It may have been from years of bowling or simply a condition present since birth.
But whatever the source of the problem, it brought increasing pain to Kathleen Peck's left hip beginning in early 2009.
"It got so bad that I couldn't sleep," said Kathleen, a 52-year-old rural Augusta resident and Pfizer retiree. "If I did fall asleep the terrible pain would wake me up. And during the day, if I twisted just right, it caused excruciating pain."
In May of that year she was seen and examined by Dr. Thomas G. Ryan, an orthopedic surgeon with the Kalamazoo Orthopaedic Clinic. He diagnosed a condition called femoroacetabular impingement syndrome, better known as FAI syndrome, and early arthritis.
FAI is a condition that causes too much friction in the hip joint when the ball-shaped top of the leg bone and the socket in the hip rub together abnormally, causing pain.
Dr. Ryan told Kathleen that in the past he would have done an open surgical repair involving a major incision (about 7-10 inches long) and a prolonged recovery. "He said that it is basically similar to hip replacement surgery and that the ball on the leg bone had to be reshaped," Kathleen said.
"But he told me that he was going to Chicago in July to learn how to do the surgery arthroscopically and that he may be able to do that instead. When he came back from the training he was very excited about the new surgery."
Kathleen opted to wait. And she is delighted that she did.
Beginning about 9 a.m. Oct. 14, at Borgess Medical Center, Dr. Ryan made three small incisions in Kathleen's left hip area and, using a video camera and other tools made for the minimally-invasive laparoscopic surgery, reshaped the bone and removed a damaged portion of the ring of soft tissue, called the labrum, that lines the outside rim of the socket. He repaired the rest of the labrum, which works a like a little suction cup that holds the hip joint together.
Dr. Ryan said that when he first examined Kathleen she told him that she had had minor hip pain for some time but that it recently had gotten much worse. "That's pretty typical for someone with FAI," he said. He found that Kathleen had a bump on the leg bone that was pushing on the labrum, causing damage and pain.
The condition is often seen as the early stages on hip arthritis, he said. "In the past, we would wait to do surgery until the condition got worse and instead treat it with anti-inflammatory medications," he said.
A Swiss surgeon, Dr. Reinhold Ganz, was among the first to begin treating the condition earlier in the degenerative process, Dr. Ryan said. Ganz, however, used a surgical technique that required major cutting and reshaping and a long recovery time.
Later, other physicians began using the arthroscopic procedure that Ryan used for Kathleen.
"It really has been a big advantage to patients," Dr. Ryan said. "There is much less trauma. And now we are expanding the indications for using the technique and we are doing the procedure earlier in the disease process."
Surgery lasted approximately two hours and Kathleen left for home at 2 p.m. the same day.
Traditional open surgery typically requires a hospital stay of three or four days.
"I was walking with a walker the first day," Kathleen said, "although I couldn't put any pressure on the hip for a week. Then I could toe-tap with the walker for a week and then gradually add weight over time.
"When I went back to work (at Pfizer) I was using crutches. Two weeks after returning to work I retired, something I had been planning to do after the surgery."
Kathleen said that the care she received at Borgess was excellent. "Dr. Ryan told me I could have stayed over night but I wanted to be at home," she said. "I only had to go to the Borgess Health and Fitness Center three times for physical therapy and while there they taught me exercises I could do at home.
"I could ride the exercise bike right after surgery, and so far so good. There is no way that I would be doing as good as I am if I had had the open surgery. I would recommend the surgery and Dr. Ryan to anyone who qualifies."
Kathleen was among the first of Dr. Ryan's arthroscopic FAI patients. He said he has done about 20 since being trained.
"I can vacuum the floor, clean the house and get down on my hands and knees and the only discomfort I feel is afterwards and it's probably from the arthritis," she said. "There isn't any hip joint pain."
A Kalamazoo native and Kalamazoo Christian High School graduate, Kathleen and husband James were married in 1982. Jim retired from Graphic Packaging Inc. seven years ago. Kathleen worked at Pfizer for 31 years.
One of the Pecks' pleasures is summer rides on their Harley Davidson motorcycle.
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