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Why Are Screws Used in PAO Surgery?
If you’re preparing for or recovering from a periacetabular osteotomy (PAO), you’ve likely heard about the screws used during surgery to secure your repositioned hip socket. But why exactly are they needed?
During a PAO, your surgeon cuts and repositions the acetabulum (hip socket) to better align it with the femoral head. This corrects hip dysplasia and improves long-term stability. Screws are used to hold the newly positioned bone in place while it heals. Think of them as internal scaffolding—they ensure your hip stays exactly where it should while your bone fuses.
➡️ Read more about what happens during PAO surgery
What Determines Whether Screws Are Permanent or Temporary?
One of the most common questions patients ask after PAO surgery is:
“Will the screws stay in forever?”
The answer? It depends. Here's a breakdown of both scenarios:
Permanent Screws
In many cases, screws stay in permanently—and that’s completely safe. Your surgeon may recommend leaving them in if:
You have no discomfort or irritation
The screws are well-positioned and don’t interfere with muscle or tendon function
They provide long-term structural support
These screws are made from medical-grade materials designed to remain in your body without causing harm. If they’re not bothering you, there’s typically no need to remove them.
Temporary Screws (Removal)
In other cases, screws might need to be removed—usually 6 to 12 months after surgery. Reasons for removal include:
Irritation or pain during certain movements, like bending or sitting
Screws are pressing against soft tissue or causing inflammation
Limited range of motion or flexibility
Future imaging or surgeries may require hardware removal (e.g., some MRIs)
Removing the screws is typically a low-risk, elective procedure, and your surgeon will help determine whether it’s necessary based on your symptoms and lifestyle.
➡️ Read our guide to recovery after hip surgery
What Happens During Screw Removal?
If your screws need to be removed, rest assured: it’s not a second major surgery.
Here’s what to expect:
Outpatient procedure: Usually done under light anesthesia
Small incisions: The same general area may be used
Quick recovery: Most patients return to normal activity in just a few days
No hospital stay or crutches required (in most cases)
Many patients report that lingering discomfort improves almost immediately after screw removal.
What’s Recovery Like After PAO Surgery Screws?
Recovery from PAO surgery varies based on whether your screws remain or are removed—but the goal is always the same: full joint healing and return to function.
If You Keep the Screws In:
No extra procedures required
You likely won’t feel them once fully healed
Most patients return to daily activities within 6–12 weeks, and to full activity between 6–12 months
If You Have Screws Removed:
Expect mild soreness for a few days
Activity restrictions are minimal
No physical therapy is typically required post-removal
➡️ Explore post-op rehab and physical therapy
Tips for Traveling with Screws After PAO Surgery
Whether you’re flying across the country or taking a road trip, it’s natural to wonder how PAO surgery screws may affect travel.
Here are some helpful tips:
✈️ Airport Security: Most screws are made of titanium or stainless steel and do not set off detectors. Still, ask your surgeon for a note just in case.
🧲 MRI Safety: Most PAO screws are MRI-compatible, but always confirm before any imaging.
💺 Comfort Tips: Bring a pillow or wedge cushion for long trips. Elevate your leg when possible, and walk periodically to reduce stiffness.
💊 Plan for swelling: If you’re still in early recovery, pack ice packs or compression gear for long flights.
➡️ More pain management and recovery tips
Key Takeaways: Permanent vs. Temporary Screws
Screws are essential to stabilizing the hip after PAO surgery
Most patients do not need screw removal unless discomfort or imaging issues arise
Screw removal is low-risk and straightforward, with minimal downtime
Whether you keep them or not, the focus is on long-term hip preservation and function
Final Thoughts: Your Recovery, Your Journey
There’s no “one-size-fits-all” answer when it comes to PAO surgery screws. What matters most is how your body responds and what your goals are for healing. Whether your screws stay or go, they’re part of a bigger mission: giving your hip the structure it needs to heal, move, and support you for years to come.
Have questions? Your surgeon is the best person to help you decide what’s right based on your anatomy, recovery, and lifestyle. And remember — the team at Hip Preservation is here to support you every step of the way.
