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What Is Periacetabular Osteotomy (PAO) Surgery?
Periacetabular Osteotomy (PAO) surgery is a specialized orthopedic procedure designed to treat hip dysplasia, a condition where the hip socket (acetabulum) is too shallow to fully support the femoral head (ball of the hip joint). Without proper support, this misalignment can lead to hip instability, pain, and early arthritis. PAO surgery helps reposition the hip socket to improve joint coverage, relieve pain, and preserve the hip for long-term function.
➡️ Learn more about hip dysplasia and its effects.
Understanding Hip Dysplasia
Hip dysplasia occurs when the hip socket doesn’t fully cover the femoral head, causing abnormal joint wear over time. If left untreated, it can lead to chronic pain, reduced mobility, and early hip replacement.
Common Causes and Risk Factors
✅ Genetics – Family history increases the likelihood of hip dysplasia.
✅ Breech Birth – Babies born in a breech position are at higher risk.
✅ Firstborn Status – Tight space in the womb may contribute to hip misalignment.
✅ Female Gender – Hip dysplasia is more common in females.
Who Is a Candidate for PAO Surgery?
PAO surgery is recommended for adolescents and young adults who:
📌 Have been diagnosed with hip dysplasia via imaging tests.
📌 Experience persistent hip pain that doesn’t improve with physical therapy.
📌 Have minimal arthritis, making joint preservation possible.
📌 Wish to remain active without progressing to a hip replacement.
➡️ Read about PAO surgery for young adults.
How Is PAO Surgery Performed?
PAO surgery is a complex procedure requiring careful planning and precision. Below is a step-by-step breakdown:
Preoperative Planning
Imaging studies (X-rays, CT scans, or MRIs) help assess hip alignment.
Surgical mapping determines the precise cuts needed for repositioning the acetabulum.
Surgical Procedure
1️⃣ Anesthesia – General anesthesia is administered.
2️⃣ Incision – A controlled incision is made near the hip.
3️⃣ Osteotomies – The surgeon makes precise cuts around the hip socket, freeing it for repositioning.
4️⃣ Realignment – The acetabulum is rotated and repositioned to improve joint coverage.
5️⃣ Fixation – Screws hold the newly positioned hip socket in place.
6️⃣ Closure – The incision is sutured, and a sterile dressing is applied.
📌 Surgery Duration: 2-4 hours, depending on case complexity.
📌 Hospital Stay: 3-5 days for monitoring and initial recovery.
What to Expect During PAO Surgery Recovery
Recovery from PAO surgery is a gradual process requiring commitment and rehabilitation. Here’s a general timeline:
Phase 1: Initial Recovery (0-6 Weeks)
✅ Hospital Stay – Pain management and physical therapy begin immediately.
✅ Weight Bearing – Crutches are required to minimize stress on the hip.
✅ Physical Therapy – Gentle range-of-motion exercises prevent stiffness.
Phase 2: Intermediate Recovery (6-12 Weeks)
✅ Increased Mobility – Patients gradually transition to partial weight-bearing.
✅ Strength Exercises – Physical therapy progresses to stability and strength-building movements.
✅ Weaning Off Crutches – Most individuals begin walking unassisted around 8-12 weeks.
➡️ Read about rehabilitation exercises after hip surgery.
Phase 3: Long-Term Recovery (3-12 Months)
✅ Return to Low-Impact Activities – Walking, swimming, and cycling can resume by 3-6 months.
✅ Full Recovery Timeline – High-impact sports and activities may take up to 12 months.
✅ Ongoing Strength & Mobility – Continued physical therapy is crucial for maintaining joint function.
Post-Surgery Care Tips
✔️ Follow all weight-bearing restrictions as advised by your surgeon.
✔️ Stay consistent with physical therapy to rebuild strength and mobility.
✔️ Monitor for complications such as increased pain, infection, or swelling.
✔️ Maintain a healthy lifestyle to support joint recovery.
Long-Term Benefits of PAO Surgery
When performed before significant arthritis develops, PAO surgery offers long-term benefits, including:
📌 Pain Relief – Most patients experience a significant reduction in hip pain.
📌 Improved Joint Stability – Proper hip alignment reduces wear and tear on the joint.
📌 Delaying or Avoiding Hip Replacement – PAO helps preserve the natural hip joint.
📌 Enhanced Quality of Life – With proper recovery, patients regain active lifestyles without pain.
➡️ Read about hip dysplasia treatment options.
Is PAO Surgery Right for You?
Deciding whether PAO surgery is the best option depends on:
📌 Your age and activity level.
📌 The severity of your hip dysplasia.
📌 The presence of joint damage or arthritis.
A consultation with an experienced orthopedic surgeon is essential to discuss your symptoms, imaging results, and lifestyle goals.
Conclusion
PAO surgery is a highly effective hip preservation procedure designed to correct hip dysplasia, reduce pain, and enhance joint function. While the surgery and recovery process require commitment, the long-term benefits are life-changing for many patients.
If you're considering PAO surgery, consult a hip dysplasia specialist to discuss your options and create a personalized treatment plan.
➡️ For expert insights on hip preservation, pain management, and recovery, visit Hip Preservation today!
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