When is the Bernese procedure used?

The Bernese, also known as the Ganz procedure, was first performed in 1984 in Bern, Switzerland by doctors Reinhold Ganz and Jeffrey Mast. This operation, now a common treatment for adults in the United States, can be performed on children over the age of 10 as well as on adults, usually under age 40.

Bernese periacetabular osteotomy (PAO), or the Ganz procedure, is used when the roof of the acetabulum does not cover the head of the femur in the way it should. Using a series of controlled cuts, the surgeon moves the acetabulum away the pelvis. The placement of the cuts is where the procedure gets its name. The term "periacetabular" simply means "around the acetabulum." Following the cuts, the surgeon can rotate the acetabulum in order to to place it in a better position in relation to the femoral head. During the surgery, the doctor also can make subtle changes involving coverage in front of the joint.

This surgery normally takes between 4 to 5 hours, but can vary based on any additional surgeries performed at the same time. Research suggests that a PAO can halt joint destruction or prolong joint use for those in early adulthood, allowing a total hip replacement to be delayed.

After surgery, the patient typically uses crutches with a minimal amount of weight bearing on the affect leg for the initial 6 to 8 weeks. After that they use a cane or a crutch to help support their weight until they no longer need it.

It generally takes several months of physical therapy to strengthen the leg because the muscles and tendons are affected by the surgery and will grow weaker from lack of use.

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