Periacetabular Osteotomy

The normal anatomy of the hip joint consists of the head of the femur (thighbone) contacting the pelvic acetabulum (socket). These two components together make up a ball-and-socket joint that allows the femoral head to rotate freely within the acetabulum. The structure of the acetabulum holds the femoral head securely inside of it, preventing excessive movement.

However, in some cases, the acetabulum can naturally be too shallow, a condition known as hip dysplasia. This undercoverage of the socket around the femoral head results in hip instability, which can cause pain, various mechanical symptoms, and damage to soft-tissue structures in the joint. Because hip dysplasia is a developmental condition, symptoms often arise in childhood, so early diagnosis and treatment is common.

Here are the essential topics covered on this page:

What Is a Periacetabular Osteotomy?

Although mild cases of hip dysplasia can be treated with arthroscopic hip surgery alone to address any damage in the joint, including labral tears, the periacetabular osteotomy (PAO) is the primary surgical treatment for advanced cases of hip dysplasia. During a PAO, the surgeon makes several cuts to the bone around the acetabulum and rotates the socket so that it more fully covers the femoral head. Metal screws are fitted into the bone to secure it while it heals. This procedure restores the normal anatomy of the hip while preserving the patient’s native bone, alleviating symptoms and reducing the strain on the supporting structures of the joint.

PAO With Concomitant Hip Arthroscopy

Undercoverage of the socket around the femoral head is known to cause damage to joint structures over time. The hip labrum, the thick ring of cartilage that lies between the ball and the socket, often bears the brunt of the damage. In fact, a large proportion of individuals with hip dysplasia end up having labral tears. As such, the team of specialists at the American Hip Institute pioneered the approach of simultaneously performing a PAO to restore the bony anatomy of the hip and a hip arthroscopy to repair the labrum. Undergoing a concomitant hip arthroscopy with a PAO can halt the damage occurring to cartilage in the joint and reduce the risk of arthritis, preventing the need for a total hip replacement.

Who Is a Candidate for PAO?

The PAO is typically indicated for younger patients who have reached skeletal maturity. However, it is important to consult with a specialist to determine if you are a candidate for PAO.

Recovery After PAO

The recovery process after a PAO involves the use of crutches for several weeks to protect the newly repositioned bone. Physical therapy begins soon after surgery to restore strength and mobility in the hip. Once the bone fully heals, patients are able to return to activity without the burden of hip pain and instability.

Consult With the American Hip Institute Team

If you are experiencing symptoms of hip dysplasia, the team of specialists at the American Hip Institute can offer accurate diagnosis and lay out a variety of treatment options, ranging from conservative treatment to surgery, including hip arthroscopy and PAO.