Periacetabular Osteotomy (PAO) – What Determines Success or Failure?

The PAO surgery developed by Professor Ganz has greatly benefitted young adults who suffer from hip dysplasia. Saving the natural hip joint is often better than having a total hip replacement. Also, the PAO surgery may delay the need for artificial hip replacement. Successful PAO surgery even allows people to return to sports and activities that wouldn’t be possible with an artificial hip replacement.

The big question is “Who benefits the most from PAO surgery?”, or “Who won’t benefit and should go straight to total hip replacement?” It may be years before those answers are known for certain, but a lot of research is currently underway to try to sort out the best candidates for successful PAO surgery. Special MRI imaging techniques are being used at some centers but this is still a few years away from being highly reliable.

A recent report sheds some light on some factors that may predict long-term success after PAO surgery. This doesn’t mean that these are the only patients who should have PAO surgery because there are always a few severe cases that have good outcomes in spite of the odds. Surgeons who perform the PAO surgery know these and other predictors, and they can advise you of your chances of success.

The biggest predictors of failure within five years after PAO surgery are:

Age older than 40 at time of surgery
Poor hip congruency – poor fit between round head and oval socket
Osteoarthritis with cysts and joint space width of less than 3 mm

In spite of these predictors, PAO surgery is sometimes recommended because of other factors but these three may give you an idea of some of the things surgeons consider before recommending PAO surgery or total hip replacement.

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