Lots of people have asked why a PAO (periacetabular osteotomy) rather than a hip replacement...well here goes

A Periacetabular osteotomy is a hip preserving procedure performed to correct a congenital deficiency of the acetabulum: acetabular dysplasia. The acetabulum is your hip socket and it is this that the femur sits in. The femur and acetabulum together make your hip joint.

Acetabular dysplacia is caused by poor development of the acetabulum. Instead of being "cup shaped" it is "bowl shaped" and the acetabulum slopes steeply instead of the desired horizontal position leaving the head of the femur incompletely covered causing damage.

A PAO preserves the patients hip joint rather than replacing it with artificial parts. The PAO relieves pain and restores function AND maximises the life of the natural hip.

A PAO cuts the bone around the acetabulum that joins it to the pelvis. Once the acetabulum is detatched from the rest of the pelvis by a series of controlled cuts, it is rotated to the best position. The dysplastic roof is brought over the head of the femur giving the head normal coverage.Once all is in the correct position screws are inserted into the bone to maintain the correct position during healing. These are sometimes, but not always removed a year or so post op.

SO....why not just have a hip replacement?

1. If you are young enough you will outlive the replaced hip. this results in further surgeries and hip revision surgery can present significant problems.

2. A PAO can last years before a replacement is needed, meaning less chance of multiple replacements.

3. A PAO corrects the positioning of the pelvis meaning that when a hip replacement is required it is correctly positioned and therefore likely to last longer as the pattern of wear and tear is more normal than the pattern of wear on a non PAO replaced hip.

A PAO surgery is tougher to recover from than a hip replacement but the instant relief from pain is worth it. I am dreading my 2nd PAO which is in 15days BUT I am only dreading the recovery, not the OP itself. I know that it will be worth it and the end result will be a correctly aligned pelvis which will although me a much more normal future :-)