Although it was hoped for that joint replacement surgery would provide longer-lasting results through the development of uncemented implants and low-friction bearings, and despite its indications being extended to younger patients, total hip arthroplasty does not allow for an implant with sufficient longevity to prevent us from considering a later revision. Moreover, replacement does not systematically offer the comfort of a native joint. The development of techniques designed to preserve the native joint and slow down or avoid osteoarthritis is therefore of particular interest. The realization of a periacetabular osteotomy (PAO) in hip dysplasia falls within this framework, increasing the acetabular coverage by a reorientation of the acetabulum. The use of preoperative three-dimensional reconstruction and planning help the surgeons to predict corrections. The use of cutting guides and an intraoperative scanner ensure accuracy and control throughout the whole intervention. PAO should therefore be recognized as the treatment of choice for acetabular dysplasia in young adults, prior to the occurrence of osteoarthritis.
Key words Periacetabular osteotomy, hip dysplasia, conservative hip surgery