Surgical drains will be removed 1-2 days after surgery. Occassionaly patients require a blood transfusion.
Your incision will most likely be closed without sutures nor staples requiring removal, and will be sealed with a glue.
If you have chosen to obtain a “Game Ready” device, it will be applied at the time of surgery, and you will be trained to apply it and adjust it while in the hospital.
You will work with Physical therapy 2x a day and be encouraged to ambulate (with restrictions) as much as possible, starting the day after the surgery. Weighbearing is restricted to 30lbs on the operative side for 8 weeks after surgery to allow the osteotomy sites to begin healing. Most commonly patients utilize a walker for 3 weeks, and then transition to crutches. There are some restrictions on the range of motion after the surgery, including limitations to active flexion and flexion beyond 90 degrees. If labral surgery is performed, there may be rotational restrictions also. A continuous passive motion machine is utilized, allowing safe and controlled motion starting the day after the surgery.
*Each surgery is individualized, and therefore the specific restrictions and precautions for each patient will be different for each patient. We will spend a lot of time with you after surgery ensuring that you understand your unique protocols before you leave the hospital.
When Will I be Discharged?
Patients are discharged once pain is controlled with oral medications and physical therapy goals are met. In general, this takes 5-7 nights of stay in the hospital.
At discharge, pain medication is prescribed as well as an anticoagulant to prevent blood clots. Some degree of pain after discharge is natural, which may increase or decrease on different days, but the general trend should be toward decreasing pain. Some patients may sense an occasional “click” or “pop” in or around the hip. Numbness and a tingling sensation is common around the incision area. Patients experiencing new, severe pain or having ANY wound drainage, redness or seperation should call NHI (615-284-5800) regardless of the time or day to discuss with the oncall practitioner. *Concerns should NOT be sent by email.
When Do I Return to the Nashville Sports Medicine and Orthopaedic Center?
Follow-up outpatient visits are necessary to monitor progress by X-ray and physical examination, and to graduate patients to the next phases of rehabilitation. The first follow-up visit is usually scheduled about 6 weeks after surgery with Morgan Schlundt, the Physician Assistant. The second visit is at 3 months.
At 8 weeks after the surgery, the patient is allowed to be full weight bearing and work toward discontinuing use of the crutches (which usually takes 2-4 weeks).
Ultimately, your postoperative course depends on return of muscle strength. Working with a trained physical therapist adept in treating hip dysplasia is critical. You should develop a relationship with the therapist before surgery, and many patients benefit from working with therapists as part of the “pre-hab” strengthening program. These therapists will be critical in your post-surgical rehabilitation, particularly once weight-bearing is allowed after 8 weeks.
You will be asked to visit us 6 weeks after surgery (or see your local surgeon who might be coordinating your care locally), again at 3 months, at 6 months, and at 1 year and 2 years for routine follow-up. After the second year, we schedule appointments at 2 year intervals.
A minority of patients request removal of one or more screws that were used to fix the PAO, and this can be performed as an outpatient procedure that does not interrupt a patient’s continued full function. Patients who have undergone some femoral osteotomies at the time of PAO often require secondary metal removal for symptomatic implants.