Periacetabular osteotomy for hip preservation.

Area of Science:

• Orthopedic Surgery
• Hip Preservation Surgery

Background:

• The Bernese Periacetabular Osteotomy (PAO) is a surgical procedure for hip dysplasia.
• It has been performed for approximately 30 years, demonstrating its long-term clinical application.

Purpose of the Study:

• To review the evolution and current status of the Bernese PAO.
• To highlight improvements in surgical technique, understanding of hip biomechanics, and patient selection.
• To emphasize the procedure's role as the gold standard in acetabular reorientation.

Main Methods:

• Review of surgical technique refinements over 30 years.
• Integration of knowledge regarding Femoroacetabular Impingement (FAI).
• Analysis of advancements in understanding hip biomechanics and acetabular orientation.
• Emphasis on improved patient selection criteria.

Main Results:

• The Bernese PAO is a technically demanding procedure.
• Significant improvements in surgical techniques and patient selection have enhanced outcomes.
• The procedure offers the potential to substantially alter the natural course of hip dysplasia.
• Reproducible positive results have been achieved.

Conclusions:

• The Bernese PAO has evolved into a reliable and effective treatment for hip dysplasia.
• Despite a challenging recovery and potential complications, the procedure yields reproducible results.
• It is recognized as the gold standard for acetabular reorientation in managing hip dysplasia.