Before Periacetabular Osteotomy (PAO) Surgery
After you meet with a surgeon, imaging will be ordered. This includes any or all of the following:
Your surgeon will review the results with you. They will let you know if they feel PAO surgery will be helpful.
Sometimes there is a question about whether PAO surgery will be a success. When that happens, your surgeon will go over your case during our “hip conference.” Your case will be discussed with:
- The Division of Orthopaedics director
- Two co-directors of our Hip Preservation Program
- A joint replacement surgeon
- Clinical nursing staff
- Lead radiologist
The goal of this meeting is to cover all aspects of your case. Topics include your age, lifestyle, and expectations of and after surgery. We want to make sure that everyone, including the patient and family, agree that PAO surgery is right for the patient.
Once surgery is scheduled, there will be a pre-op visit. At that visit the nurse will go over what you need to know before, during and after surgery. She is available by phone and email if you have questions or concerns any time before or after surgery.
Pre-Op Physical Therapy Visit
You will also have a pre-op physical therapy visit. At this appointment, you’ll learn what to expect as you recover after surgery. The therapist will talk to you about:
- Home exercise after surgery
- Precautions to take after surgery
- Any post-operative equipment needs
During Periacetabular Osteotomy (PAO) Surgery
What to Expect
The surgery will take about four hours. At Cincinnati Children’s, two experienced attending surgeons perform this surgery together.
For pain control, you will receive a nerve block. This type of anesthesia uses a medication to numb a specific area of nerves in order to block pain. Using a nerve block (rather than an epidural) has been shown to decrease length of your stay in the hospital. This also decreases pain medication needs after surgery.
The hip joint includes a ball (at the top of the femur, or thigh bone) and socket (in the pelvis). Hip dysplasia occurs when there is a problem between the ball and socket. During a PAO, your surgeon will make several cuts in the bones of the hip joint. The goal is to improve the direction and/or amount of coverage the socket provides for the ball. Screws are used to hold the bones in their new position. While you heal, new bone will grow and allow your hip joint to line up correctly.
After Periacetabular Osteotomy (PAO) Surgery
What to Expect
- You’ll be in the hospital for two to three days.
- During that time, you’ll see specialists from Orthopaedics, Pain Management and Physical Therapy / Occupational Therapy.
- You will be on crutches for six to eight weeks.
- Two weeks post-op. At this visit, your surgeon will check your incision. Your dressing will be taken off. An X-ray of the hip will also be completed.
- Six weeks post-op. At this visit, you will have an X-ray of your hip joint. The surgeon will check to make sure you are healing well.
To allow the hip to heal, patients do not start physical therapy until six weeks after surgery. Sometimes physical therapy begins earlier depending on a patient’s individual needs.
Most patients go through six to nine months of physical therapy after PAO surgery. Physical therapy will help:
- Wean you off crutches
- Work on your range of motion and hip strength
- Get you back to your normal level of activity
Your therapist and surgeon will watch your healing and will clear you for certain activities as you make progress. Most patients are able to return to normal daily activities within 4½ to six months after surgery. Return to sports often happens six to nine months after surgery depending on the level of desired competition.
Our Hip Preservation team has created physical therapy protocols for PAO patients to follow. You will be able to take these protocols with you if you have traveled from out of town for surgery. Your therapist may contact our therapists for assistance.
After recovery from PAO surgery, patients have less or no hip pain. They are able to move and walk better than before surgery.