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Knee & Hip Problems Message Board

Knee & Hip Problems Board Index

Hi :)

From my limited vantage point, it would seem to me very strange to utilize donor tissue for this repair, so it sounds as if the surgeon does not expect much viable tissue and there's probably not a lot of prior research on how to circumvent that. Columbia Presby is really on the cutting edge in many areas (no pun intended), so there may be zip data outside a very few surgeries, not easily accessible to the public as the results may not even yet be published.

If you want a second opinion, there's a doc in NYC who people are willing to fly out to due to his high expertise in this area and who might provide an informative second opinion. His info is given within the beginning posts of the older thread' started by 'Tomorrow'. I noticed you're a senior member, so I don't know if you've accessed the long thread yet--it does not have any references to the use of donor tissue, but there is a lot of relevant and helpful information. I do think you're going to have to find a solution that doesn't include using stairs for at least a few months, but your surgeon will help you our with those issues.

The following doesn't relate to your question but gives a sense of what I'm learning in dealing with my own problem. I thought of starting another thread, as there are more of us who need to learn ongoing developments on this topic, but I think your post was a good way to re-start one, although the tissue grafting (?) is more specific than most people can address. I'm too new to know how this works.

I just joined tonight and am in the process of finding competent covered, repeat covered, treatment for a gluteal tear. (I felt really bad for the poster who is now uninsured and plan to post privately with some suggestions.) I have no family or real friends where I am living--hard to make friends when you're housebound--but am too compromised to move back to where my friends are, although I may have no choice. I can't even go food shopping without feeling like I'll pass out right now. (I do have two lovely Hungarian Sheepdogs, one--the 110 lb. Komondor--is probably implicated in my bilateral shoulder injuries, as well as the probable gluteal tear. Neither tolerates less than complete subservience to their needs.) In reading of the recovery process from the several treatments that posters have undergone, I'm really getting frightened, but the pain has become really unbearable and relentless.

The MRI of my pre-op L shoulder completely missed the 'significant' chondrolysis and labral tear, in addition to the expected findings, which enchanted (not) my surgeon during an arthroscopic repair. The R shoulder MRI does note the labral tear in addition to the tendon tear, etc., without mention of severe chondrolysis and my doc has this false hope that the surgery in Jan will not be so bad. I had an MRI of my hip on the 14th with several findings, tendinopathy, bursitis, subchondral cyst, and some unidentifiable little bugger. The info provided on the shoulder was simply to indicate that I don't have massive faith in MRIs, as actual op findings seem to be at frequent variance with them, and I think the consensus is that clinical findings are more accurate in diagnosing hip problems. Of course the typical course is to send a patient through a series of different specialists, which is sort of like the three blind men describing an elephant while holding different parts. Humorous if you weren't in such pain and losing your life. Then you add in the insurance requirement for 'evidence' that justifies the expenditure for treatment.... (Having worked in healthcare, the purpose of sending patients through this gauntlet of ineffective therapies is not to follow a systematic path of less invasive treatment, as purported, but to induce the patient to drop out before the really costly alternative of surgery is utilized. It's really not cost-effective, but healthcare executives are not financial wizards, just greedy ones.)

Anyway, I'm here to learn as much as I can from those kind souls who've allowed others to benefit from their difficult journeys in trying to get adequate treatment for gluteal tears. As the previous poster noted, there is a very long thread that has been closed, and which I wish remained open, as there will be plenty more of us trying to find answers on this topic which are not being provided by our 'providers.' Thank you so much to those who did provide information to the rest of us in that thread. I wish I could do the same for the initial poster in this one.
Hi everyone with the glu/med tear,
Last March, I developed a Trendelenberg ["limp"] gate and pain with every step. I went to PT, a personal trainer at the Y, a chiropractor, and an acupuncturist [sp?] to try and resolve the problem. None of these efforts were at all helpful. In July, I went to a well known orthopedic surgery and after a series of expensive tests, the dx of a glu/med tear was reached by MRI eval.. The doc had never repaired a tear like this that did not happen post THR. I also was not too happy with my interchange with him [too much to go into in this post]. He recommended that I make an app't with someone at the HSS
in NYC, which I did. After several calls, I found out that the surgery alone [not counting the hospital or anesthesia cost] was $20-25,000 and I was told that if my insurance did not think that this was a fair and reasonable fee, I would be responsible for the remainder of the bill. I then called all the major medical centers in my area [I live in Lynchburg, Va] and heard back from all of them. I chose to go to the Un. of Va Medical Center. Dr. James Browne met with me and my husband and we liked everything about him. He was the head fellow in orthopedics at Duke and has won numerous awards. He admitted that he had never done this exact surgery, but that it not "rocket science" and he explained exactly what he would do. Rather than exploring every other medical center, we decided to go with our gut feeling and have the surgery. This open repair was done on 12/28/10. Dr. Browne had informed us that the use of a donor tendon may be necessary to secure the tendon. He was very pleased with the condition of the tendon, muscle and bone, and no donor tendon was necessary.
I am now in the long process of letting the tendon heal by using a walker with only toe touching for balance, never crossing or abducting my leg, and sleeping exclusively on my back. Tendons have a limited blood supply, and take much longer to heal that bones or muscles. I have also had a torn rotator cuff tendon and a torn, distal bicep tendon, so I know of which I speak. I have also been a RN for over 30 years, so have a little more of an understanding of these kinds of things.
"Cabin fever" is really my biggest problem, but at least, as time goes on, I am able to do for myself more and more. My husband [bless his heart] took 3 weeks off to care for me, and during the first few days, I could not have managed without him. He is also an RN and is a great caregiver.
Hope this has given a few answers, I know from other posts {ie the one that was discontinued] this injury is rare and difficult to diagnose. One other thing, I think is very important to add, is that my doc told me that cortisone injections [I have had 6 in the last 10 years for what I thought was bursitis] can be very damaging to tendons and he thought that those injections were a contributing factor to the tearing of my tendon.
Take care, everyone and keep posting so we can all support one another.

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