Published by Commons Clinic. [Web version](https://commonsclinicreviews.com/articles/hip-dysplasia-pao-consultation/) Reviewer names are abbreviated. Patient reviews describe individual experiences. Review counts describe source records, not unique patients or clinical outcomes; the acquired snapshot may not include complete platform histories. Clinical education and patient accounts do not replace a consultation. Hip preservation # Hip dysplasia and PAO: what should a preservation consultation explain? A hip preservation discussion should connect socket coverage, cartilage health and your symptoms before comparing rehabilitation, PAO or other options. Published by Commons Clinic · Updated October 20, 2026 · 5 min read [Questions to ask ↓](https://commonsclinicreviews.com/articles/hip-dysplasia-pao-consultation/#consultation-questions) [Patient experiences ↓](https://commonsclinicreviews.com/articles/hip-dysplasia-pao-consultation/#patient-experiences) In this guide 1. [Understand the problem the operation would address](https://commonsclinicreviews.com/articles/hip-dysplasia-pao-consultation/#guide-section-1) 2. [Clarify the difference between PAO and arthroscopy](https://commonsclinicreviews.com/articles/hip-dysplasia-pao-consultation/#guide-section-2) 3. [Ask what makes preservation worthwhile](https://commonsclinicreviews.com/articles/hip-dysplasia-pao-consultation/#guide-section-3) 4. [Take the recovery commitment seriously](https://commonsclinicreviews.com/articles/hip-dysplasia-pao-consultation/#guide-section-4) 5. [Bring the details that help you decide](https://commonsclinicreviews.com/articles/hip-dysplasia-pao-consultation/#guide-section-5) 6. [Meet our hip preservation specialist](https://commonsclinicreviews.com/articles/hip-dysplasia-pao-consultation/#guide-section-6) 7. [Separate the socket problem from the labral injury](https://commonsclinicreviews.com/articles/hip-dysplasia-pao-consultation/#guide-section-7) 8. [Understand why preservation may or may not fit your joint](https://commonsclinicreviews.com/articles/hip-dysplasia-pao-consultation/#guide-section-8) [Go to your consultation questions ↓](https://commonsclinicreviews.com/articles/hip-dysplasia-pao-consultation/#consultation-questions) ## Understand the problem the operation would address In hip dysplasia, the socket does not provide enough coverage for the ball of the hip. That can change how forces pass through the joint and place extra demand on the labrum and cartilage. A labral tear may therefore be part of a larger structural problem. Ask the clinician to show you the relevant features on the images and explain how they connect with your pain. A number in a radiology report is a starting point for discussion, rather than a complete treatment recommendation. Your symptoms, examination and remaining joint health matter too. Sources: [AAOS OrthoInfo: Adolescent Hip Dysplasia](https://www.orthoinfo.org/diseases--conditions/adolescent-hip-dysplasia/) ## Clarify the difference between PAO and arthroscopy A periacetabular osteotomy, or PAO, repositions the socket by cutting and moving pelvic bone, then holding it while it heals. Arthroscopy works on selected structures within the joint. These procedures address different problems and may sometimes be considered together. Ask why treating the labrum alone would or would not be enough for your hip. If the recommendation includes an additional femoral procedure, ask what alignment issue it addresses. A diagram can make this far clearer than a sequence of technical names. Sources: [International Hip Dysplasia Institute: Hip Preservation Surgery](https://hipdysplasia.org/adults/hip-preservation-surgery/) ## Ask what makes preservation worthwhile The preservation discussion should include cartilage condition, how well the joint surfaces match and whether arthritis changes the expected benefit. Ask what is known from your images and what remains uncertain. Some people need additional imaging to answer a specific planning question. Compare options in terms of your own priorities. Rehabilitation or activity changes may help symptoms without changing socket coverage. An operation brings a different set of possibilities, restrictions and risks. Ask what the team would monitor if you choose to wait and what would make a new assessment appropriate. Sources: [AAOS OrthoInfo: Adolescent Hip Dysplasia](https://www.orthoinfo.org/diseases--conditions/adolescent-hip-dysplasia/) · [International Hip Dysplasia Institute: Hip Preservation Surgery](https://hipdysplasia.org/adults/hip-preservation-surgery/) ## Take the recovery commitment seriously PAO requires protection of healing bone followed by a substantial rehabilitation process. The timing of crutch progression, walking and sport should come from your treating team. Institutional rehabilitation guidance illustrates why both healing time and functional criteria matter; it is not a schedule that every patient should copy. Ask how your surgeon and therapist will communicate, which imaging or examination findings permit progression and what support is needed before you can manage ordinary daily tasks independently. Clarify whether another procedure performed at the same time changes the plan. Sources: [Ohio State Sports Medicine: Periacetabular Osteotomy Clinical Practice Guideline](https://medicine.osu.edu/-/media/files/medicine/departments/sports-medicine/medical-professionals/hip/periacetabular-osteotomy.pdf?hash=B141F41BA3B2ACE42EB0A92B44ED4CA9&rev=9b7e59342a624de29bbc59672b97de41) ## Bring the details that help you decide Bring prior images and reports, the treatment timeline and a description of the activities that provoke symptoms. Include school, work, stairs, transport and any sport that matters to you. If you have received different recommendations, bring those records too. Write down your main concern: living with current pain, the recovery burden, preserving the natural joint or uncertainty about later surgery. Ask the clinician to address that concern directly. Before leaving, make sure you understand the options, the reason for the preferred one and what information you still need to make a decision. ## Meet our hip preservation specialist At Commons Clinic, Dr. Tigran Garabekyan focuses on hip preservation, hip dysplasia, labral tears and PAO. His provider page explains that focus in more detail. The patient experiences below offer a view of communication and reassurance during care. Use them alongside a consultation that explains the structure of your hip and the practical demands of each option. ## Separate the socket problem from the labral injury HSS describes how a shallow or misoriented socket can overload the labrum and joint surface. A PAO changes socket orientation; a labral procedure addresses a different part of the problem. If both appear in your recommendation, ask the surgeon to explain the job of each operation on your own images. This is especially useful after a previous arthroscopy or when you have received different opinions. Ask which source of pain is most likely, how much cartilage remains and whether the proposed correction would leave another mechanical issue unresolved. The goal is a coherent explanation of the whole hip. Sources: [PAO Surgery (Periacetabular Osteotomy)](https://www.hss.edu/health-library/conditions-and-treatments/pao-periacetabular-osteotomy) ## Understand why preservation may or may not fit your joint Johns Hopkins distinguishes hip-preserving surgery for teens and young adults with instability from replacement for some adults who develop severe arthritis. That is a decision about the health and mechanics of the joint, not simply a preference for keeping the original hip at any cost. Ask what your examination and imaging show about the remaining joint surface and how those findings affect expected benefit. Discuss what the surgeon would recommend if you chose to wait, and what would prompt a different plan. Bring the activities you value so that preserving the joint also has a clear purpose in your life. Sources: [Hip Dysplasia](https://www.hopkinsmedicine.org/health/conditions-and-diseases/developmental-dysplasia-of-the-hip) Make the most of your visit ## Questions to bring to your consultation Choose the questions that matter most to you. Bring them along, and ask us to explain anything that is unclear. - How does my socket coverage relate to my symptoms? - What do the images tell us about cartilage health and arthritis? - What would PAO correct that arthroscopy alone would not? - Would another hip or femoral procedure be needed, and why? - What benefit can rehabilitation offer while preserving my options? - What risks and uncertainties are most relevant to my hip? - Which healing and strength milestones guide crutch use and sport? - What support, therapy coverage and time away will I need? - What problem would the PAO correct that a labral repair alone would leave behind? - How does the remaining cartilage affect whether preservation is worthwhile? - If I wait, what findings would lead you to change the recommendation? ## Sources & further reading - [AAOS OrthoInfo: Adolescent Hip Dysplasia](https://www.orthoinfo.org/diseases--conditions/adolescent-hip-dysplasia/) - [International Hip Dysplasia Institute: Hip Preservation Surgery](https://hipdysplasia.org/adults/hip-preservation-surgery/) - [Ohio State Sports Medicine: Periacetabular Osteotomy Clinical Practice Guideline](https://medicine.osu.edu/-/media/files/medicine/departments/sports-medicine/medical-professionals/hip/periacetabular-osteotomy.pdf?hash=B141F41BA3B2ACE42EB0A92B44ED4CA9&rev=9b7e59342a624de29bbc59672b97de41) - [PAO Surgery (Periacetabular Osteotomy)](https://www.hss.edu/health-library/conditions-and-treatments/pao-periacetabular-osteotomy) Hospital for Special Surgery - [Hip Dysplasia](https://www.hopkinsmedicine.org/health/conditions-and-diseases/developmental-dysplasia-of-the-hip) Johns Hopkins Medicine We use these medical sources to help explain your options and prepare you for a conversation with our team. Our guides feature our own clinicians; patient reviews describe individual experiences. [Read as Markdown](https://commonsclinicreviews.com/articles/hip-dysplasia-pao-consultation/index.md) Meet our team ## People behind your care. [**Tigran Garabekyan, MD** Orthopedic Surgeon, Hip Preservation & PAO](https://commonsclinicreviews.com/physicians/tigran-garabekyan-md/) [More about Tigran Garabekyan ↗](https://commonsclinic.com/physicians/tigran-garabekyan-m-d/) Explore our clinicians, then talk with us about your symptoms, goals, and the care you need. Patient experiences ## Experiences, *in their words.* Hear from patients about our clinicians, the conversations they had, and the support they received. Excerpt > I really appreciated the time spent with Dr. Garabekyan and his staff. M. Jasuta Rating: 5/5 · Source: Google · Date: September 12, 2026 [Reviewer’s Google activity](https://www.google.com/maps/contrib/111838596472578702647/place/ChIJOZ1cvSS-woARA3itgDdslCQ) Source link type: reviewer place Attributed clinician: Tigran Garabekyan, MD On the care experience: staff and team support Excerpt > We saw him for a consultation and I feel he did a thorough evaluation and took his time to explain his findings. G. K Rating: 5/5 · Source: Google · Date: April 9, 2026 [Reviewer’s Google activity](https://www.google.com/maps/contrib/115799999226563413675/place/ChIJOZ1cvSS-woARA3itgDdslCQ) Source link type: reviewer place Attributed clinician: Tigran Garabekyan, MD On the care experience: explanations Excerpt > always taking the time to explain, answer questions, and go the extra mile to ensure I feel listened to and supported. D. Green Rating: 5/5 · Source: Google · Date: August 30, 2025 [Reviewer’s Google activity](https://www.google.com/maps/contrib/101404819467762869190/place/ChIJOZ1cvSS-woARA3itgDdslCQ) Source link type: reviewer place Attributed clinician: Tigran Garabekyan, MD On the care experience: The reviewer describes explanations and support during a reported hip dysplasia/PAO journey. Excerpt > Dr. Garabekyan was intelligent, knowledgeable, caring and a good communicator. J. Donofrio Rating: 5/5 · Source: Google · Date: May 19, 2025 [Reviewer’s Google activity](https://www.google.com/maps/contrib/105595735771282462128/place/ChIJOZ1cvSS-woARA3itgDdslCQ) Source link type: reviewer place Attributed clinician: Tigran Garabekyan, MD On the care experience: kindness and care Excerpt > I never realized how much pain I truly was in my whole life living with hip dysplasia until I had the corrective surgery. Z. Gordon Rating: 5/5 · Source: Google · Date: August 23, 2023 [Reviewer’s Google activity](https://www.google.com/maps/contrib/114558097710001311670/place/ChIJOZ1cvSS-woARA3itgDdslCQ) Source link type: reviewer place Attributed clinician: Tigran Garabekyan, MD On dysplasia. Excerpt > We read his research and papers published on the CU-PAO and were convinced that he was who we wanted to do her surgery. G. C Rating: 5/5 · Source: Google · Date: February 17, 2021 [Reviewer’s Google activity](https://www.google.com/maps/contrib/107037661742000532401/place/ChIJOZ1cvSS-woARA3itgDdslCQ) Source link type: reviewer place Attributed clinician: Tigran Garabekyan, MD On PAO. Keep exploring ## Your next *good question.* More guidance to help you understand your options and plan your next step. Hip preservation ### [Hip impingement and labral tears: is arthroscopy the right discussion?](https://commonsclinicreviews.com/articles/hip-impingement-labral-tear-arthroscopy/) A scan finding becomes useful when it explains your symptoms and points toward a treatment with a clear purpose. [Read the guide](https://commonsclinicreviews.com/articles/hip-impingement-labral-tear-arthroscopy/) Meet the clinicians ## Explore your *next conversation.* [![Tigran Garabekyan, MD](https://commonsclinicreviews.com/assets/tigran-garabekyan-m-d.jpg)](https://commonsclinicreviews.com/physicians/tigran-garabekyan-md/) Orthopedic Surgeon, Hip Preservation & PAO ### [Tigran Garabekyan, MD](https://commonsclinicreviews.com/physicians/tigran-garabekyan-md/) Santa Monica [Meet Tigran Garabekyan](https://commonsclinicreviews.com/physicians/tigran-garabekyan-md/) ## Publisher & attribution Commons Clinic Reviews is operated by Commons Clinic. 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