June 14, 2019
Sydney Potkanowicz started experiencing hip pain at the young age of 12. “It felt like my hip joints were slipping in their sockets. It was a constant painful, uncomfortable feeling,” she says. Sydney’s mom blamed growing pains, puberty and an active lifestyle for her daughter’s aches. By the time Potkanowicz started Fossil Ridge High School in Fort Collins, the pain made playing sports unbearable. She gave up both basketball and softball. “I told people that I didn’t like those sports anymore, but the truth was that it hurt too much to run,” she says.
Time to do something about it!
It was during a family trip to San Francisco in 2017 that Potkanowicz decided something had to be done. “I took so many breaks while we walked,” Potkanowicz recalls. “There came a point where I told my mom I couldn’t go any farther. We agreed that I would see a doctor when we returned to Colorado.”
The doctor recommended surgery on both hips to repair torn labrums, cartilage rings that aid joint movement. Trauma, repetitive motions or improper hip alignments can cause a labral tear. Hip surgery on someone so young seemed drastic to Potkanowicz and her parents, so they sought a second opinion from Dr. Presley Swann, an orthopedic surgeon with Advanced Orthopedic and Sports Medicine Specialists, who performs surgeries at Sky Ridge Medical Center.
“It was so discouraging to have people dismiss my pain because they thought I was too young to have hip problems.”
Dr. Swann agreed that she needed labral repair surgery, but cautioned that the procedure alone wouldn’t solve her problem. Instead, Potkanowicz needed an additional surgery to fix hip dysplasia, a condition in which the hip socket doesn’t fully cover the femoral ball of the upper leg causing the hip joint to partially or completely dislocate. “People are born with this condition, but they might not experience problems until they become more active in their teen years or young adulthood,” says Dr. Swann. “It tends to affect girls more than boys. The joint starts to wear down from the misalignment, which is why hip dysplasia is the second leading cause of arthritis in the hip.”
Dr. Swann recommended a surgical procedure called periacetabular osteotomy (PAO). “The procedure repositions the hip socket to cover more of the femoral head,” says Dr. Swann. “This correction improves the stability of the hip joint and stops damage that can lead to arthritis. After surgery, there’s an 80 percent chance that a patient won’t need hip replacement for at least 20 years, if ever.”
“If you can fix the problem before the joint deteriorates and preserve natural bone, it’s like reversing time. A patient might not even need replacement surgery down the road.”
The right care
Only three surgeons in Colorado are trained to perform this highly complex procedure. Dr. Swann is the only one in the state who has advanced fellowship training in hip preservation techniques. “I immediately felt at ease with Dr. Swann,” says Potkanowicz. “I knew if anyone could get me back to a pain-free active life, it was him.”
Potkanowicz had good reason to feel confident. Dr. Swann performs approximately 100 PAO procedures every year on patients ranging from their teens to their fifties. His expertise has led to impressive results for patients. He performs the surgery in an extremely efficient manner, keeping patients in the operating room for about 90 minutes (most PAO procedures take up to four hours). “Because patients are in surgery for less time, they don’t lose much blood so there’s no need for a blood transfusion,” Dr. Swann says. He works with an anesthesiologist who is highly skilled at performing continuous lumbar plexus blocks. Patients go home within three days (compared to five to seven days at other hospitals) with a nonaddictive pain-blocking medication pump that they control.
On August 6, 2018, Potkanowicz, then 17, had labral repair and PAO surgeries on her left hip at Sky Ridge. She went home after two days and participated in physical therapy for a couple of months. At six weeks, she could walk without crutches. During a trip to New York City, she walked 10 miles every day. “My left hip felt great. There was no pain,” she says. A few months later in December, she had the same surgeries on her right hip. Now, three months post-surgery, Potkanowicz is pain-free and looking forward to being cleared to start running again.
“It was so discouraging to have people dismiss my pain because they thought I was too young to have hip problems,” says Potkanowicz. “One doctor suggested that I live with the pain for another 20 years and then get a hip replacement.” Dr. Swann hears these types of comments all too often from young, on-the-go patients. “There’s a mechanical reason that a person needs a hip replacement. Something is out of alignment,” says Dr. Swann. “If you can fix the problem before the joint deteriorates and preserve natural bone, it’s like reversing time. A patient might not even need replacement surgery down the road.”