| Information Category | Description |
|---|---|
| Procedure Name | Periacetabular Osteotomy (PAO) |
| Purpose | To correct hip dysplasia by reorienting the hip socket |
| Patient Demographic | Primarily adolescents and young adults (ages 12–40) |
| Performed On | Patients with hip instability, chronic pain, or limited mobility |
| Technique | Bone cuts made around acetabulum, repositioned and fixed with screws |
| Long-Term Goal | Preserve natural hip joint, prevent arthritis, restore physical function |
| Recovery Time | Crutches 6–8 weeks, return to work 3 months, full activity 6–12 months |
| Common Risks | Infection, nerve injury, nonunion of bone, blood clots |
| Institutions Performing It | Boston Children’s Hospital, HSS, Yale Medicine, Stanford Children’s Health |
| Reference | https://www.childrenshospital.org/treatments/periacetabular-osteotomy-pao |
Pao surgery is a meticulously planned chance to rewrite physical futures, not just a corrective measure. For those with hip dysplasia, this procedure—formally known as periacetabular osteotomy—offers especially creative solutions. Patients with undiagnosed or untreated dysplasia were advised for years to put off getting a hip replacement until their pain got worse. That story is being rewritten today. An elegant substitute is Pao surgery, which realigns the hip before degeneration has a chance to worsen it.
Fundamentally, Pao entails realigning the hip socket to better fit the femoral head and making precise incisions in the pelvic bone close to the acetabulum. Surgical screws are then used to hold the alignment firmly in place while the bone heals organically in its new position. This technique essentially restores joint mechanics rather than just lessening pain. For younger patients who want to continue living an active lifestyle without being constrained by a prosthetic joint, this makes it especially advantageous.
This process is effective not only because of its timing but also because of its structure. Orthopedic teams have stressed in recent years that doing Pao before advanced arthritis develops significantly enhances long-term results. If the procedure is successful, it may even prevent the need for a hip replacement in addition to delaying it. That is incredibly successful in maintaining quality of life and long-term joint health.
The decision to have Pao is frequently described by patients as both intimidating and hopeful. At the age of 24, a young runner revealed that she felt “betrayed” by her body because she couldn’t complete a jog without experiencing excruciating pain. Acetabular dysplasia was eventually discovered by her imaging after months of incorrect diagnoses. She chose Pao under the guidance of a team at HSS, and two years later, she is returning to training—not at her previous speed, but with more self-assurance and control. Her story highlights how recovery frequently becomes an extremely personal journey.
The actual physical recuperation is taxing. The majority of patients only resume full activity after six to twelve months of consistent rehabilitation, and crutches are typically needed for the first two months. However, patients usually gradually regain strength by using at-home exercises and structured physical therapy. Patients who approach rehabilitation with patience frequently report feeling much more stable and using painkillers much less frequently.
Pao surgery treats deeper problems like labral tears, which are frequently found in conjunction with dysplasia, in addition to the visible bone structures. A more comprehensive approach to hip health is made possible by surgeons using Pao in conjunction with arthroscopy when needed to repair soft tissue. Results have significantly improved in recent years, in part because of this layered approach, which treats bone and cartilage simultaneously.
Through departmental collaboration, ranging from radiology to anesthesiology, high-volume centers have improved the Pao experience. For instance, Boston Children’s surgeons can map bone angles and prepare with remarkable clarity thanks to 3D CT scans. The process becomes a coordinated effort of muscle preservation and anatomical accuracy in the operating room, reducing trauma and promoting a quicker recovery.
Although the actual surgery can be technically challenging, its effects on day-to-day living are incredibly relatable. It is a breakthrough for someone who was previously unable to walk more than a block to be able to take the train, climb stairs, or just sleep comfortably. Despite their apparent modesty, these victories have enormous practical significance. They restore dignity as well as function.
It’s also important to consider the surgery’s emotional and social aspects. Younger patients who receive a diagnosis frequently feel alone. Hip dysplasia carries an unseen burden, in contrast to the much-discussed sports injury. Online forums have developed into essential venues for patients to exchange advice on topics such as how to treat nerve pain, which pillows help with sleep, and when to stop using crutches. By sharing experiences, these online communities bridge the gap caused by low public awareness and lessen fear.
Pao is becoming more popular as part of a trend toward joint preservation in the larger field of orthopedic care. Treatments that promote longevity rather than replace function are in greater demand as more people prioritize wellness earlier in life. With its highly effective surgical solution that eliminates the need for implants or artificial joints, Pao is a perfect fit for this change.
Pao’s future appears more and more bright. The development of muscle-sparing, minimally invasive, and even robotically assisted approaches is still being researched. An already precise surgery could become much quicker and easier to recover from thanks to these developments. Being at the forefront of this evolution means better results and wider access for universities like Stanford and Yale.
However, it’s crucial to see Pao as a collaboration between the patient and the doctor, as well as between the body and the will. Success depends on the patient’s participation in each stage of recovery as well as surgical skill. Consistent rehab participants frequently feel more liberated when they return to yoga mats, dance floors, and hiking trails.
