45F with hip dysplasia — anyone have a successful PAO in their 40s?
Hi everyone! I’m brand new here and honestly still trying to process all of this.
I’m 45 and was recently diagnosed with bilateral hip dysplasia, along with CAM impingement and a fairly significant labral tear in my right hip. Until now, no one had ever caught the dysplasia, which has been a huge surprise, especially since I fractured this same hip in my 20s and had scans done at that time.
The surgeon I saw essentially gave me three options:
- Hip arthroscopy only to repair the labral tear and address the impingement, but because of the dysplasia, my surgeon believes it will eventually fail over time and ultimately lead to a hip replacement anyway. He estimated I might buy somewhere between 1–10 years with that approach.
- A PAO combined with arthroscopy. The surgeon said this is more complex at my age and even described me as “geriatric” for the procedure, which honestly scared me. He explained that recovery could take longer, and there’s a risk the bone may not heal properly, potentially leading to additional complications like a bone graft.
- A total hip replacement now.
I’m active and otherwise healthy. Before this became severe, I was lifting weights 5–6 days a week, walking 10K+ steps a day, and teaching yoga. Movement is an important part of my life, so I’m working on getting multiple opinions before making such a major decision.
I’m also in perimenopause and very aware that these are important years for building and maintaining muscle and bone. Part of me is tempted to do the arthroscopy only so I can have a shorter recovery and hopefully stay active longer in the near term. But another part of me wants to try to preserve my own hip for as long as possible, even knowing the risks and intensity of a PAO.
At the same time, I’m honestly scared by how major the surgery sounds: the long and painful recovery, the possibility of complications, and the idea of being on heavy pain medication for an extended period.
I would really love to hear from anyone who had a successful PAO later in life, especially in your early-to-mid 40s. How was recovery? Was it worth it? How are you doing now?
And if you chose another route instead, I’d love to hear about that experience too! I’m honestly terrified of making a choice I'll regret later, especially since it feels almost impossible to predict how any of these outcomes will ultimately play out for me.
Thank you so much. I already feel less alone having found this community. :)