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Hip PAO

The operation of periacetabular osteotomy is designed to move the socket (acetabulum) of the hip joint so that it covers more of the femoral head (ball). The aim is to improve the biomechanics of the hip joint and reduce the high stresses that start to cause damage and arthritis because of the shallow acetabulum. Sometimes it is recommended that an arthroscopy of the hip is undertaken sometime prior to the PAO. This allows the changes within the hip joint to be accurately assessed and and frequently procedures can be performed to the cartilage to optimize the outcome of the PAO.

The operation is usually performed either under a spinal anaesthetic with sedation, or a general anaesthetic with an epidural in place. The surgery itself usually takes about 2 hours. The incision is curved over the outside of the pelvic bone and is typically 10-12cm in length. The operation involves a series of bone cuts around the acetabulum, freeing it from the pelvis and allowing it to be moved to a new position. The new position of the joint is checked with X-rays at the time of surgery and once the optimal position for the hip has been achieved, it is fixed in place with 3 or 4 screws.

After the surgery, patients are mobilized out of bed with the aid of the physiotherapists the day after the operation. Pain is initially controlled with a self administered morphine pump (PCA – patient controlled analgesia). The aim is to get safe on crutches only putting a small amount of weight through the leg. On the third or fourth day following surgery exercises are started in the hydrotherapy pool. Hospital stay is usually 5 to 8 days.

The aim of the surgery is to improve the pain coming from the hip. It is also anticipated that the risk of the development or progression of arthritis will be reduced in the long term, however, this depends a lot on how much arthritis damage has already occurred to the joint before surgery.

Minimally Invasive (MIS) Periacetabular Osteotomy
Risks and complications
Bleeding
Nerve and blood vessel injury
Wound infections
Numbness around the wound and thigh
Arthritis
Rehabilitation following PAO
PAO Physiotherapy guidelines
How long does the surgery take?
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What happens to the labral tear?
How long will I be on crutches?
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Does a PAO affect future childbirth?
Will the screws need to be removed?