Mariah

My Hip Dysplasia Story X 9

My first hip surgery was on March 27th, 2012 and since then it has been eight years. I knew I needed to write my story down, but after the grueling physical pain that I experienced for four years straight I was emotionally burnt out. Fast forward now to May 19th, 2020 and I wish that I had wrote my story down when it was fresh in my mind. I am relying on my family and the surgical notes and dates I have, as some of the details I tried to push out of my mind because they were too painful to bare. For four years I relied on God and my family to take care of me and help me get through 9 major surgeries. I did not have a normal high school career like most teens. The hospital and doctor’s appointments became my second home and I became all too familiar with crutches, Tylenol, and physical therapy. In high school I had a few nicknames that followed me throughout all 4 years- Gimpy, gimp, crip, cripple, crutchy, hippy, and Shakira (because my hips don’t lie). It is nothing short of a miracle that I graduated High School in addition to receiving my Technical Honors diploma from my dental assisting school. Prior to my hip surgeries, I ran track, participated in 5K’s, played indoor and outdoor soccer, and had the honor of being asked to join a travel soccer team in Wisconsin. When we moved to Indiana my freshman year that is when my life changed forever. Here is my story…

After trying out for my high school soccer team, I fractured my hip. After visiting five different doctors we met Dr. S. Orthoindy.com states, “Dr. S serves as the orthopedic consultant for the Indy Racing League and Indianapolis Motor Speedway. He is a member of the Orthopedic Trauma Association and the American Academy of Orthopedics. He is board certified by the American Board of Orthopedic Surgery.” My mom, dad, and I met Dr. S and had a consultation regarding my hip dysplasia. What is Hip Dysplasia? According to the Mayo Clinic, “Hip dysplasia is the medical term for a hip socket that doesn’t fully cover the ball portion of the upper thighbone. This allows the hip joint to become partially or completely dislocated.”

During the duration of our meeting he was very attentive to my needs and thoroughly explained a treatment options & that my hip sockets were not deep enough. A Periacetabular Osteotomy surgery is performed to prevent arthritis and relive pain. According to the International Hip Dysplasia Institute, “Osteotomy means that the bone is divided and shifted to a better alignment. Osteotomy on the socket side of the hip is called “acetabular osteotomy” (PAO) is the most common procedure for young adults. This surgery involves cutting the pelvis around the hip joint and shifting it into a better position to support the stress of walking. After the hip is re-positioned, it is held in place with screws until the bone heals. As you might imagine, this operation is complex and usually performed in specialized centers that do this procedure on a frequent basis. After the operation, patients should not put full weight on their leg for up to three months, so crutches or walkers are often recommended along with a wheelchair for longer distances until the bone had healed in its new position.” He explained that the surgery entailed anesthesia, a break in the pelvis in 3 places, dislocation of the femur, hollowing out the hip socket making it deeper, and realigning the femur into the hip socket so it’s straight and sits in tighter. After Dr. S explained the procedure to me and what it entailed I felt overwhelmed and taken back by my diagnosis. The reality of what my life would be like until my hips were “fixed” was hard for me to comprehend. Prior to receiving my diagnosis, I felt as if my hips were literally tearing with each step I took and not knowing what caused my pain was immensely frustrating for my 16yr old self. After Dr. Scheid explained the procedure my parents and myself included felt it was right to proceed forward with it, so we scheduled my right hip (the worse of the two) to be done first.

On March 27th, 2012 I was scheduled for my right hip Periacetabular Osteotomy. Due to my surgery being so long ago I vaguely remember my initial feelings from this morning (kicking myself now for not journaling such a pivotal point in my life) After four hours I woke up in the recovery room on morphine with a 20cm incision on my right hip. I had a bulky dressing on my hip and a wound irrigation system attached to my hip for maximum healing. After the anesthesia wore off, I was still very out of it from the morphine and drifting in and out of sleep. The recovery from my right hip surgery was exceptionally difficult. Learning how to walk again was the most difficult thing I have ever done in my life and the amount of physical pain I felt is indescribable. I dealt with extreme nausea that ultimately led me to an unexpected weeklong stay in the hospital. The summer after my surgery I spent most of my days at physical therapy appointments, regaining strength through home workouts and laying out at the neighborhood pool suntanning.

On July 16th, 2012 I had an appointment with Dr. M due to experiencing some groin pain after returning from girl’s camp. At camp I did a lot of walking which easily made my hips sore and achy. At the appointment we discussed options for treatment of my torn labrum which included proceeding with arthroscopic surgery then or waiting to see if I continued to have pain as my osteotomy continued to heal. Ultimately, I decided to consider my treatment options at home with my family prior to making a final decision. We decided to move forward with the arthroscopic surgery and on October 25th, 2012 (two days after my birthday) it was completed. Doctor M preformed a labral repair and proximal femoral osteoplasty to help relieve my pain. There was an internal detachment between my cartilage and labrum with a type two tear. It’s fascinating to me that I read in my pathology report that the bony aspect of the acetabulum was then roughened with a motorized shaver which created a bleeding surface. Then, the labrum was reapproximated to the acetabular rim with two 2.3 mm osteoraptor suture anchors. This process ultimately made my labrum stable again and able to properly function without increased pain. Undenounced to my family and I, if we had completed the labral repair at the time of the PAO or prior to: the initial PAO most likely wouldn’t have been so painful due to the tendon being torn on top of my broken pelvis. I returned for a post op visit to Dr. M office on November 2nd, 2012 in which we discussed the progress of my healing. At this point I was weightbearing as tolerated with crutches. I had been continuing with physical therapy and making small strides weekly.

After months of strengthening my hip through physical therapy I was finally at a point where my right hip and the surrounding tendons were as strong as they could be. My left hip PAO was scheduled on June 4th, 2013 in conjunction with an arthroscopic labral repair done by Dr. M and Dr. S. At this point, I was seventeen years old. For Dr. M’s portion of the surgery, he discovered extensive tearing and instability in the labrum. Once his portion of the surgery was complete, Dr. S started the PAO. A fifteen-centimeter anterior incision was made over the hip, centered over the anterior superior iliac spine. The surgery was completed four hours later with success. I woke up in the recovery room with a bulky dressing over the incision and a wound irrigation system intact. This time around, my incision was glued as well as stapled. The staples on both sides of the incision looked like train tracks all the way down. It was not any easier going into my second PAO because knew how sick I got the first time and how painful it was due to not being able to take any pain meds. The long road to recovery ahead entailed, dreadful long nights in excruciating pain, taking my first steps after the surgery, countless physical therapy sessions, missing out on another year of sports, church dances, and socialization with friends.

On October 28th, 2013 I had an appointment with Dr. M after my postop visit with Dr. S due to painful snapping in my right hip. Dr. S sent me over to Dr. M for a second opinion on a possible rescope with hardware removal. After discussing treatment options my family and I agreed to go forward with a left hip arthroscopy labral repair, iliopsoas tendon release and hardware removal. In the office I had the injection procedure done and it went well. I returned on November 11th, 2013 for left hip incision drainage. The proximal incision from the recent hardware removal had been mildly bleeding. On November 13th I returned to Dr. M’s office for a quick postop after my labral repair and hardware removal and had the sutures removed. On November 21st, 2013 I had the arthroscopic surgery on my left hip for labral repair, iliopsoas tendon release and hardware removal. The same night of surgery I noticed that my leggings were wet on the incision site and after discussing my symptoms with the doctor, they instructed me to come into the office the next morning for an emergency appointment. The doctor had me pack the wound with wet to dry gauze and had me proceed with caution. On November 29th, 2013 I was admitted to the OrthoIndy for irrigation and debridement to bone along with closure of my 3cm wound. During the procedure, multiple liters of irrigation fluid were used to irrigate the wound. The screw hole was over drilled with a 3.5 drill bit and a repeat irrigation was performed. After that, the wound was then closed and then a bulky dressing was applied to the site.

On December 21st, 2013 I opted for an exploratory surgical prevention to determine the cause of the continued snapping in my right hip. While in surgery, Dr. M discovered that my labrum was healed and intact circumferentially. I had dense scar tissue anteriorly in between the iliopsoas tendon and the reflected head of rectus. I had adhesions from the dense scar tissue to the capsular side of the labrum. One area that the doctor thought could be impinging still was taken care of also. The incisions were closed, and the surgery was successful. On December 27th, 2013 I had a follow up with Dr. M and we discussed my progress and the moderate groin pain I was having on the right hip. At this point I was seven weeks post left hardware removal-deep, hip arthroscopy, and one-week status iliopsoas release.

On January 8th, 2014, my family and I met Dr. S at the hospital because I had symptoms of a fever and the incision site was swollen and draining. I was seen in his office earlier that morning due to recurrent fluctuant buildup of fluid over the anterior iliac crest. I had the small wound dehiscence several weeks ago following the hardware removal and had the irrigation, debridement, and wound closure. Given my flu-like symptoms Dr. S was reasonably certain that I had a wound infection. Since my parents and I showed up to the hospital for an appointment that morning, it was a surprise that I was admitted to the hospital for surgery following my appointment. The surgery was inpatient so they could monitor my care overnight and the following day. Once I woke up from my surgery an infection control specialist came into the room and explained the steps that she would take to insert a picline into my arm to prevent the spread of the staff infection. The steps go as followed: sterilize site of insertion, make an incision for tubing insertion, feed the tube to heart while watching tubing move on ultrasound on my arm.

On November 17th, 2014 I returned to see Dr. M for hip pain that would appear randomly sporadically while exercising a few times per week. Dr. M reviewed my x-rays that he ordered while I was there with my dad and I. Structurally, I looked solid, even though my hip was irritated with certain movements. He seemed to think that my pain stemmed from poor mechanics, decreased strength or an irritated iliopsoas tendon. He recommended that I see a physicial therapist for treatment  and a full evaluation of my mechanics. He felt that I was okay to leave on my mission in Colorado that I was assigned to from The Church of Jesus Christ of Latter Day Saints. He instructed me to treat my hip pain symptomatically with ice and the appropriate medication.

On December 5th, 2014 I had my very last hip surgery (#9) to remove the remaining hardware. I had been experiencing some nagging discomfort, so I opted for surgical intervention. I did not want to leave on my mission only to find out that I had to return home early due to the screws that kept nagging me. Through small stab wounds the hardware was removed, both from the iliac crest as well as the deeper hardware. The wounds were thoroughly irrigated and closed. Under fluoroscopic guidance, an intraarticular right hip joint injection was performed. The surgery was successful, and my small incisions healed fine.

Since day one I was diagnosed with hip dysplasia I embarked on a journey that would forever change my life. I ultimately decided that I was not going to let this trial limit me from being the best version of myself. With Every surgery, sleepless night, tear I’ve cried, relearning how to walk, triumphs, achievements, I’ve come to one conclusion about my life as a whole and my hip surgeries during those brutal life changing 4 years of surgery after surgery; life is constantly changing and we as humans are constantly evolving into who we are to become. The choice is ours to decide how we are going to live our lives and if we are going to let our trials tear us down or be the reason we come back stronger and more resilient.



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