Innovations in Joint Preservation Procedures for the Dysplastic Hip “The Periacetabular Osteotomy”

The Bernese periacetabular osteotomy is an effective treatment for symptomatic developmental dysplasia in the prearthritic young adult hip. Refinements in the periacetabular osteotomy technique and perioperative management have markedly improved the clinical outcomes and recovery in these patients. We will review the clinical presentation of acetabular dysplasia, indications for surgery, perioperative management, and contemporary refinements in technique including refined acetabular reduction, adjunctive hip arthroscopy, femoral head-neck osteochondroplasty, femoral procedures, and rapid recovery protocols. In well-selected patients, this reconstructive osteotomy should be considered safe and effective in alleviating pain and improving hip function in patients with symptomatic acetabular dysplasia.