Deciding to get surgery

Deciding to get surgery was a tough decision for me. FAI impingement and labral tears are not exact sciences in the way that an ACL tear in the knee or a rotator cuff tear in the shoulder are. The latter two are no brainers and there are several doctors in Austin I would go see for those procedures without hesitation. But with FAI impingement the more I researched the surgery, the more I became wary.

Quickly I decided that I would have to travel as few surgeons in Texas specialized in hip arthroscopy. If you needed a new hip altogether, there were plenty of Dr's to choose from. But if you needed bone spurs shaved down and labrums repaired arthroscopically, there were just very few qualified to do it.

I also debated for many months whether I even needed the surgery at all. I read many horror stories on the internet of people whose surgery went wrong and now they were worse than before. But I realized that people whose surgery went well probably were out there living their life rather than writing on internet chat rooms.

And when I started looking at the long term research, FAI impingement was fairly common amongst young athletic men. As long as it was detected early and operated on properly, many of them went back to their sports and most studies showed an 85% success rate after 10 years. For surgery, those are pretty good odds.

Still I wasn't convinced so I cut back on all my activities, got PRP injections (Platelet Rich Plasma, it's supposed to stimulate cartilage growth) into the hip and waited. As long as I did very little, my hip hurt very little. So after a few months the choice became clear: continue to baby the hip and be pain free, or get the surgery and get back to an active life. I decided that even though calling myself "young" or "athletic" may have been a bit of a stretch, I didn't feel so old or unathletic as wanting to have to worry about the consequences of going for a run or a hike when I felt like it.

I did tons of research of which Doctor to go to. In a way it was a great limitation to have no real local option. It meant anywhere in the US was fair game. Many of the top ones were used to out of state patients so getting the surgery and leaving a few days later would not be a big deal.

Now along the way of realizing I had a bad hip, I thought I had injured the groin muscle of my other hip. But when I talked to several Dr's who looked at x-rays of both my hips, they told me there was a high likelihood that I had impingement in both hips and would probably get labral tears on both sides as a result. Again I had a dilemma as the idea of flying somewhere once to get surgery didn't seem too bad. But to go out there once, get the surgery, be on crutches for 6 weeks, finally recover only to go do it for the other hip basically meant being out of action for 6 months. But I figured 6 months over a life time isn't that long a time period, so mentally it was what I was ready to do.

But as luck would have it, one of the Dr's in LA that I contacted said his company couldn't help anyone out of network, but he recommended I contact Dr Thomas Sampson out of San Francisco. Dr Sampson ended up emailing me before I contacted him and offered any help he could. This was when I was still trying PRP and other things so we played telephone tag but I never actually spoke to him.

Finally after spending five months looking for other answers, I had decided to get the surgery and was actually pretty set on going with another Dr when I decided that I should at least talk to Dr Sampson. I mainly wanted to be reassured that I was doing the right thing and since he had been the most accessible of any of the surgeons I wanted to go with, I also wanted to hear from an expert in the field as to what I should expect. I'd mainly been talking to people who knew a little about the condition, but Dr Sampson has been doing hip surgery for 25 years and has been a leading innovator in hip arthroscopy for at least 10 years.

I called his office and they scheduled a time for him to call me the next day. The other Dr's office actually called me about 20 minutes before he was supposed to call me and I didn't answer their call. I just wanted some reassurance, someone who knew the subject matter better than anyone to tell me it would be okay. I got a lot more than that.

I was able to talk to one of the top surgeons in the world for over half an hour with no assumption of any financial gain. I got to talk to a man who was experienced but still highly passionate and constantly searching for new ways to do what he does even better. Dr Sampson explained in great detail how his technique varied in almost every aspect, from where he started the surgery, to the amount of time the hip is in traction, to his philosophy on whether crutches were needed post operatively.

He also said that it was likely I had labral tears and impingement in both hips and that he had done the operation on both hips together many times. He recommended it so that the body did not compensate for the "good" hip quickly turning it into the "worse" hip. He also said that many of the studies he had personally done over the years showed that there was no difference in terms of recovery rate, cartilage reformation and pain levels of people who were on crutches for 6 weeks after surgery vs those who were on them only a few days after surgery. He told me exactly what he thought was happening in my condition in terms of the labrum and the cartilage and that he was very certain he could fix my condition.

By the end of the conversation I realized there was no one else on the planet that I could go to. I told him I'd be seeing him soon and a little over a month later, I was in his office meeting him for the first time.