Ganz et al. introduce the Bernese periacetabular osteotomy (PAO), a four-cut technique performed through a single Smith-Petersen approach for symptomatic acetabular dysplasia in adolescents and adults. The paper describes the operative technique, indications, postoperative protocol, and preliminary radiographic and complication data from the first 75 cases performed between 1984 and 1987.
Prior reorientation procedures — Salter innominate, Steel triple, and dial osteotomies. Each had meaningful limitations: insufficient correction magnitude, pelvic ring disruption, altered true pelvic diameter, or dependence on hip spica immobilization. The Bernese PAO solved all of these simultaneously, and this paper is the founding technical description.
When you evaluate a young adult with symptomatic hip dysplasia and preserved joint space, the PAO is the reconstruction to offer. It corrects both anterior (VCA) and lateral (VCE) coverage deficits in one operation through one incision, without changing pelvic dimensions or requiring casting. Use the false-profile radiograph to quantify anterior coverage (VCA angle) preoperatively. It is indispensable for planning and is underused in routine hip evaluations.
This paper also contains the first systematic observation that labral tears accompany dysplasia in roughly 20% of cases. A finding Ganz's group later developed into the formal framework linking dysplasia, labral pathology, and femoroacetabular impingement that defines modern hip preservation surgery.
Ganz et al. introduce the Bernese periacetabular osteotomy (PAO), a four-cut technique performed through a single Smith-Petersen approach for symptomatic acetabular dysplasia in adolescents and adults. The paper describes the operative technique, indications, postoperative protocol, and preliminary radiographic and complication data from the first 75 cases performed between 1984 and 1987.
Prior reorientation procedures — Salter innominate, Steel triple, and dial osteotomies. Each had meaningful limitations: insufficient correction magnitude, pelvic ring disruption, altered true pelvic diameter, or dependence on hip spica immobilization. The Bernese PAO solved all of these simultaneously, and this paper is the founding technical description.
When you evaluate a young adult with symptomatic hip dysplasia and preserved joint space, the PAO is the reconstruction to offer. It corrects both anterior (VCA) and lateral (VCE) coverage deficits in one operation through one incision, without changing pelvic dimensions or requiring casting. Use the false-profile radiograph to quantify anterior coverage (VCA angle) preoperatively. It is indispensable for planning and is underused in routine hip evaluations.
This paper also contains the first systematic observation that labral tears accompany dysplasia in roughly 20% of cases. A finding Ganz's group later developed into the formal framework linking dysplasia, labral pathology, and femoroacetabular impingement that defines modern hip preservation surgery.