Combined Hip Arthroscopy & Periacetabular Osteotomy (PAO)Surgery: Patient Education

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Hip dysplasia is a condition in which the hip socket (acetabulum) is too shallow or misaligned, leading to poor coverage and support for the femoral head (the ball of the hip joint). This misalignment places excessive stress on the labrum (the cartilage ring lining the socket), increasing the risk of labral tears, pain, and early-onset osteoarthritis. Left untreated, hip dysplasia can progress to bone-on-bone arthritis, eventually requiring total hip replacement.

If you’re unsure whether your symptoms may be related to this condition, start by reviewing our Comprehensive Guide to Hip Dysplasia.

combined periacetabular osteotomy and hip arthroscopy surgery

What Is Combined Hip Arthroscopy and Periacetabular Osteotomy Surgery?

A Periacetabular Osteotomy (PAO) is the standard surgical method for correcting hip dysplasia. This procedure repositions the hip socket to improve alignment and reduce abnormal joint stress. For patients with additional soft tissue damage—such as labral tears or cartilage injuries—a hip arthroscopy may be performed at the same time.

Learn more about the difference between these procedures in our post: Comparing PAO Surgery and Hip Scope Surgery.

Key Goals of Combined Hip Arthroscopy and Periacetabular Osteotomy Surgery

Stabilize the Hip Joint: Proper socket alignment reduces joint stress and improves biomechanics.
Repair Labral and Cartilage Damage: Arthroscopy allows surgeons to repair or debride damaged tissues.
Preserve the Natural Hip Joint: Early intervention can delay or prevent total hip replacement.
Improve Quality of Life: Patients often experience improved mobility and reduced pain post-surgery.

For more on treatment results, visit Success Rates and Outcomes of Hip Preservation Procedures.

Preparing for Combined Hip Arthroscopy & Periacetabular Osteotomy Surgery

Pre-Surgical Physical Therapy

Strengthening the surrounding hip muscles improves stability and recovery. Watch our video on YouTube to get started.

Exercises to Strengthen and Get You Ready for Hip Arthroscopy

QR Code for exercises to strengthen hip muscles pre-surgery

Medication Guidelines

Stop the following 1 week before surgery:

NSAIDs, vitamins, and supplements
GLP-1 medications (e.g., Ozempic, Wegovy)
Oral contraceptives (stop 4 weeks before surgery)
Dental procedures should be avoided 6 weeks before/after surgery

Talk with your PCP or endocrinologist about pausing diabetic medications like metformin.

What to Expect During Your Hospital Stay

Day of Surgery

Start using a Continuous Passive Motion (CPM) machine
Begin light in-bed exercises and mobilization

Days 1–3 Post-Surgery

Daily physical and occupational therapy begins
Learn to use crutches, transfer in/out of bed and car

Discharge is usually possible by Day 3

post periacetabular osteotomy and hip arthroscopy surgery

Aftercare and Recovery

For a full overview, explore our Post-Surgery Rehabilitation Guide.

Activity & Weight Bearing

Use crutches or a walker for 6 weeks with partial weight bearing (20 lbs max)
Alternate positions every 30–60 minutes
Spend 1–2 hours per day lying on your stomach to prevent stiffness

Pain Management

Multimodal pain relief includes Tylenol, NSAIDs, muscle relaxers, and opioids
Use ice therapy in 20-minute intervals for the first 3 days
Stool softeners and anti-nausea medications can help manage side effects

Equipment and Wound Care

CPM Machine: Use 4–6 hours per day for 6 weeks
Hip Brace: Wear while walking for 6 weeks
Dressings: Keep in place for 7 days; avoid soaking wounds for 4 weeks

For related recovery exercises, check out our post: Hip Bursitis Exercises for Post-Surgery Rehabilitation.

Risks and When to Call Your Doctor

While most patients recover without issues from combined hip arthroscopy and periacetabular osteotomy, potential complications include:

Infection
Blood clots
Temporary nerve numbness

Contact your surgical team if you experience:

A fever over 100.4°F
Redness, pus, or increased swelling
Difficulty urinating or severe pain

Final Thoughts

By combining hip arthroscopy with PAO surgery, patients receive a comprehensive approach to both structural and soft tissue correction. This dual procedure improves long-term joint preservation, reduces pain, and enhances quality of life.

For more educational resources, visit our Hip Preservation Patient Education Library.

If you’re considering surgery, it’s also helpful to review real-life Patient Stories to learn how others successfully navigated the journey.