climbing/skiing after hip surgery (specifically periacetabular osteotomy)

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. 

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!!

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. 

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. 

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

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?

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.

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 

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.

Hi all, I am an avid rock climber who is about to have a total hip replacement surgery due to osteoarthritis . My orthopedic surgeon strongly recommends to completely stop climbing after surgery (forever). His concern is the possibilities of the ball popping out of the socket due to the loads and stress put on the hip from climbing. Apparently if this happens you have big problems. I have asked about the possibility of just climbing easier grades. Again he insists its not worth the risk. If you have knowledge and/or experience in this area I sure would appreciate your thoughts. Thanks.

I've had labrum acetabular surgery and reconstruction twice  on my left hip. Turns out 15 years of ice hockey is bad on the hips and essentially dissiengrated my labrum. Total recovery was about 6 months, but I was walking and doing light activity in a few weeks. I still have hip pain but don't find it incredibly limiting. I ski and climb (moderately) definitely not "aggressively" however this is not due to my hip but rather my athletic abilities in general. I'm out most weekends without complaint. My advice is to be incredibly diligent about PT. 

I had 2 prior hip surgeries.  I labral clean up.  1 labral reconstruction at Steadman Clinic. Now a replacement of that same hip.  Climbed again after the last 2.  Now wondering what will happen.  Anyone who had their hip replaced willing to comment on how long until they were back to climbing?

Thanks
Claudine

I've had both hips replaced in my early/mid 50's, one about 7 years ago and the other probably 4 years ago.  Had very positive results, as prior to the surgeries I experienced a lot of pain walking, couldn't sleep, couldn't remain seated in the same position for any length of time, etc.  All of those issues resolved fully, so definitely improved my quality of life greatly.

My recovery to basic function was pretty quick, I was able to return to work after 2 weeks (I'm a social worker, so needed to drive, get up and down and walk a fair amount, but nothing too strenuous).  I was biking within a few weeks and did some toproping about the same time, though my surgeon was pretty appalled to hear that, and it probably wasn't the best idea in hindsight.  Mostly you really want to avoid dislocation, which is much more common in the first several months post surgery.  I rationalized that doing things other than the prescribed walking and PT were good for strengthening and range of motion, and they may have been, but they created the risk of falling or putting the leg in a position that would have levered the hip out, which would have been bad.  However, it didn't feel that fragile, and I was pretty careful, and it worked out OK.

I found improvement slowed after the first month or two, but progressed in small increments for a year or two.  The one concession I've made permanently is avoiding groundfalls or jumping down from things, as I can imagine a sudden, uncontrolled loading of the joint in certain positions could be a problem.  So I use a stick clip now and don't boulder at all, am much more cautious in talus and boulder fields.  There are also a few yoga positions that are off the table, like pigeon, as I can feel it putting stress on the involved hip in a way that feels bad.

Couple other things that I think are important--definitely tell your surgeon about your lifestyle and what you want to maintain.  I lobbied for a larger ball, as I think it's more stable and gives better range of motion.  I also wish I had done a program of stretching prior to the surgery, as my muscles had tightened significantly from favoring the bad hip for several years, which neccesitated using a shorter implant, which resulted in my leg being shorter after the first surgery.  However, the second one ended up evening things out, so it worked out OK.

I had a total hip replacement about three years ago.  I can do all of those climbing maneuvers without significant limitation.  It took about a full year to feel confident with stemming and drop knees.  Other things that I can do are: hike and bike without limitation, ski telemark with no problems from the hip, heavy weight lifting, endurance horse racing.  Running is more problematic.  If it were my passion, I would do it but I never really loved it so I'm just not doing it anymore.  I have run up to 10k on trails since the replacement but I didn't think it was a good idea so I quit.  Figured I should save the wear and tear on the prosthesis for stuff I really like to do.  I can't sumo deadlift over 400 lbs without my replaced hip complaining.  Don't seem to have any limitations from the hip with conventional deadlift or squatting below parallel.  Anyway, that's been my experience so far.  Who knows what tomorrow may bring.

Only issue I have involves drop knees where one leg crosses the other and rotates simultaneously.  I feel resistance in that position, so don't push it any further.  Otherwise, range of motion significantly beyond what the official recommendations are, with my surgeon's tacit approval.  As I said, my biggest fear now is an uncontrolled fall which I could imagine twisting and bending my legs around in a way that would lever the artificial joints apart.  So, no bouldering.  I also ski much more conservatively, as I can imagine a tumbling fall with skis on would be kinda risky. 

I had a PAO 10 months ago and am climbing 5.12 sport and 5.10 trad, including big alpine days. If anyone wants to chat about the recovery or who’s debating PAO with a THR, let me know and I’d be happy to!

I am now 3 weeks out of the THR.  I hiked 3 hours this weekend.  I hope this bodes well for the future.  Still no climbing as I fell on my hand 3 days out of surgery and tore a tendon in my hand.  That seems to be my bigger problem now for climbing!  Bad luck I guess.

I forgot about this thread and am glad to have found it again. It turned out I'm not a candidate for PAO, and instead need a double hip replacement. I was advised to wait however because I don't have enough arthritis yet. The labral tear and broken cartilage were caused by an accident and are not repairable because of (previously undiagnosed) hip dysplasia. They told me that arthritis hardens the hip complex and that hardening holds the replaced joint in place... they said I would be at significant risk of dislocation if I didn't wait. I found that reformer pilates has been immensely helpful in strengthening key support muscles and I've been able to return to weight lifting, long distance thru hiking, climbing, etc after the accident for the past 2 years now. I have pain EVERY day, but once I get moving it dissipates. Now it turns out, I am dealing with lumbar stenosis and need spinal surgery in December. I have no idea if it's related to the hip issues or how it might affect them, but I'm very curious to get through with it and see. Maybe I can put surgery off longer if this takes care of more of the issue. 

For those with THRs... did you go with anterior surgery? Did you get to choose specific hardware? Curious if any of you are in WA and who your surgeon was... I'm planning to use Dr. Barrett in Renton, but he may retire before I'm ready. 

Front approach is key.  I did mine in NH.  Still have Soaz tendon issues and lifting my leg is a nightmare.  However, the terrible bone pain is gone.  Good Luck!