Daniela Perdomo spent years mastering dance routines and gymnastics skills, but as a high school freshman trying cross-country for the first time, her body suddenly rebelled. What started as a typical runner’s soreness soon became debilitating pain that consumed every aspect of her life: It hurt to walk, stand, and even sit for long periods of time.
“About nine months later, I was having to take a painkiller almost every day,” Daniela said. “The pain became unbearable, and I was crying all the time.”
It was the beginning of a journey to get answers, and that led her from doctors’ offices to operating rooms to ultimately discovering her life’s calling.
Trusting a provider
The path to diagnosis proved long and discouraging as Daniela’s symptoms were initially attributed to growing pains and swollen growth plates. An orthopedic surgeon diagnosed her condition as hip dysplasia and recommended waiting before doing invasive surgery. She completed six months of physical therapy, but her pain persisted.
Seeking a second opinion, the family scheduled an appointment with Alfred A. Mansour III, MD, an adolescent and young adult sports medicine and hip preservation surgeon at UT Physicians Orthopedics — Memorial Villages, who would become Daniela’s surgeon. His approach, analogies, and visual demonstrations deeply resonated with Daniela as she faced a life-changing decision.
“He talked about a snowball effect and how I was living my whole life tiptoeing,” she said. “One day, something would push me off the edge, and I’d slide down and keep picking up snow. He said he could stop that snowball before it crashed.”
Getting a diagnosis
Mansour confirmed Daniela’s previous diagnosis of hip dysplasia, a condition that develops a shallow hip socket. It’s particularly common in active young women, especially dancers, and can be easily missed on a casual X-ray review. Mansour said patients are likely to become symptomatic sooner when hip dysplasia is combined with a high activity level, as in Daniela’s situation.
Daniela’s case also involved cam impingement, a large bump on her femur that prevented the femoral head’s ability to smoothly move within the hip.
Treating just one or the other wouldn’t solve Daniela’s problem. Mansour recommended hip arthroscopy with a periacetabular osteotomy (PAO), addressing both the labral tears and the underlying bone structure problems.
“Sharing this type of diagnosis with the family is going to be a harder conversation than run-of-the-mill hip pain and requires figuring out how not to be discouraging,” said Mansour, professor of orthopedic surgery at McGovern Medical School at UTHealth Houston.
His approach balances technical expertise with deep empathy for young healthy teens and their families navigating a challenging diagnosis. It’s the first surgery for many patients, and he welcomes questions as families do their homework.
“It’s a pretty invasive procedure,” Mansour said. “But we do it through a small approach, if we can.”
Although just 15 years old, Daniela felt ready for surgery to help her pain.
“I had a big smile on my face. I was so excited for my surgery,” she said.
Pursuing hip surgery
Daniela’s surgery in February 2023 on her right hip combined hip arthroscopy with a PAO. Mansour performed a keyhole incision to look inside the joint and treat the labral tear. While using the camera, he could visualize the large bump and sculpt it into a proper shape.
Next, he made a 12-centimeter (nearly 5-inch) incision to carefully access the bone, performing four precise cuts to reposition it and correct the alignment. Mansour viewed Daniela’s bone on an X-ray machine during the procedure to help guide the rotation and increase coverage of the socket in the correct spot. Once in position, he added screws to lock it in place.
Navigating recovery
Successful outcomes after surgery depend heavily on collaboration with physical therapy. Mansour said it’s truly a partnership with physical therapists in the clinic. They are experts in hip rehabilitation and part of the hip preservation program. They designed an aquatic program that takes the weight off and provides motion that can’t be replicated with gravity.
“I’m a huge fan of the aquatics program. I think it helps with the strength because you can walk normally in the pool with only a fraction of your body weight on your legs,” Mansour said. “Patients who do it and really buy into it are better sooner.”
Mansour said PAO is a fairly uncommon procedure, and his team offers a specialized center for it with physical therapists proficient in treating it. They’ve developed a 50-page packet for therapists with patients living outside Houston who need to complete physical therapy in their communities.
The demands of Daniela’s recovery process made it difficult for her to maintain the high academic performance she thrived on. Ultimately, she realized she had to switch her focus to her health. Despite the challenges, Daniela reached a recovery turning point six weeks after surgery and went on to complete nine months of physical therapy to regain her strength.
Moving to future surgeries
When her left hip began showing similar symptoms of hip dysplasia during her recovery process, Daniela knew she would need surgery on that side, too. She underwent successful left-hip surgery in her junior year, followed by a third surgery in July 2024 that removed the hardware from the previous surgeries.
Finding purpose through adversity
Daniela’s experience during her surgeries profoundly shaped her future aspirations. Inspired by the many health care professionals who went above and beyond to help her, she’s heading to the University of Cincinnati’s nursing program this fall. She plans to become a certified registered nurse anesthetist.
“I met people who found the right answers, like Dr. Mansour, who went above and beyond to explain everything,” Daniela said. “I want to be that person for somebody one day — an advocate who says, ‘Yep, you have something wrong. Let’s figure it out.’”
Advice for other young patients
Looking back on her experience, Daniela emphasized the importance of self-advocacy and perseverance for others going through a similar diagnosis. She said to trust your gut, listen to your body, and don’t give up on hope.
“Advocate for yourself. That was the biggest lesson I learned,” Daniela said. “There’s only one person who knows the truth, and that’s you. You have to learn to communicate that to other people.”
Daniela’s mom, Liliana, proudly shared how much Daniela matured through the process by being curious, wanting to be involved in decisions, and asking questions.
“I have to remind her how much she has achieved and overcome through all these surgeries,” Liliana said. “I wish I could have done something to prevent her from going through this experience, but she really grew up. She will advocate for her patients and become an amazing health care professional.”
Living a grateful life after surgery
Daniela has no regrets about her decision to have surgery. She said she would do it again in a heartbeat. Recent experiences highlight just how much her life has changed. When she and her mom went for a three-mile walk, she was overjoyed when she realized it didn’t hurt. She and her family also took a previously canceled trip to Italy last year, which Daniela said was the best trip of her life.
Although Daniela had to give up competitive dance and running, she found new passions in health care. She served as an officer of her school’s HOSA-Future Health Professionals club for three years, including president during her senior year.
“Without these surgeries, I don’t think I’d be able to be a nurse, standing for so many hours in a day, and go down this career path,” she said. “These surgeries allowed me to still have a full future.”
