Periacetabular Osteotomy for Hip Preservation

The Bernese periacetabular osteotomy has been performed for approximately 30 years. In that time, it has proven to be a technically complex procedure with the potential to considerably improve the natural history of the dysplastic hip. Significant refinements in the surgical technique combined with the recognition of femoroacetabular impingement, improvements in the understanding of hip biomechanics and acetabular orientation, and more discerning patient selection have improved the outcomes related to this procedure. Although the surgery is complex and the potential for complications exists, the results are reproducible and the technique has become the gold standard for acetabular reorientation.

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The Bernese periacetabular osteotomy (PAO) allows for improved position of the weight-bearing acetabular hyaline cartilage. It allows joint medialization and version reorientation while the posterior column is left intact.
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The procedure is indicated in patients who have minimal hip arthrosis and symptomatic hip dysplasia with a concentric hip joint.
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The procedure has a significant learning curve but has a reproducible technique with a low complication rate while prolonging the natural hip joint.
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Acetabular reorientation with a PAO can also improve symptoms from pathologic acetabular retroversion or anteversion.