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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Is Periacetabular Osteotomy Surgery A Complicated Procedure?

Age:32, Gender: Female Hi there - I m just looking for any information you may have about the frequency of complications in PAO surgery - I am particularly worried about the potential for permanent nerve damage to the pudendal nerve. I m a 32 yr old female, 5 9 125 lbs, otherwise healthy, but was diagnosed in 12/16 with pincer-type FAI (w/acetabular retroversion) in both hips by an orthopedic surgeon after looking at my Xrays. My left hip s been symptomatic for over a year, & the pain became constant (a labral tear is also suspected). I ve bee in physical therapy 2x a week since mid-December. Since my pain levels remain the same - and my right hip is becoming symptomatic in the same way - the surgeon I ve been seeing wants to refer me to a surgeon at Tufts or Lahey to look into PAO surgery. I m still waiting to hear from the doctor for the new doctor s contact info. In the meantime, I ve tried to do some research on PAOs. I ve not found much information about how often permanent nerve damage involving the pudendal nerve occurs. Given what functions damage to that nerve would impact, I m pretty worried. I m just looking for other opinions/information wherever I can get it, to better prepare myself when having the consult with the new surgeon. Any info you have would be much appreciated. Thank you, & take care. More details about the presenting complaint: Diagnosed with pincer type FAI w/acetabular retroverson, constant pain in anterior left hip for over a year. Pain wakes me up at night sometimes. Initial pain onset was 3yrs ago, intermittent, w/no obvious event causing it. Right hip has the same impingement & is also becoming symptomatic, despite doing physical therapy 2x a week for the past 3 months. I ve also begun using a stationary bike at home on minimal resistance for 45 min to an hour every other day to supplement my physical therapy homework exercises. The bike does not exacerbate my pain, fortunately. At recent ortho followup, I was informed I was being referred to a new surgeon at either Tufts or Lahey who performs periacetabular osteotomies, as the ortho I d been seeing does not perform that specific procedure. Current medications: 15 mg meloxicam once a day every day. 1000 mg acetaminophen every 6 hours as needed for hip pain. I still experience breakthrough pain on these medications most days, but do not want to take stronger medications or narcotics, as they upset my stomach a lot. Unrelated to the hip condition, I also take a daily multivitamin, an albuterol inhaler for asthma & sumatriptan 100 mg for migraines when they occur; one at onset - repeat in 2 hrs if needed/not exceeding 2 tablets in 24 hrs. Lab tests performed: X-ray
Mon, 4 Feb 2019
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Anesthesiologist 's  Response
Hello,

As far as the problem your problem is concerned you have been advised in a correct path taking suitable medication. Pain or deformities are corrected only by surgery. This is the best option for long term results.

Long term painkillers will effect kidneys, hip problems will increase and activity will reduce. These are the main side effects if you're not opting for surgery.

Hence you can go ahead with proper surgical treatment periacetabular osteotomy is a good surgery preserving most of the original tissues.

Any treatment has risks ranging from0.01 to 1 per cent nerve injuries. I personally advise you to accept this mild risk to prevent long term disability.

Hope I have answered your query. Let me know if I can assist you further.

Take care

Regards,
Dr Anusha Molugu, Anesthesiologist
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Is Periacetabular Osteotomy Surgery A Complicated Procedure?

Hello, As far as the problem your problem is concerned you have been advised in a correct path taking suitable medication. Pain or deformities are corrected only by surgery. This is the best option for long term results. Long term painkillers will effect kidneys, hip problems will increase and activity will reduce. These are the main side effects if you re not opting for surgery. Hence you can go ahead with proper surgical treatment periacetabular osteotomy is a good surgery preserving most of the original tissues. Any treatment has risks ranging from0.01 to 1 per cent nerve injuries. I personally advise you to accept this mild risk to prevent long term disability. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Anusha Molugu, Anesthesiologist