3/29/2011 8:43PM - in reply to Ned Schneebly Reply | Return to Index | Report Post
Thanks everyone,
I am going to try to stay in the Boston area if I can. However, I can't even get an appointment with the first doctor I called until August. I am waiting for a call back from the 2nd doctor. So that leads to skeptical's advice. Do you wait for the best doctor or go with an up and coming one where you can get an earlier appointment (and I mean someone with recomendations like up above)? A few years ago only a few doctors did this, but now many more are doing it.
Ned, I had a cortisone shot in the fall, it worked for only about 5 days.
Neliah, how have your last two weeks been?
My MRI shows a possible small tear on the superior labrum and a possible small tear on the posterior labrum with no mention of an impingement yet. I haven't been able to run since September.
TDF
RE: Hip Labral Tear surgeon in the Boston area? 3/29/2011 8:50PM - in reply to Been through it Reply | Return to Index | Report Post
Thanks Been through it,
How is your hip now? Are you back to full running strength?
Dr. Martin is a new name to add to my list. I have had hip problems for years, but having to stop at the end of the summer was new. I have had tons of PT this year with no improvement in being able to run more than a mile or two when I try. So I definitely believe surgery is necessary if I want to run.
adsfkljl
RE: Hip Labral Tear surgeon in the Boston area? 3/29/2011 8:58PM - in reply to TDF Reply | Return to Index | Report Post
Dr. Ochiai in northern Va did mine in September and I'm pretty much back to normal. I didn't have resurfacing done so I was able to start running in about 6 weeks. I was doing a lot of yoga before and started with light stretching pretty early after the surgery. Did physical therapy for a few months until the strength was fully recovered. The only setback I've had is some ITBS on the repaired hip side but it's going away and I'm hoping to race some this summer. No horror story here. He's a very good surgeon.
Neliah2507
RE: Hip Labral Tear surgeon in the Boston area? 3/29/2011 9:24PM - in reply to Been through it Reply | Return to Index | Report Post
Quoting Been Through It:

"I'm going ot be honest.. the surgery is a tough one. Since it is rare most PTs dont know how to properly rehab patients that undergo repairs. But if you are debating on whether or not to do the surgery in general I would 100% say that you should go for it."

"rehab, it is ridiculously slow - I won't lie. You also need to expect a few setbacks here or there. In general though, the things that I have learned are to really stick to your strengthening program. If you slack AT ALL in your strengthening you will sincerely regret it. I am proof of that. "



These are two great pieces of advice. I think I am learning the hard way that while my PT is great in terms of mentally helping me, he's not doing much for me physically. He has a very hard time grasping just how serious the surgery is. I think PT's hear "arthroscopy" and think it's not a big deal. It's a very CLEAN surgery from the outside. They will make 3 small incisions on your hip about the length of 1''. They are SMALL. Obviously the better the surgeon, the cleaner the surgery. But in reality, it's very rough. They put your leg in traction, sutures are used to sew back on the labrum, and your bone is shaved (often on your hip AND your femur). Also, some people need tissue repair or debriment. This leaves a LOT of tenderness for weeks to months. You lose a lot of ROM.

Even though the surgery fairly harsh on the inside, I would say its' still a much quicker rehab for those who are in shape beforehand, young, and are patient. I was on a bike 24 hours after surgery. I wasn't biking hard but literally every day is noticeably better than the next. It's not always a full 6 weeks on crutches. You just need to listen to your body and be smart.

I'm doing ok since two weeks ago. I'm having some tenderness near my sacrum and my glute med is VERY tight which is causing me a lot of discomfort. But other than that I'm walking normally, I can bike for over an hour, and I sleep very comfortably for having surgery 4 weeks ago. My pain level is VERY tolerable. It's mostly my own fault my muscles are in a bit of a spasm at the moment because I accidentally tweaked my hip a little bit getting out of my car very quickly (hip abduction is painful for weeks afterwards).

August is a VERY VERY long time to wait just to see someone. That's very surprising. I don't think you should just go see ANYONE, but I do think you should find someone else who is willing to see you sooner. There ARE good surgeons who can see you quicker.

Obviously Dr. Kelly in NYC is my first choice. I've never heard a bad thing about him. There is a Dr. Carter in Syracuse, NY who is also VERY experienced. Over 1200 surgeries to date. I think maybe 1500 if I'm not mistaken. Not many Drs have that experience. He's working with a friend of mine right now who not only has impingement but a fracture in his lower spine from running on unstable hips.
caretaker
RE: Hip Labral Tear surgeon in the Boston area? 1/2/2012 4:32PM - in reply to Been through it Reply | Return to Index | Report Post
Hi--could you explain more details about your rehab? what kind of strengthening? where in the boston area did you go for rehab?
thanks
Gobstopper
RE: Hip Labral Tear surgeon in the Boston area? 1/2/2012 5:05PM - in reply to caretaker Reply | Return to Index | Report Post
To all the people saying "rehab is better" and "avoid surgery"... Have you ever had a labral tear? I think not. If you don't know what you're talking about, don't offer your opinions on this thread. I've had 2 labral excisions, (done in Madison by Dr. Keene), and both only took 6 weeks to recover from. (As in, I was running a mile every other day 6 weeks out from surgery.) I've had stress fractures that have taken longer to heal than that. The surgery really isn't painful to recover from either. I took ONE of the pain pills that I was prescribed, and didn't really even need that...just took it as a precaution. So all of the people on here who are sharing negative thoughts about labral surgery, shut up. I might add I ran PR's in ALL distances after I recovered. So don't worry about "never getting back to your old self" as some people expect. Good luck with the surgery dude.
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