Periacetabular osteotomy for hip dysplasia coming up!

I have had two PAOs (one on each hip). I had mine done by Dr. Joel Matta in Santa Monica, California. Definitely recomend going to see him if you can. I got great results both times, and had a pretty smooth recovery. Dr. Matta is able to do the surgery in about two to three hours, preventing the need for a blood tranfusion during surgery. Other great surgeons are Dr. Sink in New York City and Dr. Millis in Boston; I visited both of them before finally deciding to have my surgery done by Dr. Matta. The healing process is very long and can get frustrating. You won't feel much pain the first day because everything is still numb, but it is important to make sure you figure out how to manage your pain early on because if you don't, the pain can get bad. You can get put on a pain pump that allows you to push a button every ten minutes and recieve medicine, but I reccomd asking your doctor to manage your pain medicine for you because if you fall alseep for a long period of time, you may wake up in pain because you won't be pushing the monitor during sleep. Also, make sure you ask your doctor ahead of time about ways to manage nausea because that is a common side affect of the pain medicine used for this surgery. Overall, if you manage your pain medicine, you shouldn't feel any severe pain, but you obviously will exerience some discomfort. You will be very dependent on others for a while, and you will be immobile which can get frustrating, so be prepared for that. Its a lot to go through and mentally and emotionally its not easy, but I really do recomend the surgery because it does have great results. Also, it is important to make sure you use a good doctor because a lot of docotors out there are not experienced and having a great doctor is key for a good recovery. Hope this was somewhat helpful!

Would love to learn more about your experience with the PAO surgery and Dr Matta. I am considering tge procedure and concerned about the recovery process. Let me know if we can discuss over email. Thanks.

Hello Elizabeth,

My name is Claire and I am scheduled for a PAO next month with Dr. Matta. I am 27 years old and a school teacher. I was wondering how long after your surgery were you recovered enough to go back to work? The school year is starting soon and I'm not sure how long I am going to need a substitute in my classroom. 

Thanks,

Claire

Hi Zoe, I have just gone through exactly what you are going through. I did a lot of triathlon but had to stop because of pain training for the running - but otherwise have a totally healthy and active life. I was diagnosed with hip displasia when I was a child (am now 36) and when I went for scans the surgeon told me things will only get worse. I had my PAO surgery 8 weeks ago so it is still early days, but my recovery is going well - I can walk around the house with no crutches and can go on an exercise bike for 30 minutes + albeit at fairly low resistance-  nothing like some of the nightmare stories I read about on the internet. The thing that made me decide was that a significant factor in the long term success of the operation is how much existing damage is done to the joint. I want a hip that will let me play football with my son in 10 years time! My operation was done by Marcus Bankes who seems to have quite a good reputation for PAO surgeries - although I only researched London based surgeons.

Huge thanks Paul. Really appreciate your comments

Hi there,

You're the first person I've found online anywhere that was operated on by Johan Witt. My surgery (left first) is on 8th June and I'm doing as much research as possible. He's already said I will need both done. Now you're a year on, how was the recovery? And did you have the other ones done?

I've heard all good things about Johan from people in the medical profession and I'm also going to be in the London Clinic so I'm sure I'll be well looked after, but would be great to hear your feedback.

Hope all is well for you now...

Karen

Hi!

I too am about to undergo a PAO on my left hip with Johan Witt on the 29th of June, after being told I would need both done eventually!

I'm a little bit nervous about it, despite already having had 5 hip surgeries and was wondering if it was at all possible for you to let me know how yours goes, and what it's like after you've had yours done?

Good luck, and hope it all goes well!

Lauren

Yes of course, in fact that's exactly what I was going to suggest. This will be my first hip surgery though so sounds like you've had a worse ordeal over the years. I'm very nervous and I'm less than 2 weeks away.

I have set up an email address for personal use so please do email me a week or so after (15th ish) and I'll get back to you:

Best

Karen

Emis Moderator comment: I have removed the email address as we do not publish these in the forums. If users wish to exchange contact details please use the Private Message service.

http://patient.uservoice.com/knowledgebase/articles/398331-private-messages

HI Lauren,

My daughter Lucy had a PAO nine weeks ago at Guy's Hospital under Mr Marcus Bankes. He also works with Mr Witt at another clinic. The whole experience so far has been a positive one. Lucy was operated on the Monday and discharged on the Thursday, so hospitalization was only four days. She was up out of bed the next day with physio help and completed a small staircase. The day after that she went up and down a full staircase. Pain management was excellent, and continued for three weeks at home with a combination of Morphine , Ibuprofen and Paracetamol plus anti sickness drugs. Lucy has been doing daily exercises as suggested by Guy's and hydrotherapy, which we booked locally and really made a difference. Lucy was back at school after four weeks and off crutches after six. She does get tired and achey if she overdoes it, but really it's still early days. Swimming and exercise bike now and at six months she can start running. Improved surgical techniques nowadays, combined with smaller incisions, good pain management and rehab/exercises mean that if all goes well you can progress fairly quickly. 

 

Thank you so much, this has been really helpful! It's helped make my mum feel better about the surgery too as I'm only 16 myself!

I'm glad it went really well for her

I was told by Mr Witt that I would have to have an epidural etc for 3 days, so I take it that it's possible to have it removed sooner? Also how did she find the travel home? From what I understand it's meant to be really painful! Sorry for asking so many questions!!

Thank you

Lauren

3 days for the epidural? Mine is due out later that day/evening. Although I am sure every case is different though so your acetabular may be shallower or the femoral head a different angle (mine is normal). I've got to the age of 39 (although I've had issues since I was about 11) but failed NHS diagnosis has led to a very late correction.

I'm sure it will all be well for us all! :-) 

My acetabular is quite shallow and my femoral head is angled wrong too, but hearing that you are having your epidural out soon after gives me hope that it won't have to be 3 days!!

thank you!

Lauren

I'd be very surprised if it was in that long... that's a long time without feeling your legs but then I'm not a Doctor! Why don't you or your mum give Barbara a call as I'm sure she'll put your mind at rest. She's been great with me and very supportive.

K

That's a good idea, I'll get my mum to give her a call, thank you for your help!

HI Lauren,

Lucy came back from theatre with various drips, drains, a self administering morphine pump and a catheter. But most were removed by day 2. We took Lucy home in the car which was about an hour. We made sure that she had painkillers just before we left, pillows for support, sat in front seat and just took our time. Like you Lucy is young, but also generally fit and had a positive attitude to her recovery. She was moving about home and sitting or lying down etc fairly quickly. Your Mum will be a great support and don't be afraid to ask for help or painkillers when you need them. I wrote down a timetable for all of the drugs which I tried to stick to. Occasionally Lu had extra Morphine but the pain was controlled really well, which meant that Lucy could sleep well at night and move well during the day. One thing I would recommend is a seat for the shower. Very useful and gives you a bit of independence. Lucy is due to have her other hip operated on next summer after A levels, and fingers crossed it will be a smooth recovery again.

Many thanks for mentioning the seat...I'm pretty organised but I hadn't thought of that, so I've just ordered one.

10 days and counting...

Karen

Thank you, I'll make sure to have some pillows with me in the car! And I hadn't thought of a shower seat either so I'll have to get one of those too!

I hope it all goes well for Lucy again!

Lauren

Hi Karen,

All the best with your op. You sound well prepared. One other recommendation that Lucy was given was Bio Oil to help the scar heal and settle. She just dabs a little on morning and evening. 

Keep in touch.

kind regards,

Nikki.

Thanks Nikki, I will be using something similar which is 100% plant based. I wouldn't be putting Bio Oil on my skin - it contains parrafin!

 

Hi Lauren,

I'm not sure yet how you communicate separately with other users,  but if as a fellow teenager you wanted to communicate with Lucy, she would be happy to chat. She was planning on doing a blog about her Guy's and post op experience specifically for teenagers, but hasn't got round to it yet. You've probably had exams and stuff too. I will encourage her again. Lucy's motto post op was 'short term pain for long term gain'

Good luck. 

Definitely think you should both compare and stay in touch as you're similar ages. I, on the other hand, am an oldie in comparison! 

Not sure why but my reply to your bio oil comment is being moderated but I didn't put any links or anything in it.

 

Hi Karen,

We have been thinking of you today and hope that all went smoothly, and that you are soon up and about again. Good luck.

Nikki and Lucy.

Hiya

Thanks for checking in. Unfortunately, all didn't go according to plan. I had a severe anaphylactic shock in theatre to one of the meds and they had to abort the surgery (they'd not started actually). I'm OK but apparently it was very rare. I'm scheduled again for next Wed so hoping for less drama!

Best

Karen

Poor you. After all of the build up, you must have been exhausted. We hope that Wednesday's reschedule goes according to plan. Take care.

Nikki and Lucy x

Nikki,

 

Thanks for sharing. That's pretty impressive that your  daughter was off her crutches at only 4 weeks! I'm due to PAO in September and I'm  dreading it. Can I ask, did your daughter have much pain in her hip before the surgery. The reason I ask, is I have only mild dysplasia and mild discomfort so I'm really just doing the operation to prevent the condition worsening, so it's a very difficult decision to make. I found the recovery after the first one very difficult, hence my reluctance to get the second one done

Eimir

Hi Eimir,

Lucy was off crutches after six weeks not four. But she did go back to school after four weeks. Lucy had been in pain for about 2 1/2 years before her op, especially after sport. She is a keen hockey player. Usually the pain lasted for a few days, but wasn't agonizing. She took occasional Nurofen. Our local hospital didn't really deal with the chronic pain and it was only once she was referred to Mr Bankes at Guy's that progress was made. The suggestion was that if Lucy had carried on though, that her hip condition and mild dysplasia would have worsened with time. I can only talk from Lu's experience, but her fixed hip does not now cause any pain. She is now 13 weeks post op and progressing well. Her main aim now is to increase stamina. Lucy is young, fit and of small build and I think that helped. She will definitely go ahead with her other PAO next summer if all goes welL So I hope that your op goes well and that your recovery goes smoothly. Happy to chat further. 

 

Hi All,

Just to let you know that I seem to have created two user names titch245 and nikki245. Not sure how to resolve, but I will respond to both. I'm rubbish at technology!!

Nikki and Lucy.

Hi Karen,

How is your recovery going? Hoping that your second attempt all went well. Lauren and Lucy have been communicating, and Lauren had her op today. So hopefully the three of you PAO hippy chicks are all looking at a better quality of life as far as pain management and living life concerned.

 

Hi Nilki and Lucy,

I'm doing well thanks after the aborted attempt to first time around. Found out since I messaged you before that I almost died on the table and they were charging the crash pads. I'm very grateful that the anaesthetist, Bruce Martin, was a specialist in cardio so he was able to react quickly.

I'm doing really well now - 2 weeks post-op - and hydro is going well. I've been exchanging emails with Lauren with all my progress reports and they've said its really helped so looking forward to hearing from them after her op today.

Did you say you were off crutches at 6 weeks?! That seems very quick!? I've been told 6 weeks limited weight bearing and up to 4-5 months on crutches.

Best

Karen

Hi Karen,

You deserve to have a good recovery, after your experiences last time. Yes Lucy was off crutches at 6 weeks. Starting to think that maybe she has been very lucky, comparing her recovery to others and listening to advice that others of you are being given. But fingers crossed they may say the same to you. She had a post op check at six weeks and that's when she got the go ahead. Lucy really felt the benefit of hydrotherapy too. We paid for five sessions as no NHS near us, but after that physio just said go to local pool.

Glad that you're on the road to recovery.

Morning!

Thank you that's very kind.

That really was fast but then again Lucy is still very young and at that age, the bones fuse together a lot faster. I'm a ripe old 39 ?? so it will take a lot longer.

I too have already been in a normal pool twice since coming out. I have a slight advantage in that I have lots of Physio friends, the clinic that has looked after me for nearly 5 years and I also do their marketing so I'm pretty knowledgable about the exercises etc. I had booked hydro too, but the distance I have to travel, it's just not worth continuing past next week.

So, how long ago was Lucy's op? And is that it now? Sorry - this string is so long! ??

Was she under Mr Bankes at London Clinic... I was Johan Witt.

Not heard from Lauren's mum yet so hope all is well.

Best

Karen

Hi Karen,

Lucy is now 13 weeks post PAO. She had her surgery under Mr Bankes at Guy's Hospital. The care there from start to finish, and from all of the specialities was excellent. We saw him at 12 weeks and asked about having the screws/pins removed, as they do bother Lucy at times. So the aim is to have them removed in October, as a day case. Her left hip will then hopefully be operated on after her A levels next summer. Lu is basically functioning normally now, just with reduced stamina. Obviously sport is off the menu for a couple more months, but really it's a case of patience and increasing strength.

Lucy heard from Lauren yesterday on Facebook and everything sounded positive.

 

Thank you!!

Can I just check with you and other PAO folks about the stairs. I'll be staying with a friend whose stairs has walls nut not a banister. Is this difficult to manouever? I'm worried about falling when I have nothing to hold on to.

HI Eimir,

You will need to discuss this with your physio in hospital. Does your friend have a handrail on the wall? Lucy was given a method for getting up and down stairs, based on using a handrail/bannister and then leading with particular leg depending on up or down. I stood behind Lu the first few times as she was nervous like you. But physio should be able to come up with a plan.

Hi Eimir,

I'm 2 weeks post PAO. One of the friends that was looking after me when I left hospital had the same. It's one of the questions the physios should ask (if not tell them) and then they will show you the method on 2 crutches. As long as you have good balance on your crutches, it's not too different to rails. They will probably just advise that you have someone walking in front / behind you in case you wobble.

Good luck!

Karen

Hiya

I forgot to reply. Yes I've heard from Lauren a few times now. She mentioned they had a problem with her PCA motor but was quickly and efficient sorted. They are so good at London Clinic!

That's interesting about the screws - I have in my head that they will wait until I go in next year for the right hip, but we'll see. I can certainly feel something 'foreign' in me but I'm still only 2 and bit weeks post, so that could be anything. I'm off the Targinact now and only taking a couple of the Oxynorm daily so pain must be reducing. Just relying on paracetamol and nurofen by early week. It will be nice for 'other things' ???? to get back to normal - if you know what I mean!!!

Thanks again for the chats and advice - I am sure we'll be chatting again this time next year if I don't hear from you before.

Best Wishes to Lucy

Karen x

Hi lovely- I know you posted this around a year ago, but Mr. J. Witt done my PAO surgery at UCLH almost 6 weeks ago..... I was wondering how your recovery went?

I personally was in hospital for over a week, plus was sent home with a walking frame- but was given crutches around 3 weeks ago ..... initially my recovery was slow.... but it's suddenly taken a turn for the better.....

Wow it sounds like you had a hard time at the start but glad things are progressing. I was onto crutches by the Sat (op on Wed) and a flight of stairs by the Sun. I came off crutches in record time after about 11 weeks (which for a 39yr old isn't bad!) however, I absolutely nailed the Physio and exercises and did way more than I was asked... Just ensuring that I didn't do things I shouldn't be. I was on a bike after 7 weeks (static) and after building my way up, I did my first spinning class since pre-op this weekend. Walking is good too - up to 8 miles in the surrey hills. It's not come without its problems though - I have bad knees too which has stopped me doing certain exercises, particularly those that fire the glutes which is critical so keep doing those butt clenches as often as possible!!

Anything else I can help with, let me know.

Karen

Oh... The email told me you'd messages me and only just saw this was for MrsC25. Sorry! 😂

Hi my 14 year old daughter is about to have PAO operation would appreciate any advice

Thankyou

Hi, my daughter just turned 11 years old.  We recently went to doctor office for checking her spine, but incidentally found she has hip dysplasia the left hip.  The doctor recommended Triple Osteotomy which is similar to PAO, but performed for premature child.  I am so worried about the operation.  My daughter was not even in pain.  We went to see another surgeon, who suggested put her on observation till she reaches skeletal maturity, then perform PAO.  I am super confused about what to do.  

Hi Nikki,

I have just been reading your old posts and wonder how your daughter Lucy is getting on now a year post surgery. My 19 year old son who is also a very keen hockey player has been recommended for a PAO next summer. He picked up an injury skiing last February which as a result of scans etc diagnosed mild hip dysplasia. He is seeing Mr McBryde in Birmingham as he is at uni there and has been told that having a PAO will reduce the possibility of THR by 80% by age 50. He is very positive about it al but I am anxious about the recovery and how his joint will be down the line. As he is young as Lucy was I was just wondering how she was getting along and the possibility  of putting them in touch with each other further down the line? Thank you. Fiona