Preservation Surgery for Hip Dysplasia

Blake Sadorf, of Oconomowoc, was in his sophomore year at Marquette University when he noticed his left hip aching during runs. He added more stretching to his routine, but the pain lingered. He gave up running and tried to ignore his painful hip, but eventually even sitting in the car was difficult.

“Finally, I thought, ‘I need to try to do something about it,’” he said.

After trying months of physical therapy at another health system, Blake turned to the Froedtert & the Medical College of Wisconsin health network for a second opinion. 

Imaging tests revealed he had hip dysplasia, an abnormality of the hip joint that likely occurred during his development. His hip socket was tilted backward instead of forward, a condition known as retroversion of the acetabulum, which affected how the ball of his femur (thigh bone) fit into his hip socket. The shape of his hip caused a painful condition called hip impingement, and it eventually damaged his labrum, a ring of cartilage around the rim of the hip socket.

Blake first saw Demetrios J. Douros, MD, orthopaedic surgeon and MCW faculty member who ordered imaging tests and gave Blake a hip joint injection to treat his pain and inflammation. Dr. Douros then referred Blake to Caitlin Orner, MD, orthopaedic surgeon and MCW faculty member who treats complex hip cases in young adults. Blake’s situation was also discussed at the monthly orthopaedic specialty board so the team could create the most appropriate treatment plan.

“It’s so important to have a team approach when a patient’s issue is complex,” Dr. Orner said. “We have an extremely well educated, multidisciplinary team of people who specialize in the hip. This is what we do all day, every day.”

“I’m glad I got multiple opinions,” Blake said. “I really liked how they didn’t jump to any conclusions right away.”

Fortunately, Blake had options to preserve his hip.

“A hip replacement is a great surgery, but it’s not always the answer, especially in young patients or patients with arthritis,” Dr. Orner said. “And the longer we can save hips, the better.”

Hip Preservation Procedures 

In January 2024, Blake went to Froedtert West Bend Hospital for a hip arthroscopy, a minimally invasive procedure that uses a small camera and tiny incisions to access the hip joint. During the arthroscopy, Dr. Orner repaired Blake’s hip joint labrum and reshaped his femoral head to make it rounder.

About a week later, Blake had a more complex open surgery at Froedtert Menomonee Falls Hospital.

“When patients have dysplasia or retroversion, I sometimes have to make cuts in the pelvis bone to change the alignment of the hip, which is what we had to do for Blake,” Dr. Orner said. “This is called periacetabular osteotomy, or PAO. It was a bigger surgery and a longer rehabilitation process. Blake did really well.” 

For the PAO, Dr. Orner made a series of cuts in the bone to mobilize the socket before using screws to stabilize it in a new position. Dr. Orner is one of few surgeons in the region who perform this specialized hip preservation procedure, which can reduce pain, restore function and prevent further deterioration of the hip joint.

A PAO is not recommended for every hip case — people with progressive cartilage injury and arthritis may not be good candidates for the procedure. For patients like Blake, it can eliminate the need for a total hip replacement or postpone it for decades.

Rehabilitation Facilitates Smooth Recovery

Blake recovered at his parents’ home, attending his college classes virtually. He had to use crutches and avoid weight-bearing activities for six weeks. Total recovery typically takes nine to 12 months, and Blake continued with physical therapy for about six months.

“We have amazing therapy teams who are experienced at taking care of these patients, and physical therapy is extremely important for a smooth recovery,” Dr. Orner said.

The hard work of rehabilitation was worth it. Blake has returned to everyday activities and sports, including basketball, volleyball, pickleball, running and biking.

“I’m really happy with the results,” Blake said. “I would totally do it again. I wish I’d had it done sooner.”

Now a medical student in Des Moines, Blake is considering a career as a surgeon and has already talked to Dr. Orner about a shadowing experience.

“After my surgery, I thought it would be super cool to help people like she does,” he said.

Early diagnosis and treatment of hip problems can preserve your original hip joint. Froedtert & MCW surgeons offer the latest and most comprehensive hip preservation treatments. Call 414-777-7700 for an appointment. Learn more at froedtert.com/orthopaedics/hip-preservation.