Back in the Game
On any given day, Julie Firestone can be found walking the golf course (18 holes), strolling through the cobblestone streets of Italy or Greece, or running up and down the family home’s 18 stairs up to 30 times a day as she chases her three young children. She does it all pain-free after hip-preserving or partial hip replacement surgery. Firestone is 36; her surgery was nearly 10 years ago.Born with congenital bilateral hip dysplasia, Firestone spent the first four and a half years of her life in a cast because her acetabulum, the socket in the hip, weren’t completely formed.
“I was a breach birth, but the doctor’s knew immediately that something was wrong,” said Firestone. “My feet were positioned up by my ears, which simply wasn’t natural.”
To correct the problem, doctors put her in a body cast that had to be changed every six weeks. When the casts were finally removed, Firestone had no muscle tone, no flexibility. Her mother enrolled her in a tumbling class and she began to heal.
“My first memory form childhood is riding a big wheel,” Firestone said. “I didn’t walk until I was 5. But as the years went by, I also became very good at gymnastics. That tumbling class set the stage for the next phase of my life.” Firestone became so good at gymnastics that she eventually earned a full, four-year scholarship to Southern Utah University where she became the first gymnast ever to quality for post-season competition. But the casts from her infancy hadn’t solved her acebabulum problem. In fact, she fractured her acetabulum during her years of competition. Throughout her teenage years and into her early 20s, she experienced severe pain and could hear “lots of clicking sounds” when she moved. Ten years later, Firestone was an X-ray technician, working for two orthopedic surgeons. At 25, she was no longer participating in gymnastics, but living with debilitating pain on a daily basis. She also happened to have a set of X-rays that had been taken years ago. Her bosses both looked at the film, independent of one another, and both told her to see Joel Matta, MD, Medical Director of the Hip and Pelvis Institute at Saint John’s Health Center in Santa Monica and an internationally recognized pioneer in periacetabular osteotomy, or PAO, surgery.
“Dr. Matta wanted me to have surgery right away,” Firestone said. “But I had just gotten engaged and I wanted to walk down the aisle. I didn’t want to do it on crutches!”Eight months after her wedding, in January 1999, Firestone underwent a periacetabular osteotomy, a procedure that preserves the patient’s own hip, thereby preserving the natural joint as well as self-maintenance capabilities so that the patient can remain as active as her normal life permits. “Periacetabular osteotomy is a procedure that can fix a shallow hip socket, as was the case with Julie,” explained Dr. Matta. “Our goal is to take an abnormal hip and make a normal hip.”PAO preserves and enhances a patient’s own hip joint rather than replacing it with an artificial part. The goal is to alleviate pain, restore function and maximize the functional life of a dysplasic hip. During the procedure, the bone around the hip socket is cut, detaching the acetabulum, which is then rotated into a new position.
“I have a couple of pins and screws, but it’s all my own bones,” said Firestone. “My own acetabular, my own femur.” The PAO procedure was developed in 1984 in Switzerland. Dr. Matta has been performing this type of surgery since 1987.Said Firestone, “I was on crutches for six weeks. Within three months of the surgery, I was at 30 percent weight bearing, and it only got better after that.”
Now, nearly 10 years later, Firestone is pain-free and the mother of three healthy children, though her middle child, her daughter, was also born with hip dysplasia. She was put into a soft brace just after birth—“like suspenders attached to loops”—that held her feet open. Today, at age 5, she’s just fine.
As is Firestone, who readily credits Dr. Matta with changing her life. “Five months after my surgery, I was walking the cobblestone streets of Italy,” she said. “I’ve traveled to Turkey, Greece, Russia. All places where I needed to be able to walk. Without this surgery, I wouldn’t have been able to march forward and experience life-changing events.”
Like taking her son to baseball practice, her daughter to dance class and her youngest to the park. Like living a lovely, happy, fulfilling pain-free life.
That’s a walk definitely worth taking.