Periacetabular Osteotomygreenspun.com : LUSENET : About Joints : One Thread
I am being considered for this type of surgery for a congential hip dysplasia. Anyone have the surgery? What are the problems associated with this procedure? THR has a long and stable track record, how does this compare?
-- Carla Sharp (email@example.com), August 07, 2003
I had this surgery on July 31,03. So far I don't have many complaints. I'm 26 and after 4 years of pain, in January the doctors finally figured out what was wrong, Acetabular Dysplasia. I was born with the hip disorder and wore a brace for the first 9 months of my life. I didn't have any problems until I was about 22 . Prior to the operation a had to donate 2 units of blood, which they I needed back after the operation. I spent 7 nights in the hospital, that week was pretty painful but by the time week 2 started and I was at home the pain lessened daily and I was only taking advil for pain. By the end of week 2 alot of the pain was gone, for me the worst part is the crutches. Now at 4 1/2 weeks post op I take advil maybe every 3 days because of a sore back from sitting and laying on it all the time. I can lay on me stomach and on my good side for periods of time and even on my bad side sometimes, I could do this at 3 weeks post op. I haven't experienced any of the pain that I had before the operation but I haven't walked yet either. I was given this surgery to possibly prevent a THR. If ypu have any questions E-mail me.
-- LISA (firstname.lastname@example.org), September 02, 2003.
I had this surgery at the University of Iowa Hospital on 8/21/03. I'd been having steadily increasing pain for the past 5 years (I'm 37), and I'm only sorry I had to wait as long as I did. My doctors recommended against a THR for the simple fact that they don't last long enough to be useful for a young person. THRs can be redone, sometimes, but each time will probably be less successful. (Apperently the athlete Bo Jackson is a good example of why THRs are not recommended for younger people.)
The most common problem with the surgery is an infection of the incision site, although this is rarely a serious problem. Sometimes nerve damage will occur, but very often this will not be permanent; many patients report tingling or numbness in the toes on the surgical side due to nerves being stretched during the procedure, and this resolves without any treatment. Anyone who has this surgery is at very high risk for developing blood clots in the legs, so you'll have to take blood thinners and wear ugly elastic medical stockings for about 6 weeks after the procedure. I didn't do any autologous blood donation, and I was pretty anemic for the first week after the surgery, but I was feeling noticeably better by 10 days afterwards.
Currently I'm getting around with a walker. My other hip is also dysplastic, so I'm actually having more pain on the non-surgical side thanks to the increased workload. I'm not allowed to bear any weight on the surgical side for a total of 2 months, then I'll be allowed to gradually increase weight-bearing until I can walk normally, probably around 4 months from now. I'm expecting to use crutches during the intermediate time.
If you have this procedure done, you most likely will be unable to voluntarily lift your leg at the hip for as long as 2 months. This will make stepping in or out of a bathtub/shower difficult. You'll probably need something called a transfer bench that allows you to sit down outside the tub, then slide over and lift your legs over into the tub. A handheld shower is a big help, as you won't be taking tub baths or showering standing up for awhile. A frame or commode over the toilet so you have armrests to push up from will also help a lot.
One other thing to consider regarding a periacetabular osteotomy is that it's most likely to be successful if your joint and cartilage are still intact. Hip dysplasia predisposes you to early arthritis that can progress very quickly, and if that's already happened, then you aren't a good candidate for the procedure. If you do decide to have the procedure, don't delay it too long.
I was pretty nervous about having this done, even though I'm a nurse and probably understood what would happen better than someone without a health care background. But I can already tell that I made the right decision, and I'm very eager to have the second side done. (My doctor says this is the case with most of his patients.) I'd be very happy to answer any other questions if I can, and feel free to e-mail me. I wish you the best of luck!
-- Jacqueline Foster (email@example.com), September 06, 2003.
I'm 16 and I had the surgery in May 2004 I was walking with a walker the next day because I am so young I heal better. The only problem is at 6.5 weeks I am walking with no crutches around the house (even though i shouldn't) but my butt muscle has been enlarged and I can't sit on it.
-- Krista (firstname.lastname@example.org), June 20, 2004.
I had this surgery done on my right hip in January 2001. I am very pleased with the surgery. I do not have any pain in the right hip area but I did lose the feeling on the outside of my thigh to my knee. This feeling has not come back and I don't expect that it will. It is a little annoying sometimes but not painful.
My recovery was about 3 months to get back to work (office work). I was back to golfing within 5 months and playing softball in by the summer of 2002. My right hip will sometimes feel a little tight but there is no pain.
I am probably going to have the left hip operated on this year or early next year. The pain is started to get in the way of my daily activities.
I also have hip dysplasia that was not diagnosed until I was 34 after years of pain in the hips.
-- Randi Johnson (email@example.com), July 08, 2004.
Well, this board is amazing, I found an awesome friend from Las Vegas who had this done around the same time, and who is in my age range. What a life line to have, to be able to talk to someone who knows exactly what is going on! The only complication I have has is a large pin, slipping out of place harpooning (lol my favourite metaphor for this situation) my buttock muscle, hence the large pain I was complaining about before. I am getting it removed tommorow and then starting therapy shortly after and off my crutches. It has been almost 2 and a half months. So thats about it. Krista
-- Krista Collin (firstname.lastname@example.org), July 14, 2004.
I have to agree that this message board has been great. I don't know how I would have made it through this without the "awesome friend" I met here. I am almost 9 weeks post op and the pain is pretty good. Actually my hip feels great but my back is very sore from the crutches and laying down so much. The only complication I am having is an inablity to lift my leg. My extension and abduction are both in normal limits but my hip flexors refuse to pick up my leg. It is like my brain is not communicating with the muscles. Has anyone else had this problem? I started therapy three weeks ago but I am really not seeing any improvement. One other thing...leg length difference. Since the surgery my operated leg is about 1.5 inches longer than the other and it is making walking very difficult. Did this happen to anyone else? Thanks so much -Jeni
-- Jeni (email@example.com), July 15, 2004.
My son, 13 years old, has bilateral familial multiple epyphiseal dysplasia. He was diagnosed at 6, after several years of limping, and a stint of refusing to walk at 2 1/2 years old. He had this surgery Monday 8/2/04, and it has been a very rough week. He has lost the feeling in his left foot (surgery side) from the ankle down. He is in a brace now to hold his foot in proper position. The right side also appears to have suffered some type of weakness. Our doctor, at Boston Children's Hospital says that this happens in 1% of the population who have this surgery. We are awaiting a consultation with a neurologist who specializes in nerves in this area of the body. Has anyone else known of this problem? My son is very depressed, as are myself and my husband.
-- karen johnson (firstname.lastname@example.org), August 07, 2004.
http://www.geocities.com/young_hip_patients/index.html young hip patients go here
-- Krista (email@example.com), August 11, 2004.
Hello.. I am scheduled to have this surgery on Oct 13. I was born with bilateral hip dysplasia and had a few surgeries when I was a baby and again when I was 6. I am 23 now and have been experiencing pain in both hips for about a year. I am going to get my left hip done. I would appreciate anyones advice or knowledge about what they went through. How long the surgery is, length of hospital stay, how long until the pain subsided, amount of time you couldn't walk. I would appreciate anyones feedback.....Thanks! Andrea
-- Andrea Bosart (firstname.lastname@example.org), August 13, 2004.
Hi, I had the PAO procedure on July 16 at the Mayo Clinic in Rochester MN. Like others, I also found that the pain the first week was the worst with it lessening quite a bit with each passing week (I am now 5 weeks post op). Sitting and laying around has been the worst - the lack of independence has been driving me insane. My doctor did approve me to drive at three weeks- (yipee)- so that has helped my sanity. I have been putting weight on my operated leg while using crutches for about two weeks and that is going well. Like another post here, I have also noticed that it seems like my operated leg is longer but thought I was imagining it. The only other big problem that I have had is with my incision opening up in several spots - right now I'm irrigating and packing the wounds so that they heal from the inside out.... need to be very careful with this. I will be glad to be through the next couple of months and back to normal.
-- Kathy Formo (email@example.com), August 19, 2004.
Hello everyone! I am a 25 year old female with hip dyplasia. I had a PAO on my left hip in December of 2002. I am now scheduled to have my right hip done October 6th of 2004. I can't wait. I had AMAZING results from my first surgery. My surgery was performed by Dr. Mast in Sparks, NV. This surgery has changed my whole life for the better. I started having hip pain when I was about 19, but I ignored it. The pain continued and by the time I was 22, my hip would have these pains so bad that my leg would just give out and I would fall over. The pain was so intense it would wake me up in the night. After 4 doctors told me there was nothing wrong with me, I found a doctor who correctly diagnosed me. After doing a lot of research and seeing several doctors for a second opinion, I found Dr. Mast. Before my surgery I could barely walk a block, I now run every day. The recovery was painful and long, but it was so worth it. I would be VERY catious about walking on your hip too soon, even if it feels ok. The people on here that did not follow their doctor's orders are really putting their hips at risk. DON'T WEIGHT BEAR before the ordered time!!! I am getting my right hip operated on in about 5 weeks, and other than the pain that comes with the recovery, I cannot wait to get my surgery done! The results are 100% worth it!! Please email me and I would be happy to share my story or answer any questions. This is a scary thing to go through, but you'll be so happy you did!!
-- Lindsey (firstname.lastname@example.org), August 30, 2004.
You are doing the right thing be researching as much as you can. I actually met Lindsey (above post) through a hip website. We went through it about the same time 2 years ago.
Honestly, there are only about 4-5 doctors in this country worth using. I have heard too many testimonies of people using these doctors who say they are specialized and then come out months later with major problems. I used Dr. Mayo in Seattle/Tacoma. He was fabulous and a perfectionist. Lindsey used Dr. Mast in Reno and also had good results. I hear Dr. Matta in L.A. is good and Dr. Millis I believe in Mass. is good also. That would be my advise to you.
The recovery is 12 weeks. Crutches and no weight barring for 12 weeks. The first 2-3 weeks are pretty rough but managable with pain meds and support from loved ones. I have had both sides done and have 8 inch scars over each hip, right along my binkini line. They are very fine and not very noticable at all. Some doctors stitch differenly, ask around.
After crutches you go to a cane or one crutch for a couple of weeks. Physical therapy for 2-3 months 2-3 times a week is extremely important.
When the time comes for you to go in, email me and I would be happy to help you with what to bring to the hospital, etc.
Good luck! You will be so much happier when you have had it done. The pain before hand can get pretty unbearable.
-- Susie Blake (email@example.com), September 02, 2004.
I posted a comment, and stated anyone could email me, however my email has changed. My new Email in firstname.lastname@example.org
-- Lindsey (email@example.com), September 22, 2004.
I had the surgery in October 2003 in London, England. The surgery itself was fine and I recovered well. I would add that 16 months on I am still in pain due to the arthritus that was already present prior to surgery. It was still worth having the operation, I would have been in worse pain had I not have had surgery.
-- Katie Sheehan (firstname.lastname@example.org), February 15, 2005.
Hi my name is sara.i am 38 years old. i had my op in november 2004.i have had a pretty bad time of it since the op as had to stay in an extra week with complications. i had trouble moving my toes and they were numb. when the nurses tried to get me out of bed after three days the pain was awfull shooting right down my operated hip into my foot. unfortunately they bruised the sciatic nerve when doing the op after three months i have had no improvement and i am still in loads of pain and still on crutches. it seems that most of the threads ihave read have been succesfull. if any one out there has had the same comlications please let me know as will it be permanent? or just hoping it will get better with time.
-- sara smith (email@example.com), February 19, 2005.
Hey, I am 20 years old and I had the procedure done seven weeks ago today! (start of January, 2005). I was born with congenital hip dysplasia and after a couple of osteotomies when i was young my hip started giving me pain again as i got late into my teens. My surgeon referred me to another surgeon who performed the procedure. I had the procedure done not only because of the pain but because i was starting to lose mobility in my leg. Also, the chances of getting arthritis in my hip were quite large and once you have got arthritis the surgery cannot be performed. It's also better than having a total hip replacement as you get to keep your own bones :)! Whilst i did not have pain 24/7 the breaks between the pain got shorter and shorter as my hip worsened. After the surgery i felt great, i had an epidural catheter in so i couldn't feel anything from my waist down, the pain admittedly though was quite severe when the epidural was taken out. I didnt get out of bed for the first couple of days and I had trouble getting out of bed for the first week. I used a walking frame for a few days before moving onto crutches, which i am still using and will be for another three weeks! I was in hospital a total of ten days, and the pain after about a week dulled off to the point where i haven't had a single pain killer in about 5 weeks! At first, I had alot of trouble lifting my whole leg off the ground, it is gradually getting better now though. Also i have nerve damage down the outside of my thigh but apparently this is normal and i am already gaining back feeling. Basically, i feel that anyone in the same situation who has been recommended the procedure should go for it- you may want to seek a couple of opinions for comfort though :). I already feel an improvement, i feel straighter and the bone that used to stick out the front of my hip is no longer there! Whilst the decision was hard to make about getting the procedure done, i am sure the long term benefits will be worth the 12 weeks on crutches and a bit of pain :) Plus i will be able to go back to my sport at the end of the year which i was having to start to give up because of my hip! Time will tell :)
-- Pip (firstname.lastname@example.org), March 02, 2005.
I am 38 years old and scheduled to have this surgery performed in late April 2005 by Dr. Trusdale at the Mayo Clinic. I am most concerned about traveling back from Rochester only a week after surgery. Does anyone have any advice?
-- Lisa Mattivi (email@example.com), March 09, 2005.