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A Periacetabular Osteotomy (PAO) is a hip preservation surgery offered by Dr. Joel Williams in Chicago to correct acetabular dysplasia (problem with the hip socket shape and/or position). In this procedure, the pelvis is carefully cut and the socket is repositioned to better cover the femoral head (the “ball” of the hip), improving joint stability, reducing abnormal stress, and helping delay or prevent the onset of arthritis. It’s designed for patients whose hip socket is shallow, improperly positioned, or causing labral cartilage damage and hip pain.
Many people with hip dysplasia don’t realize there is a structural issue until they begin experiencing persistent groin or hip pain in their 20s or 30s. Over time, hip socket malalignment and abnormal stresses can cause cartilage and labral damage, labral tears, rim fractures, and accelerate degenerative changes. Without correction, dysplasia often leads to arthritis and decreased function. A PAO preserves the natural hip joint and can restore more normal mechanics, improving pain, function, and long-term joint health. Many studies have shown excellent long-term patient outcomes for properly selected patients.
Adolescents and adults with acetabular dysplasia who have hip pain, instability, or functional limitations.
Patients whose imaging (X-rays, MRI, CT) show suboptimal socket coverage of the femoral head.
Patients who have labral tears, cartilage damage, or early symptoms but not yet advanced arthritis.
Active individuals who want to preserve their natural joint, delay need for hip replacement, and return to high function (sports, physical jobs, etc.).
Patients who understand the recovery process and can commit to physical therapy, weight-bearing restrictions, and follow up care.
Dr. Williams performs the PAO under general anesthesia. In many cases, computer‐assisted navigation or imaging may be used (preoperative CT scans or 3D imaging) to tailor the correction precisely. The acetabulum is cut in a controlled fashion and repositioned into better alignment. Screws stabilize the repositioned socket. If needed, a femoral osteotomy, hip arthrotomy or hip arthroscopy is performed concurrently for associated deformities or labral tears.
Hospital Stay & Early Recovery
Typical hospital stay in Chicago is about 1-3 days, depending on pain control and early progress with physical therapy.
Physical therapy begins soon after surgery to work on joint range of motion, gentle mobilization, and to learn how to use assistive devices (walker, crutches).
Weight bearing is restricted (e.g. ~30-lbs) on the operated side for about 6 weeks. Full weight bearing without crutches usually comes at 8-12 weeks.
Recovery timelines vary based on fracture severity, surgical vs conservative treatment, patient comorbidities, and rehabilitation adherence. Some general milestones include:
Weeks 1-2: Pain and swelling are common; walking with crutches; gentle motion.
Weeks 3-6: Gradual improvements; physical therapy is optional; adherence to weight-bearing limits important.
Weeks 6-12: Progress toward full weight bearing; more therapy for strengthening and mobility.
Months 3-6: Most patients are walking without support, improving function; continue therapy for strength, gait training, and returning to daily activities.
6-12 months: Return to higher activity levels (sports, etc.) is possible depending on your healed anatomy, goals, surgeon’s guidance.
Long-term studies indicate that PAO, in properly selected patients, results in substantial improvement in pain and function, good patient-reported outcomes, and delays or avoids hip replacement.
As with any major surgery, there are potential risks. These include:
Infection, bleeding, or blood clots (deep vein thrombosis)
Nerve injury or irritation, numbness around the incision
Non-union or delayed healing of bone cuts or osteotomy sites
Stress fracture or stress reaction
Ectopic bone formation
Malposition of the socket, requiring revision surgery
Hardware irritation or need for removal of screws
Pain or swelling during recovery, which usually improves with time
Conversion to hip replacement
Dr. Williams’ Chicago team evaluates each case carefully to maximize benefits and minimize complications. Detailed preoperative planning and close follow-up are key.
Board-Certified Hip Surgeon: expertise in routine and complex hip procedures
Nationwide Recognition: patients from Chicago, Detroit, Milwaukee, Grand Rapids, St. Louis, and Columbus seek his care
Education and Training: learned from world-renowned experts at top-tier institutions in the United States
Comprehensive Care Team: coordinated care with physical therapy, rehabilitation, and follow-up support at Chicago’s premier (ranked #1 by US News and World Report) hospital
Advanced Imaging & Planning: precise assessment for personalized treatment strategies
Patient-Centered Approach: clear communication, education, and guidance throughout your treatment
Whether you live in Chicago proper, nearby suburbs, or metro areas across the Midwest, Dr. Williams provides accessible, expert hip care. From initial consultation and imaging to surgical treatment and rehabilitation, his Chicago office is equipped to deliver complete, coordinated care.
If you’re experiencing hip pain or suspect hip dysplasia in Chicago or the surrounding region, reach out to Dr. Williams for a consultation. Together we'll review your imaging, evaluate if you’re a candidate for PAO, and map out a treatment plan that aligns with your goals - whether that’s preserving your hip for active life, reducing pain, or returning to sports.
If your doctor suggests hip treatment, seek a second opinion and explore the best option.
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