Frustration! long recovery continues..

I had my 6 week followup after my screw removal today. I am about 10 days from being 6 months post my PAO/debridement surgery. Although that sounds like a long time, in terms of full recovery its about half way there!

I have had a definite increase in pain over the past 3 weeks, with pain mainly on weight bearing, but also more recently on rest too. If I lie on my left side, I get a build up of pain from my groin going all the way to my ankle over about 5-10 minutes. It gets so sore that I have to turn over and it takes a while to go after that. My walking tolerance is about a supermarket shop (30-45 mins), before I am limping badly and need to stop. I know other PAO ladies who seem to be completely back to normal at this stage, so getting a bit frustrated I am not one of them!

Mr F isn't really sure why I am getting such pain, my xrays look good, all osteotomies are well healed - although I still have some impingement on the left side, as the acetabulum has a weird wave like bit that sticks out over the femoral head. This could well be why I cannot get more than 95 degrees flexion and may never get more than this. In terms of coverage, my left hip is worse than my right now, but to remove any more acetabulum would make me even more dysplastic. He doesn't think this is bad enough to be causing the pain though anyway, nor is the screw still left in the pelvis (it was too awkward to remove). He thinks the pain when lying on my side might well be a joint effusion and that when the femoral head is pushed into the joint, it is causing the fluid to make the capsule bulge and stretch, referring pain all down my leg. The anterior groin pain is probably just massive inflammation from the scar tissue all contracting down. He wondered whether imaging would be useful, but thinks the screw would obscure any decent MRI images and I don't want a CT, as I have already had two on my pelvis.

So the verdict was to rest more and take more painkillers, see how things go for the next 3 months - how frustrating. I am happy there is nothing serious bony wise going on, but wish I had more of an idea what the next few months hold. I have only 4 weeks left at med school, then I start work at the end of july and I have to be functioning enough to cope for long days, as I don't get any sick pay for the first 4 months and I cannot afford to take time off for these hips. If I am still getting a lot of pain in 3 months, he thinks perhaps a hip arthroscopy to get rid of scar tissue in the joint would help. I am really not keen on this as I think I have had enough surgery in the past 3 years, but I may have a different view if I am still struggling in 3 months. Fingers crossed, it slowly improves by itself...