PAO (periacetabular osteotomy)

PAO (periacetabular osteotomy) is a type of hip preservation surgery. It is used to treat hip dysplasia, where the hip socket isn’t properly supporting the joint.

Understand what’s causing your pain

A thorough, specialist assessment

Your consultant will carefully listen to your symptoms and learn how they’re affecting your movement before explaining whether hip preservation surgery (PAO) could help.

 

Protect your natural hip

Surgery with a long-term view

PAO repositions the hip socket to ensure pressure is spread more evenly across the joint, which reduces hip pain dramatically as well as delaying the need for hip replacement

 

Care shaped around you

Support through recovery

Your care team will be there to support you at every step, creating a plan tailored to your progress and the activities that matter to you.

 

PAO overview

PAO (periacetabular osteotomy) is a type of hip preservation surgery. It is used to treat hip dysplasia, where the hip socket isn’t properly supporting the joint. During PAO, your surgeon moves the hip socket into a better position to create a more supportive position for the ball. This can ease your pain and make moving around more comfortable. By distributing pressure more evenly across the joint, the procedure may also give your natural hip extra protection and delay the need for a hip replacement. After carefully assessing your hip, your consultant will explain what PAO can do for you and answer any questions you might have.

How is surgery carried out?

PAO is an open hip procedure and is performed through an incision less than 10cm long. You’ll be asleep during the operation because you’ll have sedation with the spinal anaesthetic, making you comfortable and relaxed throughout.

 

Your surgeon makes precise cuts in the pelvic bone around the hip socket. This adjustment helps position the socket to give the ball better support. Screws hold the bone securely while it heals.

 

Rarely, the surgeon will also need to adjust the upper thigh bone so the ball sits more securely within the socket. This process, called a femoral osteotomy, involves carefully cutting and realigning the bone before securing it with a plate and screws while it heals.

 

Before your surgery, the consultant will talk you through the approach and what it could mean for your recovery, so you feel well-informed and supported.

 

Are there any risks?

PAO is a major operation, so it’s understandable to have questions about the risks involved. Your consultant will explain everything clearly and give you time to decide what’s right for you.

 

Possible complications include:

 

  • Infection
  • Bleeding
  • A blood clot
  • Injury to a nearby nerve or blood vessel
  • A numb area on the side of the thigh
  • The bone taking longer than expected to heal or not healing fully
  • Pain or stiffness that continues after surgery
  • Needing another operation

 

The operation may not relieve all your symptoms, and joint wear and tear (arthritis) can still happen as time goes on. However, your care team will do all they can to reduce the risk of complications and explain which ones are most relevant to you.

 

Contact our appointments team
PAO overview

PAO Recovery

First 6 Weeks

Protecting your hip

You’ll usually use crutches to protect your hip and begin gentle exercises while the bone starts to heal. Hydrotherapy is particularly useful during this phase.

6 weeks to 6 months

Rebuilding your strength

Your physiotherapy will gradually help you rebuild strength and feel more confident as your activity levels increase.

6–12 months

Returning to activity

You may begin returning to running or sports in stages once your hip has healed and you’ve rebuilt enough strength and movement.

Working with hip professionals and teams

Our hip specialists support professional athletes, sports teams, active individuals and people whose work places high demands on their hips. Working closely with radiologists, physiotherapists and the wider multidisciplinary team, they provide coordinated care from diagnosis through to rehabilitation, helping each person return safely to sport, work or everyday activities.

 

The same specialist expertise and collaborative approach are available to every patient, whatever your activity level or recovery goals.

Working with hip professionals and teams

How to pay

We offer flexible options depending on how you choose to access care at Fortius. Whichever option you choose, we’ll help make the process clear and straightforward from the start.

Private medical insurance

Private medical insurance

If your care is covered by private medical insurance, we’ll usually invoice your insurer directly. Please check your policy in advance and request an authorisation code if your insurer requires one. You’ll be responsible for paying any policy excess or costs that aren’t covered by your insurance.

Paying for yourself

Paying for yourself

You don’t need private medical insurance to access care at Fortius. If you’re paying for your own treatment, our team will explain the costs clearly and provide a personalised quote before you decide whether to go ahead.

 

Find a clinic near you