Patient Relations
Wael Al Omari was born with arthrogryposis multiplex congenita, a rare condition that causes problems with his joints – especially his hips. This is his story about undergoing a bilateral hip replacement at JHAH.
“I used to joke about lighting up every airport metal detector with my titanium hips,” Wael Al Omari chuckles. He had just returned from Umrah, and on the journey to Mecca and back, was relieved to discover that the airport metal detectors remained silent.
Weeks before embarking on his pilgrimage, Wael had his right hip replaced at Johns Hopkins Aramco Healthcare (JHAH) Dhahran. Three years earlier, he had had his left hip replaced, also at JHAH.
“I got an electric wheelchair just to play it safe during Umrah,” the 41-year-old says. “I haven’t needed a walking aid since the third week after surgery, but I tend to push myself, so I knew I needed to be cautious.”
A double hip replacement is uncommon for a person of Wael’s age. What makes it even more unusual was that Wael was born with arthrogryposis multiplex congenita, a rare congenital condition that limits joint mobility due to muscle and tendon tightness. Indeed, only a handful of double hip replacements involving patients with arthrogryposis have been documented globally.
People with arthrogryposis can suffer joint problems in various parts of the body. Wael has a particular issue with his hips.
The hip joint is known as a “ball and socket” joint because of the shape of the articulating bones. Sometimes, arthrogryposis can cause hip dysplasia, an abnormality whereby the “ball” of the hip joint is prone to popping out of its “socket.”
At the age of eight, Wael underwent a complex operation to fix his hip dysplasia. “After that, my joint motion wasn’t as bad,” he says. “I could play football. Aside from a little muscle pain, I didn’t have any major challenges. This lasted all the way through college.”
But by 2017, after years of wear and tear, Wael was experiencing significant pain from severe osteoarthritis in and around both hips – the kind of pain that made even small movements a significant battle. The pain was radiating through his back, thighs, and knees.
It was at this point that Wael decided to visit Dr. Mojieb Manzary Head of Orthopedics at JHAH Dhahran.
“Dr. Manzary immediately researched if anyone with my condition had undergone double hip replacement before,” Wael recalls.
Only a handful of such cases existed in medical literature, but he never made me feel like an experiment. He was honest, calm, and told me he preferred to delay surgery due to my young age.
In 2021, however, the pain became “unmanageable,” Wael says. “My quality of life had plummeted. I told Dr. Manzary, ‘I don’t expect perfect joints, I just need to keep moving. Please help me with this pain.’”
In May 2022, Dr. Manzary replaced Wael’s left hip.
“It was a tough procedure because patients with Wael’s condition tend to have very tight muscles,” Dr. Manzary says. “This makes it much harder to manipulate the muscles during surgery, especially when putting the joint back together. Then there was the fact that Wael had undergone complex surgery when he was six years old to fix his hip dysplasia. This added to the complexity of the hip replacement surgery.”
Wael says the muscle tightness immediately after surgery was “tough” but “the results were worth it.” He quickly regained function, albeit with a noticeable leg length difference. Special insoles helped restore balance.
All was well until Wael went on a walking holiday in Morocco earlier this year and felt significant pain in his other hip. He immediately returned to JHAH.
Dr. Manzary says the surgery on Wael’s right hip was “much harder” than the left hip because the right leg needed to be lengthened fractionally to match the left leg. Wael was in the operating room for about six hours, and in hospital for four days after that.
I’m pain-free now
Physiotherapy is ongoing, and my gait still needs work, but the worst is behind me. I sleep better, move easier, and my life has improved dramatically. The goal was eliminating the pain – and we did it.
Reflecting on his journey, Wael credits a “full-system effort” from his JHAH care team, “from the surgeons and nurses to the physiotherapists. The care was consistently excellent.”
Of Dr. Manzary, he says: “He’s more than a doctor. He’s a compassionate guide. He never treated me like a medical rarity – he treated me like a human being. He was accessible during every step of the journey, always just a message away.
“Thanks to him, I’ve reclaimed my life. I may not be an athlete, but I’ve got my freedom back. That’s everything.”