Effects of PAO on Total Hip Replacements Later in Life

Effects of PAO on Total Hip Replacements Later in Life

Does previous pelvic osteotomy make it more difficult to perform a total hip later in life?

That question was recently the subject of a study published in Clinical Orthopedics and Related Research.

This was studied because of concern that previous surgery (PAO) may increase the complexity of later surgery (total hip replacement). Pelvic osteotomies are performed in children and young adults to postpone total hip replacement as long as possible; but even those who have had pelvic osteotomy will eventually need a total hip if they live long enough.

These authors looked at results of total hip replacements done for hip dysplasia in patients who had not had any previous surgery and compared those results to patients who had previous pelvic osteotomies at an earlier age. The good news is that these authors found that pelvic osteotomy does not lead to more complications, failures, or unsatisfactory outcomes than patients who were having a total hip as their first operation.

Of course, it would be better to avoid any surgery, but pelvic osteotomies may be necessary in children and young adults. This study tells us that doing this type of surgery to postpone a total hip doesn’t cause problems when a total hip is needed later in life.


K. Tokunaga, et.al., Effect of Prior Salter or Chiari Osteotomy on THA with Developmental Hip Dysplasia, CORR 469:237-43, Jan., 2011