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climbing/skiing after hip surgery (specifically periacetabular osteotomy)

Original Post
Max S · · Steamboat Springs, CO · Joined Aug 2017 · Points: 0

I was just wondering if there are people out there that have had PAO (periacetabular osteotomy) surgery and have been able to return to trad climbing and/or skiing hard, and what was your time frame to return? I'm supposed to get this surgery on my left hip in 6 weeks because I have hip dysplasia in that hip as well as a torn labrum. Also, I've been told by multiple doctors that I am too young, early-mid twenties, for a THR. I work as a guide in the summers and patroller in the winter, so I'm just wondering if there are others who are super active and aggressive climbers and skiers that have had this procedure? Any and all thoughts are appreciated. Thanks. 

Greg Egbert · · Unknown Hometown · Joined Feb 2017 · Points: 0

I didn’t have the same surgery, but I did have hip surgery to repair a torn labrum and fix a bone defect in both the hip and femur. For me it was six months before I started climbing and about 12 months before I felt comfortable doing anything. I still have issues almost 18 months out but they are tolerable. One advantage you have is your age (I’m almost twice your age.) My advice to you is to follow your doctors orders, do the PT as directed (hopefully your doctor has a cadre of PTs at his disposal), and don’t try to get back to full activity too quickly. You’re young and have a lot of life ahead of you. An extra month or two or more now to ensure you can climb/ski hard later in life is totally worth it.

Alyssa K · · South Lake Tahoe · Joined Mar 2014 · Points: 35

Haven't had it done, but I just want to advocate for getting a second/third opinion! I also have hip displasia and have torn my labrums multiple times. A Stanford ortho was really pushing for me to do the PAO surgery but I was reluctant since it's honestly a pretty horrifying surgery. Ended up doing a capsular plication (basically tightening the hip socket) to resolve the instability that was causing the labrum tears. 5 years later, so far so good (was back to long alpine days with a pack after about 10-12 months). Although I now avoid bouldering falls and running on pavement, both of which I think led to the labrum tears.

And I want to second what Egbert said: PT will make or break whether you have a full recovery, a good PT is absolutely worth the time and money!!

Max S · · Steamboat Springs, CO · Joined Aug 2017 · Points: 0

Hi guys, thank for your replies. I totally agree about PT, and like most in the climbing community im super motivated to work hard to recover.

Alyssa, do you have borderline dysplasia? I've had 5 opinions now (3 say surgery, 2 say wait) and have read extensively into dysplasia and treatment options and have never come across capsular plication for treatment of moderate to severe dysplasia. And yea, the PAO does seem shitty, but the idea is to do it while I'm young and still have intact cartilage, better ability to recover, and, if all goes well, not have to worry about my hip for a loooong time. 

Cheryl Perry · · Bellingham, WA · Joined Dec 2017 · Points: 0

I am facing the possibility of PAO as well and havethe same question. I'm 41 though and on the border of age for that surgery. I won't know more until ican see the surgeon in September. It was complicated (and discovered) because if car accident. Hoping to avoid THR for awhile. 

Max S · · Steamboat Springs, CO · Joined Aug 2017 · Points: 0

cheryl, you can message me if you have any questions. I'm getting it done in 2 weeks

simone A. · · Unknown Hometown · Joined Jul 2018 · Points: 0

hi guys
I'm happy to have found this forum... I think, I have the same diagnosis as you MAx. Borderline dysplasia... Since a week it is clear, that I have to do a PAO... I'm afraid of the consequences of this operation.. I hesitate a bit because I'm not sure if all the sport like climbing, ski touring, trail running,...  is possible (painless) after that operation? Of course the surgeon say yes, it is. What are your opinions/experiences?

Max S · · Steamboat Springs, CO · Joined Aug 2017 · Points: 0

Simone, I just got left PAO surgery 5 days ago, so it is too early to tell the outcome, but you can direct message me if you have any questions.

Luna Luna · · New Haven, CT · Joined Mar 2016 · Points: 60

if found this thread a few months late.. but I had a labrum repair on my left hip about 6 weeks ago... I'm being told it will be about 3 months until I'm allowed to lead again but I'll be limited for 4-5 months.   Right now I'm walking and allowed to TR with limited mobility but as long as I don't push it NO PAIN!! where there was constant pain before.

I didn't have hip dysplasia, but I had completely torn the anterior aspect of the labrum so... 6 weeks walking and on TR with no pain doesn't seem so bad.. the hardest part is being okay with "taking it easy" and gaining a little weight, because I'm not allowed to do much 

fossana · · leeds, ut · Joined Apr 2006 · Points: 13,231

I had a labrum repair (w/o PAO) in 2007 at Steadman-Hawkins (now Steadman-Philippon) in Vail. I didn't have a traditional labral tear symptoms, but rather years of hip flexor tendonosis (one incident of hip locking) from ultrarunning and no relief from PT or other less invasive measures.  Several orthopedists advised me that the tear was causing instability and the source of my symptoms.  Steadman-Hawkins was aggressive with pushing low impact exercise immediately after surgery, so they put me on a stationary bike within 12 hours of surgery.  I was told that the main thing to avoid was falling on that hip, but otherwise I could bike and hike.

The surgery did nothing for the tendonosis.  Ultimately, I cut way back on running mileage and my symptoms became manageable.  Since then I've returned to high mileage and long alpine days. In retrospect I don't think I should have had the surgery.

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