JOINT BASE SAN ANTONIO-FORT SAM HOUSTON, Texas —
Brooke Army Medical Center orthopaedic surgery recently celebrated a milestone, completing the 100th hip preservation surgery for adult hip dysplasia.
The procedure, called periacetabular osteotomy, or PAO, involves cutting the pelvis around the hip joint and shifting it into a better position to support the stresses of walking. After the hip is re-positioned, it is held in place with screws until the bone heals. After the bone heals, the screws can be removed, but this is not usually necessary.
“PAO is only performed at select medical centers throughout the United States because of the complexity of the procedure and the advanced training required,” said U.S. Air Force Lt. Col. Matthew Schmitz, chief of the young adult hip preservation service at BAMC. “Young adult hip preservation is a relatively new service in orthopaedic surgery, focusing on surgical techniques to correct anatomic problems of the hip joint in active patients to delay or potentially eliminate the need for hip replacement.”
Schmitz started the Department of Defense’s sole Young Adult Hip Preservation Service at BAMC in 2012. As the only high-volume PAO center within the Department of Defense and South Texas, BAMC has become a referral center for beneficiaries with dysplasia requiring surgical treatment with 50 of the PAOs being performed in the last two years.
“Adult hip dysplasia is being more commonly recognized as one of the primary reasons for a young person’s hip to fail and cause significant pain, disability, and early arthritis,” Schmitz said. “If caught early in childhood, dysplasia can be treated with non-surgical means, but once a person has entered their teenage years, the only surgical treatment is PAO.”
Schmitz says he is committed to hip preservation and studying the outcomes of these procedures. His work has been highlighted with his acceptance into the Academic Network of Conservational Hip Outcomes Research and with a recent publication in the Journal of American Academy of Orthopaedic Surgeons titled “Developmental Dysplasia of the Hip in Adolescents and Young Adults.”