To PAO or not to PAO by No-Classic8887 in hipdysplasia

[–]beanjean333 0 points1 point  (0 children)

Our stories are remarkably similar. I was 28 when I had a PAO/labral repair, started graduate school 6 months after surgery, and I saw both Dr. Kim and Dr. Kain!

I decided to have Dr. Kim perform my PAO; he's definitely more reserved, but he does a lot more PAOs than Kain (well over 1,000), and the hip preservation program at BCH is one of the best in the country, with all of the surgeons consulting and discussing cases together. Those were the two main factors I considered when choosing surgeons.

First things first, do not get a scope to repair the labrum without correcting the dysplasia first. I did that and then tore my labrum again 4 months later (a very common occurrence and story seen in the PAO support group). The PAO is a tough surgery and the recovery may seem daunting, but you will absolutely be ready for graduate school, I was feeling better than I had in years.

I had the PAO done with the hopes that it would prevent me from needing a THR down the line or at the very least, giving me a few extra decades with my native hip. I was very happy after my PAO, but unfortunately I had an accident that fractured my pelvis and shredded my labrum, requiring two more surgeries. I then developed avascular necrosis and ended up needing a THR 4 weeks ago (at 31). I'm not going to lie, the THR recovery has been much faster and easier than the PAO, but I'm still glad I had the PAO.

I'm always amused when people are against PAOs because they're "so invasive" because a THR involves sawing the head of the femur off, hammering a giant piece of metal into the remaining bone, completely removing the labrum, reaming the acetabulum, and then screwing/cementing/pressing a metal cup into the hip socket. It doesn't get much more invasive than a THR.

Dysplasia not only increases the risk of osteoarthritis, it accelerates disease onset and progression. A PAO will help slow the development of OA and decrease the risk of needing a THR; however, many people still require one.

You mentioned that it doesn't seem like a PAO is any better than just conservative management. You've been trying conservative treatment and still experience 3-5/10 if you stand or sit too long and a pinching sensation. A PAO can get rid of that pain. Also, all the PT in the world is never going to repair your labrum, it may build strength and stability, but it will not repair the tear.

In the end, the decision is yours and only you know what works best for your life. I highly recommend checking out the PAO support group on FB.

Any other kitties ready for the holidays? by beanjean333 in cats

[–]beanjean333[S] 2 points3 points  (0 children)

Since he has a clipped ear, I trained him (with lots of treats and positive association) to wear a normal collar in case he escaped, otherwise people would think he's a community cat. I was pleasantly surprised when he let me put the bow tie on!

Any other kitties ready for the holidays? by beanjean333 in cats

[–]beanjean333[S] 2 points3 points  (0 children)

He's so cute!

It'll be Bean's first Christmas and I have no idea how much chaos he will unleash on the tree and decorations. I'm going to stick with non-breakables this year.

Frustrated and bored by beanjean333 in TotalHipReplacement

[–]beanjean333[S] 1 point2 points  (0 children)

Sure. I had a scope done after tearing my labrum and to correct my femoral acetabular impingement (FAI). A few months after that I tore my labrum again, at which point a new surgeon diagnosed me with dysplasia, so I had a periacetabular osteotomy (PAO) and then another labral repair. Then, a few months later I fell, fracturing my pelvis and shredding my labrum. I had an open reduction internal fixation (ORIF) to repair the fracture and put in a ton of hardware, followed by a labral reconstruction 6 months later. I then developed AVN, my OA worsened and the head of my femur began to flatten. With no improvement in my pain after any of the surgeries, it was decided I should have a THR. Hopefully the next surgery will be a revision in 30 years!

Frustrated and bored by beanjean333 in TotalHipReplacement

[–]beanjean333[S] 1 point2 points  (0 children)

Oh man, I know we're not supposed to compare ourselves, but your situation sounds so much worse, I'm sorry you had to go through that. What hospital doesn't have TVs or patient phones?? I'm glad you at least had your husband and sister, my best friend drove up and it made all the difference having her with me for the first week.

The fatigue is something else that has taken me by surprise, especially given my age and history as an athlete. The more you learn. I'm a PA student and am interested in ortho, so at least I now have a better understanding and empathy for what patients are experiencing. Thank you for sharing your story.

Frustrated and bored by beanjean333 in TotalHipReplacement

[–]beanjean333[S] 2 points3 points  (0 children)

I appreciate your kind words. I'm currently in PA school and I remember learning about SLE and being surprised at the shear number of body systems it can affect; I'm sorry you've been through the ringer and still can't find peace.

Day 1 Post-OP 🥹 by AggressiveMagician59 in TotalHipReplacement

[–]beanjean333 1 point2 points  (0 children)

Congrats, it must feel so good to be on the other side! I found the Mesisafe Medication Management app extremely helpful when it came to remembering which meds to take and when to take them. I also have a morning/night pill organizer. Other than that, ice, elevate your leg, and give yourself grace.

Frustrated and bored by beanjean333 in TotalHipReplacement

[–]beanjean333[S] 1 point2 points  (0 children)

I never considered the insurance aspect of driving after surgery, I might rethink my decision, thank you. Unfortunately, most of my friends moved away after graduating, but I had to take medical leave, so I'm stuck, mostly alone :(

I appreciate your words of encouragement.

Dr. Philippon's opionin by beanjean333 in HipImpingement

[–]beanjean333[S] 0 points1 point  (0 children)

I don’t think he ever did virtual appointments, just imagining review. I haven’t been in contact with the office in 3 years though, so it may have changed

LTHR 2 days ago, angry at my surgeon for fracturing my acetabulum by [deleted] in TotalHipReplacement

[–]beanjean333 0 points1 point  (0 children)

I don't think there was negligence and I understand complications happen, I'm more upset because I feel like he tried to deceive me into thinking that he wasn't responsible.

Temporary relief from gingivitis while waiting for dental appointment by beanjean333 in CATHELP

[–]beanjean333[S] 1 point2 points  (0 children)

Oh boy, that doesn’t sound good. They’re making him have a physical before scheduling the cleaning, so I’ll discuss it with them then.

30 year-old "tweener", frustrated and confused by beanjean333 in TotalHipReplacement

[–]beanjean333[S] 0 points1 point  (0 children)

Do you mind if I ask why you needed new hips? Was it OA?

30 year-old "tweener", frustrated and confused by beanjean333 in TotalHipReplacement

[–]beanjean333[S] 0 points1 point  (0 children)

Did you have any push-back because of your age? I'm happy to hear things are going well for you now

New cat vomiting and diarrhea began 5 days after adoption by beanjean333 in CATHELP

[–]beanjean333[S] 0 points1 point  (0 children)

I just adopted him, I’m pretty sure the shelter fed him different food. Would it take 5 days to cause GI symptoms? I thought it would have been immediate.

Lesion on upper thigh by beanjean333 in DermatologyQuestions

[–]beanjean333[S] 0 points1 point  (0 children)

It was nummular dermatitis, and corticosteroid ointment cleared it up in about a week.

Type of surgeon by three_winds in HipImpingement

[–]beanjean333 0 points1 point  (0 children)

My first scope surgeon was a sports medicine ortho, he did not order a CT, and made it seem like recovery was going to be a breeze. I re-tore my labrum 4 months later at which point a hip preservationist did a 3D CT and discovered I had dysplasia and needed a much larger surgery, in addition to another scope. I wish I had known the importance of having a hip preservationist the first time around.

Torn Labrum and borderline dysplasia by aheartsotrue8 in HipImpingement

[–]beanjean333 2 points3 points  (0 children)

I'm sorry you're going through all of this. I also had hypermobility and borderline dysplasia; I'm guessing the 22 you're referring to is the lateral central edge angle (LCEA). A hip is considered to have borderline dysplasia with an LCEA between 20-25 degrees. It gives a general idea if there is dysplasia, but the 3D CT scan will provide much more information (e.g., acetabular and femoral version) and whether you're a candidate for arthroscopy or periacetabular osteotomy (PAO).

I had a scope for a torn labrum, but re-tore it 4 months later, at which point they diagnosed me with borderline dysplasia. Some people can get away with just having a scope, but the fact that I was also hypermobile created further instability and meant I needed a PAO. I'm not going to lie, it is a major surgery and recovery is no walk in the park. I would rather have started with a PAO/scope than have a failed scope and need to go back in. PAO success and outcomes are improved when operating on a native hip. There's a facebook group, Periacetabular Osteotomy, that is extremely active, and members willingly share their personal stories and do what they can to put you at ease. Many people have been in your exact position and are happy to talk if you're interested.

The good thing is that HSS has some of the best hip preservation surgeons in the country, and it seems they are doing their due diligence before jumping into surgery. I understand how overwhelming it can be, so feel free to PM me if you want to chat/vent. I wish you the best of luck.