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Cadaveric dissections with a detailed description of the vascular supply of acetabulum and periacetabular bone set the stage for an intrapelvic approach, which offered the largest acetabular correction possible combined with safe intracapsular access. The final composition of osteotomies required the development of several instruments and cutting devices before the feasibility could be tested on a series of cadaveric hips.<\/jats:p><jats:p>While the sequence of the osteotomies remained largely unchanged over time (except for the pubic and ischial osteotomies), several propositions for an easier\/less invasive approach have been discussed; some made it into standard practice. Efforts were undertaken to optimize the learning curve and minimize failures using video-clips, hands-on courses, fellowships, publications, and ongoing mentoring programs. In retrospect, with almost 40\u00a0years of experience, such efforts have promoted a worldwide adoption of the Bernese periacetabular osteotomy.<\/jats:p>","DOI":"10.1186\/s10195-023-00734-2","type":"journal-article","created":{"date-parts":[[2023,11,2]],"date-time":"2023-11-02T15:02:29Z","timestamp":1698937349000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Bernese periacetabular osteotomy (PAO): from its local inception to its worldwide adoption"],"prefix":"10.1186","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9515-5018","authenticated-orcid":false,"given":"Reinhold","family":"Ganz","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Leunig","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,11,2]]},"reference":[{"key":"734_CR1","first-page":"124","volume":"9","author":"A Codivilla","year":"1901","unstructured":"Codivilla A (1901) Operative treatment of congenital dislocation of the hip. 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