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How a PAO is done – in layman’s terms March 1, 2010

Posted by hiphoperation in The op.
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A doctor and fellow PAO patient recently described how a PAO is done:

The cutting is done in part with mallets and chisels (exactly like a carpenters!) and a small electric saw… The leg is moved from straight to bent at hip and knee throughout operation but very little twisting, to ensure freedom of joint movement and to get to the joint. He [the surgeon] puts a big screw called a swhanz screw into the pelvis near acetabulum and once all the bone cuts (or osteotomie) are done uses this to mobilise the acetabular fragment and with use of x-rays gets it into the best position. Then uses 3-4 (4.5 mm wide and 10-14cm long) screws to fix it in place.

He then reattachs the two muscles he cuts to get to the hip join back to the pelvis with fibre wire. Stops all bleeding and closes. It’s obviously a lot more complicated than that and takes about 2-3 hours.

Simple as that!


Introduction September 13, 2009

Posted by hiphoperation in Pre-op.
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I was born with congenital dislocation of my right hip and thanks to some surgery between the ages of one and four I have lived a normal life without any major problems. My right leg is definitely less flexible but this has only been a problem when attempting to do things like yoga.

Almost two years ago, I started to get pain in my hip after walking for long periods. This coincided with a move back to London so I put the pain down to marching around on concrete and being generally unfit. The pain got more regular and progressively worse so in summer 2008 I finally went to my doctor to ask for advice.

I was refered to University College Hospital and had a couple of x-rays and MRI scans. My x-ray (below) showed damage to the hip socket and that the ball of the hip was not in the ideal position.

Note - the ball was to show how big a hip replacement might need to be

I don't have a ball up my bum. It is supposed to show how big a hip replacement might need to be.

From this you can see that the ball is not sat in the socket properly

From this you can see that most of the ball is outside of the socket.

The various scans also found that my hip socket was quite shallow and that the top of the femor is also an irregular shape. So all in all, a pretty dodgy hip. And to make it worse, the surgeon told me that it is common for hip problems to resurface as you approach 30!

In May 2009 I had a hip arthroscopy to investigate the source of the pain in my right hip further. The surgeon found damage to the hip socket as a result of the ball and socket not fitting together properly. To prevent further damage, it was recommended that I should have a periacetabular osteotomy (PAO) to fit the two parts together. He told me that this wouldn’t enable me to cross my legs properly but had a very good chance of getting rid of the pain. He also told me that the surgery should delay a hip replacement – I will have to have one (or more) but not for a while hopefully…

So I am now booked in for my PAO on Tuesday 22 September. I have created this blog as a way for me to put down my thoughts and hopefully manage my nerves and frustration. I don’t expect anyone to read it but there might be others going in for similar operations in the future who will find it useful.