{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T03:53:25Z","timestamp":1790913205995,"version":"4.1.0"},"reference-count":36,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T00:00:00Z","timestamp":1788480000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T00:00:00Z","timestamp":1788480000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Surgery"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Periacetabular osteotomy (PAO) is an established joint\u2010preserving procedure for symptomatic acetabular dysplasia and other forms of acetabular malalignment. Although minimally invasive techniques have reduced surgical morbidity while maintaining correctional accuracy, the procedure remains technically demanding and relies heavily on intraoperative fluoroscopic guidance. Existing descriptions of minimally invasive PAO provide limited detail regarding the systematic use of fluoroscopy throughout the osteotomy sequence. This article describes a standardized fluoroscopy\u2010guided technique for minimally invasive PAO.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Operative Technique<\/jats:title>\n                    <jats:p>The procedure is performed through an 8\u201310\u2009cm inguinal incision with preservation of key soft\u2010tissue structures. A sequential series of fluoroscopically guided osteotomies of the superior pubic ramus, ischium, supra\u2010acetabular region, and posterior column are performed using defined radiographic landmarks and checkpoints. Biplanar fluoroscopy is integrated throughout the procedure to confirm osteotome trajectory, osteotomy depth, fragment mobility, and final acetabular correction. Intraoperative assessment includes restoration of acetabular coverage, version, and inclination, with confirmation of lateral center\u2010edge angle, T\u00f6nnis angle, anterior wall index, and posterior wall index. Technical pearls, pitfalls, and strategies to minimize neurovascular injury are highlighted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This standardized fluoroscopic protocol provides a reproducible framework for minimally invasive PAO. By integrating step\u2010specific radiographic guidance with key anatomical landmarks, the technique aims to improve osteotomy control, optimize acetabular correction, and enhance procedural safety, particularly during the learning phase of this complex hip\u2010preserving procedure.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/os.70426","type":"journal-article","created":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T02:41:56Z","timestamp":1788576116000},"page":"2247-2259","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Intraoperative Fluoroscopy for Minimally Invasive Periacetabular Osteotomy: A Standardized Step\u2010By\u2010Step Operative Technique"],"prefix":"10.1111","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7625-6465","authenticated-orcid":false,"given":"Matthias","family":"Wittauer","sequence":"first","affiliation":[{"name":"Melbourne Orthopaedic Group  Melbourne Australia"},{"name":"University of Basel  Basel Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0070-035X","authenticated-orcid":false,"given":"Batool","family":"Bosakhar","sequence":"additional","affiliation":[{"name":"Melbourne Orthopaedic Group  Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jitendra","family":"Balakumar","sequence":"additional","affiliation":[{"name":"Melbourne Orthopaedic Group  Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,4]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-198807000-00006"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otsr.2022.103283"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1186\/s10195-023-00734-2"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otsr.2020.08.012"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otsr.2021.103078"},{"issue":"2","key":"e_1_2_12_7_1","first-page":"137","article-title":"Outcomes of Periacetabular Osteotomy for Borderline Acetabular Dysplasia","volume":"105","author":"Nepple J. 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