Thursday, March 25, 2010

Not all PAOs are created equal

I recently compared my x-ray with another hip chick's x-ray. Granted, all bodies are different and all surgeries are different too. People recover at different rates and have different reactions to medications and procedures. Surgeons use different protocols and techniques.

Her x-rays looked really different from mine. She only had 3 screws, and by the angle it looked like they were all holding the acetabular bone fragment in place and none were holding detached muscles. Her three small screws were all lined up neatly in a row, all pointing the same way. My 13 screws are much larger, in different places, and at various angles.

When she told me her surgery only lasted an hour, and that she was going to be off crutches and back in spinning class 4 weeks after surgery and back to work in less than 2, I started to wonder, did we have the same surgery? If I'm healing so darn fast (by all accounts), and I'm at 8 and 4 months respectively for dumb and dumber, then why does the thought of a spinning class even now make me shudder, knowing I wouldn't be able to walk at all the next day? And why did my surgeries, performed by an equally competent and well-regarded surgeon, take OVER SEVEN HOURS??

Why such a difference? In a relatively simple PAO, the acetabular bone is cut and reoriented and then screwed back in place. The quad muscles are not cut, and the hip capsule is not opened. In a not-so simple PAO like mine, the quad muscles are cut to access the hip capsule; the hip capsule is opened; and various things are done in there (from shaving impinging bone to re-shaping the femur to repairing a damaged labrum, all of which happened to me). All of this additional trauma makes for a longer recovery.

Broken bones usually heal much faster than traumatized muscles and soft tissues, so this all makes sense. It explains why, all other things being equal, some people heal much faster from their PAOs and are able to regain more function. Mystery solved!


Matt said...

If you ask the doc I'd be very curious to hear his answer.

ojulius said...

Holy crap, you had muscle cut? My PAO was much like the other woman's that you describe. 3 screws. If I recall, this is called a Gantz procedure or something along those lines.

ojulius said...

Hey Terri, for some reason I can't find your email. I'm sending a woman, Sarah, over to your blog. She had a PAO and used to skate. I think the 2 of you will have some things in common. :)