The hip is a ball-and-socket joint. The ball at the top of the thigh bone normally fits securely inside the hip socket.

In some people, the hip socket is too shallow or is not positioned properly. As a result, the ball of the hip is not covered adequately. This can cause hip pain, instability and increased stress on the joint over time.

Periacetabular osteotomy is an operation that changes the position of the patient's own hip socket to provide better support for the ball of the hip.

The aim is to improve the way the hip works, reduce stress on the joint and, in suitable patients, help preserve the natural hip.

When is periacetabular osteotomy needed?

Periacetabular osteotomy may be considered when the hip socket does not provide enough coverage for the ball of the hip and the joint is still suitable for preservation.

It may be recommended when:

• There is persistent hip pain related to poor coverage of the hip

• The hip socket is too shallow or poorly positioned

• The problem is causing increasing stress on the hip joint

• The hip is still in reasonably good condition and can be preserved

• Non-surgical treatment has not provided adequate relief

The decision depends on the patient's symptoms, age, hip movement, X-rays and other scans, and the condition of the hip joint.

What is periacetabular osteotomy?

Periacetabular osteotomy is an operation that changes the position of the hip socket without replacing the hip joint.

The surgeon carefully makes several cuts in the bone around the hip socket. The socket is then moved into a better position so that it provides improved coverage and support for the ball of the hip.

The repositioned bone is held securely with screws while it heals.

The patient's own hip joint is therefore preserved.

What happens during the operation?

The operation is performed through a cut around the front and side of the hip.

The surgeon carefully makes controlled cuts in the bones around the hip socket while keeping the socket attached to the surrounding tissues.

The socket is then moved into the planned position.

Once the socket is correctly positioned, it is held in place with screws. The bone gradually heals in its new position.

The exact amount and direction of movement are planned according to the shape and position of the individual patient's hip.

What are the benefits of periacetabular osteotomy?

When appropriately selected, the operation can:

• Improve the coverage of the hip socket

• Reduce excessive stress on the hip joint

• Improve hip stability

• Reduce pain related to poor hip socket coverage

• Allow the natural hip joint to be preserved

• Potentially delay or reduce the need for hip replacement in suitable patients

The aim is not simply to change the appearance of the hip on an X-ray. The socket is repositioned to improve the way the hip functions and bears weight.

What is recovery like?

Recovery after periacetabular osteotomy takes several months because the bone needs time to heal in its new position.

In the early period, walking is usually protected with crutches. Hip movement and exercises are increased gradually.

Recovery generally includes:

• Pain and swelling control

• Protected walking with crutches

• Exercises to maintain safe hip movement

• Gradual strengthening of the muscles around the hip

• Progressive increase in weight on the leg

• Gradual return to normal walking and activities

Your surgeon will guide the progression of weight-bearing and exercises according to how the bone is healing.

When can I return to sports?

Returning to sports takes longer than returning to everyday activities.

The bone must first heal adequately and the hip must regain sufficient movement, strength and control.

Low-impact activities are usually introduced before running and jumping. Higher-impact and competitive sports are added gradually when the hip has recovered sufficiently.

The timing varies between patients and depends on the type of activity and how the hip heals.

What are the risks?

Periacetabular osteotomy is a major hip-preserving operation, and complications can occur.

Possible problems include:

• Infection

• Bleeding or blood clots

• Numbness around the surgical area

• Hip stiffness

• Continued pain

• Problems with bone healing

• The hip socket not being positioned ideally

• Irritation from the screws

• Damage to nearby nerves or blood vessels

• The need for another operation

Most patients are carefully assessed before surgery to determine whether the procedure is suitable for their hip.

Frequently Asked Questions

Is periacetabular osteotomy the same as a hip replacement?

No. Periacetabular osteotomy preserves the patient's own hip joint. The hip socket is repositioned rather than replacing the ball and socket with artificial parts.

How long does recovery take?

Recovery takes several months because the bone needs time to heal in its new position. Walking with crutches is usually required during the early part of recovery, followed by gradually increasing activity.

Will I be able to return to sports?

Many appropriately selected patients can return to sports after the hip has healed and strength and movement have recovered. The return should be gradual, with higher-impact activities introduced later.

Can periacetabular osteotomy prevent a hip replacement?

The operation is intended to improve the way the hip functions and may help preserve the natural hip for longer in appropriately selected patients. However, it cannot guarantee that a hip replacement will never be needed.

Who is a good candidate for periacetabular osteotomy?

The operation is generally considered for patients whose hip socket provides inadequate coverage but whose natural hip joint is still in sufficiently good condition to be preserved. A detailed examination and appropriate imaging are needed to determine whether it is suitable.