Table 2.

Advantages, Risks, and Limitations

Advantages

The use of a single operative table and a single preparation and drape leads to decreased OR time.

Removal of the perineal post decreases the risk of iatrogenic neurologic injury.

Our technique yields an overall reduced anesthetic time.

The presence of the tensiometer on the leg holder allows for objective measurement of the amount of traction used to limit the amount of traction required to obtain adequate distraction.

The combined approach allows for addressing both intra-articular and extra-articular pathology during a single anesthetic event.

Risks

Traction boots must be appropriately padded and applied; otherwise, the patient may end up with soft-tissue wounds.

The traction pad places increased friction on the epidural catheter, which is at risk of displacement during patient positioning.

The surgical bed is narrow and short, placing the patient at risk of falling if improperly positioned or secured.

Unknown potential complications may occur with our technique.

Limitations

PAO and hip arthroscopy are very specialized procedures with a steep learning curve, thus requiring the presence of either a single surgeon skilled in both procedures or 2 specialized surgeons.

Skilled OR staff is required to assist with manipulation of the leg holder to appropriately adjust leg traction and leg positioning throughout the case.

A skilled fluoroscopy technician is necessary to obtain the appropriate fluoroscopic views during the PAO.

OR, operating room; PAO, periacetabular osteotomy.