Surgical Hip Dislocation Combined with Periacetabular Osteotomy

The surgical hip dislocation and periacetabular osteotomy (SHD/PAO) is a combination of procedures used to manage complex deformities involving both the proximal femur and acetabulum. The most common indication for this surgical strategy is to treat residual, symptomatic Legg-Calve-Perthes deformities (Perthes deformities) or “Perthes-like” deformities resultant from other developmental disorders. These hips commonly have an aspheric femoral head, intra-articular abnormalities (labrum, articular cartilage, and ligamentum teres), intra-articular impingement, extra-articular impingement, and instability from secondary acetabular dysplasia. The SHD/PAO procedure allows comprehensive correction of all aspects of the disease and is the optimal strategy for many patients with these challenging deformities. Hips with epiphyseal dysplasia, e.g., Morquio disease with similar complex deformities can also present an indication.