PAO surgery vs. torn labrum repair? Confused!

kmk42019

new member
Joined
Oct 14, 2016
Messages
4
Age
40
Location
Baltimore, MD
Country
United States United States
My wife and I went to the doctors because she's been having right hip pain the last few weeks. He said that she has mild hip dysplasia and a torn labrum on her right side. We want to have kids soon and are confused with our options.

Option 1: repair torn labrum arthroscopically and hope that it holds for a while. The cause of the torn labrum remains unrepaired(due to hip dysplasia) but it will help with the pain. Recovery time about 6 weeks on crutches.

Option 2: Do the PAO surgery(periacetabular osteotomy). This surgery is much more invasive , where he would be cutting the bone and rotating it. He's only done 30 of these. It would correct the issue that caused the torn labrum but it's a much more intensive surgery. Recovery time is about 6 weeks on crutches also.

We are confused on what to do here. She's only 33 years old. We could do the less invasive operation that only corrects the torn labrum but the underlying cause is still there. Or we could do the PAO and risk a more complicated procedure that corrects the cause of the torn labrum. Any advice will be so greatly appreciated. We are confused!


Sent from my iPhone using BoneSmart Forum
 
Hi I think you have to weigh both options up. If the underlying condition isn't sorted then it risks the labrum getting more damaged. Do you have doubts due to the surgeons experience at the 2nd option? With the labrum it depends how bad the tear is sometimes they can repair it other times they have no choice but to do a debridement which is what happened to me so they cut the tear out and cleaned up the damage. I'm in my 30s also so understand the effect it has on your wife.
 
I don't think either of those are good options. It depends upon how damaged that labrum is and whether there is any collateral damage in the joint itself. You need to read this to understand it more Femoro-Acetabular Impingement (FAI). If the damage is advanced, then you really ought to be thinking about a hip replacement. Otherwise she could be spending up to 10 months in significant pain and still end up with little or no benefit.

You will probably have made a big intake of breath at the suggestion of a hip replacement at her age but it's not that uncommon. We've had lots of members in their 30s, many in their 20s and even a few teenagers! Teenage hip replacements

You might like to see our star, shugaplum, who had her hip done at the tender age of 24 and two years later, which was last year gave birth to a fine baby boy!

2 shugaplum's lift 4m small-horz.jpg


You'll probably be thinking 'how long will it last' which won't be surprising but modern hips last well and so if some surgeon start talking about them lasting 10 years and every 10 years she'll have to have it done again, you'll know it's not true!
Longevity of implants and revisions: how long will my new joint last
Hips that have lasted 32, 40, 41 and 45 years
67½ year old - the THRs, not the patient!
 
Hi, I was diagnosed with the exact same condition as your wife about six years ago. I was 39 and told that I had a labral tear, as well as hip dysplasia that was mild on one side and moderate to severe on the other.

I went to see a surgeon in the DC area who had an amazing reputation for repairing these types of tears who told me that arthroscopic surgery was not an option for me. Like your wife, my hip dysplasia is the underlying condition that is causing the wear and tear, labral tear and other issues. The surgeon told me that the arthroscopic surgery would not help me due to the underlying condition and the arthritis that would eventually follow.

I now have a completely arthritic hip and I am going to have to get a hip replacement. PAO was never an option for me. It was way too invasive and there was no way I'd consider it. I would seek several opinions before proceeding just so you know all of your options. Incidentally, the initial pain from the labral tear actually got better over time - oddly enough! It is just the arthritis that I deal with now.


Sent from my iPhone using BoneSmart Forum
 
Welcome @kmk42019 - both options sound incredibly painful and from what people mention on here and you read the recovery is tough for arthroscopy. PAO sounds excruciating!

I was 33 when I had my son. So I understand you wanting to have kids soon. I had a tough pregnancy with my hips so there really isnt any advice I can offer you both except that I am thinking of you both with this tough decision. The only thing I would suggest is getting a second opinion.
 
Hi there, I went to see Dr. Andrew Wolff in Bethesda. He was fantastic! I actually saw him twice; once for the left hip tear and then a few years later when a second tear developed on the right side. Both times he told me that arthroscopic surgery is a tough surgery to recover from and I only had a 50/50 chance of feeling better. He also said that I would eventually need a hip replacement anyway due to the arthritis so there was not much point in pursuing arthroscopy.

At the time, he did not participate with insurance so he's out of network but I just paid out of pocket for an office visit. I want to say it was only $150 or so, but worth every penny in my opinion. Here's a link to his website:

https://andrewwolffmd.com/

Good luck and keep me posted!


Sent from my iPhone using BoneSmart Forum
 
Hello,

I'm wondering what your wife ended up doing? I find myself in the same situation and live in the Annapolis area. The idea of the PAO is very daunting and I've read some things online that make me extremely hesitant. Would love to hear what your decision was.

Thanks!
 
@acadw welcome to Bonesmart! Unfortunately, the person who started this thread has not been back to Bonesmart since December 2016. He may still see your comment and respond here, but you might want to start a thread of your own as well. That will get more attention from other members who have something to contribute.
 

BoneSmart #1 Best Blog

Staff online

  • Jaycey
    ADMINISTRATOR Staff member since February 2011

Members online

Forum statistics

Threads
65,181
Messages
1,597,065
BoneSmarties
39,365
Latest member
Dave4562
Recent bookmarks
0

Latest posts

Back
Top Bottom