Periacetabular Osteotomy

What is a periacetabular osteotomy?

Periacetabular osteotomy (PAO) is a surgical procedure to correct hip dysplasia by reorienting the socket (acetabulum). The benefit of PAO is that it preserves the hip joint and preventing or delaying the need for a total hip replacement later in life.

What is hip dysplasia?

Acetabular dysplasia, or more simply hip dysplasia, occurs when the hip socket (acetabulum) is too shallow to hold and support the rounded ball (femoral head) the ball that normally fits snugly into the hip socket.

When the ball doesn’t fit properly into the socket, the cartilage, and ligaments that normally support the joint become irritated and damaged due to abnormal mechanics. This can lead to pain, disability, and discomfort. You may no longer able to do activities you like to do such as running, riding a bicycle, dance, playing sports, and working out. Additionally, more pressure is placed on the hip, which makes you more likely to develop osteoarthritis.

What causes hip dysplasia?

Hip dysplasia results from problems that prevent the hip from developing normally. One cause of dysplasia, a condition called developmental dysplasia of the hip, which may be present at birth or occur at any time until children’s bones stop growing. Other musculoskeletal and neuromuscular diseases that develop during childhood, such as cerebral palsy, can also cause hip dysplasia.

What are symptoms of dysplasia?

• Groin (or hip) pain after sitting or standing for long periods
• Groin (or hip) pain during deep flexion or hip rotation
• Frequent positional change while sitting or standing
• Fatigue with activities (running, dance, playing sports)
• Pain with activities (running, dance, playing sports)
• Snapping or popping or clicking in the front of the hip
• Pain radiating into the thigh or buttocks
• Groin (or hip) pain during deep hip stretches
• Stiffness of the hip, decreased motion
• Instability of the hip, with fear of “giving out” or “giving way”

How is hip dysplasia treated?

A minor case of dysplasia that’s caught at an early stage may improve with injections, activity modification, and physical therapy. Getting an early diagnosis is often a challenge, however, as symptoms such as pain, loss of motion, and a limp may only develop after years of repeated stress have been placed on the joint.

Patients who have severe or well-established hip dysplasia may require surgery to correct the problem and restore normal hip movement. However, if arthritis has developed, Dr. Park may need to discuss surgical options (total hip replacement) other than PAO.

How is periacetabular osteotomy performed?

PAO is a complex surgery that involves cutting the socket (acetabulum) from the rest of your hip bone. Then Dr. Park repositions the socket so that it provides a better fit/coverage for the ball (femoral head)

After the correct position and angles are achieved, Dr. Park stabilizes the socket’s new position with screws. You’ll need to use crutches for about six to eight weeks after surgery, and your full rehabilitation takes about three to six months. In the end, most patients can return to all their usual activities at about 6 months to a year.

If you have ongoing hip pain and stiffness, call the Houston office of Kwan (Kevin) Park, MD, or book an appointment online today to see learn more about periacetabular osteotomy.

Additional Resources

Adolescent Hip Dysplasia

Hip Dysplasia