Surgical Anatomy of the Rectus-Sparing Approach for Periacetabular Osteotomy

Abstract

The Bernese PAO is performed through a single incision. All cuts are performed from the inner side of the pelvis, avoiding interference with the vascularity of the acetabular and periacetabular bone, which mainly comes from the outside of the pelvis⁸. The procedure needs minimal hardware for fixation, and partial weight-bearing can be allowed. The PAO provides a wide range of acetabular reorientation options. Wide capsulotomy and intra-articular procedures are possible, as well as additional femoral corrections. Childbirth via natural delivery is possible even after bilateral PAO⁹. Nerve injuries can be guarded against with careful surgical execution of the osteotomies⁴.