Grace Brueggman – PAO Method

Grace Brueggman

Grace Brueggman is a 23-year-old Pittsburgh native who keeps a pretty busy schedule. 

When she’s not studying to earn her master’s degree in Robotics Systems Development at Carnegie Mellon University, you can find her leading an active lifestyle – rock climbing, skiing, playing tennis, or doing yoga. What you wouldn’t know about Grace if you saw her today is that she has overcome some major hip problems with the help of UPMC Children’s Hospital of Pittsburgh’s Adolescent and Young Adult (AYA) Hip Preservation Program

Hip conditions like hip dysplasia or hip impingement can make daily life painful. For young athletes and active people like Grace, the pain can be even worse. 

“When I was 17, I was running track and discovered that I had some pretty severe pain,” said Grace about when she first remembers experiencing hip pain that impacted her quality of life.

At that time, Grace and her family did a great deal of research and met with a few specialists. She was diagnosed with hip dysplasia in both hips, a condition where the top of the thigh bone doesn't fit into the hip socket because the socket is too small. This causes pain, but it can also damage the cartilage and lead to arthritis. 

They explored several options for treatment including specialists in South Carolina, where she was attending boarding school at the time, as well as across the country.

This included learning about the Child and Young Adult Hip Preservation Program at Boston Children’s Hospital, whose surgeons are leaders in the periacetabular osteotomy (PAO) surgical treatment of hip dysplasia. 

But the thought of traveling to Boston in the middle of her high school experience didn’t feel like a great option to Grace. She decided that she was going to do what she could to manage the pain and push off any surgical interventions as long as possible. 

And that approach worked … for a short while. 

Fast forward several years and Grace had returned to her hometown where she was attending the University of Pittsburgh and competing on the club gymnastics team there. That was when the pain became too much to handle and Grace and her family decided to revisit treatment options. 

That’s when Grace’s mother, Judy, read about a doctor who had trained at the program in Boston and was now doing surgery close to home. 

Care Closer than She Thought

The doctor Grace’s mother had read about was Michael McClincy, MD, pediatric orthopaedic surgeon in the AYA Hip Preservation Program at UPMC Children’s Hospital. And he was now doing surgeries using the PAO method right here in Pittsburgh. 

The goal of the AYA Hip Preservation Program at UPMC Children’s is simple: To help your hip joint work better so that you can keep doing what you love. The team works with patients to reduce pain and help them delay or avoid hip replacement surgery.

While the program is housed at UPMC Children’s, it sees teens and adults up to age 35 who have chronic pain because of structural hip problems. 

“While we see a wide range of people, we focus on those who have no more growing to do,” says Dr. McClincy. “Many are athletes or active people whose sport or activity has made their pain worse, like Grace.” 

To say that the Brueggman family was excited about the possibility of getting world-class care without having to travel hundreds of miles is an understatement. 

The family decided to reach out and learn more and were able to quickly get in at Children’s for some scans and a consultation with Dr. McClincy. 

Caring for the Whole Person

From their first interactions with Dr. McClincy, Grace and her family were assured that they were in the best hands at UPMC Children’s. 

“He really is just so awesome,” said Grace of Dr. McClincy. “He is a very available doctor – he never made us feel like he was in a rush and he gave us space to talk through every question and concern we had. He was often saying things like ‘This is what I would do for my daughter,’ which really instilled a lot of confidence in us that he had our best interests at heart.”

To treat Grace’s hip dysplasia, Dr. McClincy would be doing PAO with a hip arthroscopy to address her dysplasia and a labral tear in one hip. By combining both hip arthroscopy and PAO, we would be able to address both of Grace’s issues in a single operation. This combined procedure ensures that we maximize Grace’s ability to recover to her greatest potential in the shortest amount of time. 

According to Grace, Dr. McClincy was very cognizant of the impact that surgery has on a patient’s schedule and was very focused on the whole experience of treatment asking questions like, “What’s going on in your life?” and “Can you handle recovery right now?” Dr. McClincy also provided the Brueggmans with access to past patients of the UPMC Children’s program who were willing to talk with current patients about their experiences.

“It was great to connect with other people around my age who had gone through the surgery so I could know more about what to expect,” said Grace. 

And now, Grace is actually on the other side of things. She is in touch with three or four current patients to answer any questions they might have. 

“Whether it’s sharing information like ‘Make sure you get this certain type of shower stool,’ addressing anxieties around the recovery, or encouraging the patients to find a ‘still’ hobby that doesn’t require movement – I got really into painting personally -- it really helps to talk to actual people who have been exactly where you are,” said Grace.

Grace ended up having surgery on one hip and waiting a year to get the same surgery on the other hip. For her, she says that she mentally needed more time in between, something the physicians at UPMC Children’s were happy to accommodate. 

Why Choose UPMC Children's Hospital of Pittsburgh for Hip Pain Care?

There have been major advances in the last 10 years in the treatments for young adults with hip joint issues. The AYA Hip Preservation Program at UPMC Children’s brings a level of expertise to treating hip disorders and injuries that's unmatched in the Pittsburgh region. The program offers the latest techniques for both hip arthroscopy and PAO, meaning Dr. McClincy and each of his patients can choose the surgical approach that's best for them. 

In addition to treatment for hip dysplasia, Dr. McClincy treats all the major structural hip conditions that affect adolescents and young adults including femoroacetabular impingement (FAI) or hip impingement, hip labral tears, and slipped capital femoral epiphysis (SCFE).

Some of the services available at the UPMC Children’s AYA Hip Preservation clinic include:

  • A dedicated on-site physical therapist (PT) that is a key part of each patients’ rehab.
  • 3D printing and virtual surgery so that the doctor can do a trial run of the patient’s operation before the actual surgery.
  • On-site injections that can provide same-day shots for pain relief.

Excellence in orthopaedic surgery

Michael McClincy, MD is one of a handful of surgeons in the country trained in both hip arthroscopy and PAO. This breadth of experience in advanced hip preservation techniques improves our ability to develop patient-specific treatment strategies so that we can do the right surgery the first time. Our patient-specific strategy means you're less likely to need revision surgeries in the future.

A team approach to hip pain care

Imaging, orthopaedics, and physical therapy all come together to assess, diagnose, and treat patients at the UPMC Children’s AYA Hip Preservation clinic. UPMC Children’s utilizes advanced imaging techniques including CT and MRI scans to make a diagnosis with the least amount of radiation. The expert nursing staff takes care of patients before and after hip surgery and helps get answers to any questions the patient has while the dedicated PTs are a key part of patients’ rehab experience before and after surgery.

Research and access to clinical trials

UPMC Children’s AYA Hip Preservation program runs frequent research studies out of the clinic, which helps to advance hip disorder treatment. It also means you get early access to the newest treatments. By continually tracking our patient’s progress, we make sure that we are providing successful, long lasting treatments.

An Active Outlook

Grace and her husband Josh atop Torreys Peak in Colorado.As of today, Grace is about 18 months out from her hip surgeries and is happy to report that she has no pain or activity restrictions. In fact, just recently on a trip to Colorado, Grace hiked not one but two “14ers” (a mountain peak with an elevation of at least 14,000 feet).

When she reached the bottom of her the second mountain, she felt tears welling up in her eyes. Beyond the emotional impact of the actual summit she just conquered, she was overwhelmingly relieved to find that she was not in any pain.

“I never would have been able to do that before surgery,” said Grace. “I was in shock, but also so, so thankful. To others who are looking into the program, I would just say that it might take you a while to be thankful, because it can be a rough recovery. But it comes. Be patient. There is a light at the end of the tunnel.” 

Photo: Grace and her husband Josh atop Torreys Peak in Colorado.