Common Questions About PAO

Here is a list of questions commonly asked about PAO. The list will evolve over time.

Disclaimer: Alexandra Hurworth is not a doctor or medical professional. All information shown here is for informational purposes only and is based on Alexandra's own personal experience. Since every body and situation is unique, this information should not be seen as medical advice or indicative of the experience you or others will encounter. Proper discretion should be used, in consultation with a health-care practitioner, before making decisions about your condition, or in undertaking anything described here. Alexandra Hurworth expressly disclaims responsibility for any adverse effects that may result from the use or application of the information contained on this site or in her book.

What is PAO?

PAO stands for Periacetabular Osteotomy. It is a surgery for correcting hip dysplasia. The “acetabulum” is the medical name for the hip socket into which the femur (thigh bone) fits; “osteotomy” means to cut the bone.

The hip preservation surgeon will “make a series of cuts to the bone (osteotomies) around the hip socket to rotate the socket into proper position,” per the Boston Children's Hospital. This allows for better coverage of the femur.

Screws are then inserted to hold the hip in place and to allow the bone to regrow overtime during recovery, at which point the screws are often removed.

If you are nervous and are the type of person who finds it reassuring to understand exactly what will happen during their procedure, check out this fantastic video. Fun fact: the video was created by The Hospital for Special Surgery (HSS), which is where I had my PAO.

What is hip dysplasia?

Dysplasia is described as “a developmental or congenital dislocation of the hip,” by the The Hospital for Special Surgery. According to the HSS, dysplasia can cause “pain in the groin and/or on the side or back of the hip joint” and/or limited mobility. It affects children, adolescents, and adults. According to the International Hip Dysplasia Institute, hip dysplasia in infants is usually “due to hip instability or dislocation”, whereas in adolescents and adults, it’s usually as a result of “the hip socket being too shallow to support the ball of the hip”.

Penn Medicine states that untreated hip dysplasia can result in the “wearing down of cartilage covering the hip and can lead to osteoarthritis”. HSS reports that the patient’s age and amount of arthritis can dictate treatment options. There are non-surgical options like steroid injections and physical therapy aimed at relieving the symptoms, as well as surgical treatments such as PAO to preserve the hip or in some cases, a total hip replacement. In infants, depending on their age, a soft brace like a Pavlik harness might be necessary or a Spika cast to hold bones in position, per Mayo Clinic.

Someone with hip dysplasia may have pain from birth or the pain may develop later in life.

According to the International Hip Dysplasia Institute, adult dysplasia is 9 times more common than infantile hip dysplasia and is the most common cause of hip arthritis before age 50.

Fun fact: Not everyone knows that hip dysplasia is "the most common complex orthopedic trait in medium and large breed dogs", according to the Cornell University of Veterinary Medicine.