What is a periacetabular osteotomy?
A periacetabular osteotomy (PAO) is the main surgical treatment for adolescents and adults withhip dysplasiawho experience pain and are limited in their daily function.
在PAO期间，髋关节保存骨科医生将在臀部插座周围对骨头（骨质瘤）进行一系列切割，以将插座旋转到适当的位置。一旦插座处于正确的位置，将插入金属螺钉以将骨头固定在适当的位置。
The goal of this procedure is to allow the hip socket to provide better coverage of the top of the femur (femoral head) and reduce stress on the rim of the hip socket (acetabulum), which is the mechanical cause of cartilage damage.
If you have alabral tear— which is a tear in the cartilage surrounding the hip joint that occurs in some patients with hip dysplasia — your PAO may be combined with hip arthroscopy to treat the tear. Arthroscopy is a minimally invasive operation that allows the surgeon to work inside the joint to repair the labral tear.
如果在存在晚期髋关节炎之前进行PAO，则可以用作终身治疗。该手术的长期目标是保持髋关节并降低患关节炎的风险。
What is recovery like?
Physical therapy (PT) usually begins the day after surgery and starts with range-of-motion exercises. Your physical therapist will assist you with walking in parallel bars and then with crutches. If you have stairs at home, you will be expected work in PT on how to go up and down the stairs.
You will be discharged with a home exercise program. Strength returns gradually after surgery, and you should be able to start outpatient physical therapy around one month after the PAO. Crutches are very important for the first several weeks after PAO. Most patients use crutches for two months post-surgery.
After the hip has healed, most patients are able to return to their highest previous level of activity. Many of our patients are able to return to competitive sports after PAO, however, each individual’s level of activity may be different.
How we approach a PAO
The hip specialists in theChild and Young Adult Hip Preservation Programat Boston Children’s Hospital have performed more PAO surgeries than any other hospital in the nation. Our specialists have led the way in innovations to the PAO surgical technique, including the development of muscle-sparing techniques that preserve the musculature around the hip and aid in the return to activities and reducing pain after PAO.
Our hip preservation orthopedic surgeons collaborate with our Departments ofNursing;Anesthesiology, Critical Care and Pain Medicine;Physical Therapy;运动药物; andRadiology提供最全面的护理。手术后，我们与物理治疗师合作，帮助患者重新恢复活跃和无疼痛。
For patients who, along with their physician, select PAO as the treatment of choice, we expect their pain and function will be greatly improved by the surgery for many years. In all cases, the decision-making process between our patients and their specialist is one of open and honest communication.