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Periacetabular Osteotomy for Hip Dysplasia

Periacetabular Osteotomy for Hip Dysplasia in St. Augustine

A healthy hip joint is one in which the ball-shaped end of the femur bone fits into the acetabulum cavity in the pelvis to form a ball and socket. The acetabulum is large enough and deep enough to enclose the end of the femur completely, allowing for a full and smooth range of motion. Hip dysplasia (literally, hip malformation) occurs when the acetabulum does not grow properly through childhood and adolescence, and cannot cover the femur fully.

Hip Dysplasia Problems

Hip dysplasia on its own does not cause suffering or complications. It is only over time and with repeated movement that people develop pain from osteoarthritis, or the wearing away of joint cartilage in the hip. How quickly arthritis develops depends on a range of factors like the severity of the dysplasia, the specific type of dysplasia, the overall health of the patient, and others.

Arthritis from hip dysplasia develops when the femur and acetabulum do not fit together properly, so body mechanics are altered in normal activities like walking. Instead of moving freely and distributing evenly the forces on the joint, the hip receives more stress on the labrum, the layer of cartilage covering the acetabulum. The out-of-position femur will rub harder on specific points on the labrum instead of gliding on it, causing degenerative damage. Eventually, there might be little to no cartilage left and bone will rub on bone, causing the person significant pain and reducing the joint’s range of motion.

Periacetabular Osteotomy Procedure

To rectify hip dysplasia, orthopaedists will sometimes recommend that the patient undergo surgery to alter the joint and correct how it works. A periacetabular osteotomy (PAO) is one common operation for patients who do not have severe osteoarthritis. It is frequently used to realign the hips of children and adolescents, but adults can benefit from the surgery as well.

The following is a general overview of how surgeons perform the basic PAO procedure, though of course each individual case may require tweaks or additional steps.

  • The orthopaedic surgeon will cut around the pelvis to loosen the area around the acetabulum.
  • The surgeon adjusts the positioning of the socket until it fits more naturally and securely around the ball of the femur.
  • Once the joint is repositioned, the surgeon will then place a few screws in the pelvis to hold the bone together to help it heal.

If you or your child has been diagnosed with hip dysplasia, speak with an orthopaedic physician to determine what treatment would best help you.

Hip Specialist in St. Augustine

If you would like to see an orthopaedic specialist in hip joint issues, request an appointment with our Joint Team at Orthopaedic Associates of St. Augustine. Our goal is to identify and implement the right solutions for each individual patient so you can get back to living a pain-free and mobile life again. To schedule your visit, you may request an anointment online or call us at 904-825-0540.


Paul Roettges, MDPaul Roettges – MD
A member of the American Academy of Orthopaedic Surgeons and the American Association of Knee and Hip Surgeries, Dr. Roettges performs hip and knee replacements as well as complex unresolved hip and knee pain.