Ganz periacetabular osteotomy: How to make the osteotomy cuts easier?

In 1982, Dr. Reinhold Ganz1 introduced a new periacetabular osteotomy (PAO) as a therapeutic measure for hip dysplasia. The primary objective of this surgical procedure was the strategic reorientation of the acetabulum to optimize coverage of the femoral head and increase the surface area of the acetabular cartilage over the femoral head, all while preserving the structural integrity of the posterior column and maintaining the natural pelvic shape. The complexity of the Ganz periacetabular osteotomy presents a formidable learning curve, owing to the proximity of numerous neurovascular structures to the proposed cuts. Additionally, the surgical approach inherently lacks direct visualization of all osteotomy cuts, necessitating surgeons to rely on anatomic knowledge and meticulous interpretation of fluoroscopic views. This article endeavors to describe some techniques designed to facilitate and enhance the execution of the osteotomy.