To PAO or not to PAO?
My right hip started hurting the summer before I had my left hip operation. It worsened a bit during my left hip recovery and it became clear that something was going on in there. My surgeons told me that the dysplasia on that side was borderline so they didn't think a periacetabular osteotomy (PAO) would be necessary. After the MRI came back showing a labrum tear and FAI, I felt really confused. If the dysplasia wasn't that bad, why did I have a tear, was it all because of the FAI or did the borderline dysplasia contribute as well? They can fix the FAI during surgery which would help prevent a re-tear but I was still nervous because I don't want to have to have multiple surgeries. I received a third opinion who agreed with Dr. LaReau and Dr. Domb about not needing a PAO. They couldn't know for sure but it was a high enough chance that the arthroscopic labrum repair by itself would be successful that I felt confident to proceed. Dr. Domb said I would be on crutches for two weeks and even offered to take out my PAO screws at the same time as the right scope. I was sold!
Let's do this!
Surgery prep was easy since I already had ice packs, my bike, and other things like a grabber. I had my pre op appointment two weeks before surgery and also needed a CBC panel to make sure I was healthy. We arrived at 6am in the morning the day of surgery and was able to get calming medication after my IV was placed. I don't remember too much after that, just a little bit in the OR and thrashing around a bit after waking up. The surgery was about three hours long, starting with removal of the four screws in my left hip. After the surgery I don't remember being in pain but I was shaking a lot. The nurse gave me two rounds of medications and then called the anesthesiologist to give me something else. I eventually stopped shaking and was able to relax and hold a conversation. I was able to get up and go to the bathroom after a bit and eat some applesauce. I was home by 1:30pm.
The bombshell
As I was waking up, I asked my husband how the surgery went. He said it went well but the labrum was too thin (calcified) to repair so they had to do a reconstruction with donor tissue. Six weeks on crutches, with the brace, and restrictions. Also, six weeks no driving. Ugh. I took it well though, due to the happy meds!
After we got home, I took two Percocet. The pain escalated quite a bit over the next couple hours and then I was finally able to take the next dose of Percocet with a Vallium and I slept. The next day, the pain wasn't as bad. I didn't need medication until the afternoon. I started my biking regime in the morning. Four times a day, 30 minutes each with no resistance. Other than that I just relaxed during the next few days and did the few exercises I could do like calf pumps and quad sets throughout the day.
Right Hip Recovery
I was able to get upstairs and shower and remove my bandages on day three. I also had my first physical therapy appointment!
On day four, we drove to Chicago (1 hour) to see the musical, Hamilton. Although I wouldn't have needed it if I were staying home, I took a Percocet in the morning to be able to enjoy the show without pain. After I got home, I took extra strength Tylenol but no longer felt like I needed the Percocet.
I started working from home on day six (a Monday) and it was nice to get into a routine. It was tough; however, because I was still on crutches and it was challenging to make meals and let the dog in and out.
The next several weeks were pretty uneventful since I was restricted to the crutches and brace. I took a low dose Valium every night to help me sleep. I was a bit stir crazy but it was nice to feel productive with work and we always made sure to stay busy and meet up with friends and attend church on the weekends. I had to go into the office a few days here and there which were uncomfortable but doable.
At six weeks post op I could finally remove my brace (yay!!!) and weaned off crutches over a few days. By eight weeks post op, I could do stairs and walk the dog.
I am currently 10 weeks post op and still regaining strength. But I can do housework, carry things up and down stairs, do some outdoor work, walk the dog, ride the stationary bike with resistance, and do some basic squats and backwards lunges!
I had a small flare up of pain this week because I went canoeing last weekend and I played a lot with my nieces. But it is getting better!
Left Hip Update
My left hip ached for a few weeks after the surgery since I was putting so much weight on it with the weight bearing restriction with my right hip. It could have also been a bit of bone pain from the screw removal. One major benefit from getting the screws out was that I could finally sleep on my left side after just a couple days post op!!
It was certainly a relief to my left hip to get off crutches at 6 weeks. Bearing all that weight helped regain some muscle but definitely flared up some hip flexor tendonitis. My physical therapist has been doing active release therapy which seems to be helping in just a few short sessions.
I am 9 months post op and finally able to say that I am very happy I had my left hip PAO and labrum repair!! My 7.5 month post op left PAO, labrum repair, bone shaving, and screw removal and two week post op right hip labrum reconstruction and bone shaving is pictured below.
