Bioabsorbable Screw Fixation for Periacetabular Osteotomy: Literature Review and Surgical Technique

Purpose: Periacetabular osteotomy (PAO) is commonly performed to treat symptomatic acetabular dysplasia, with fixation traditionally achieved using metallic implants. However, prominent implants may lead to soft tissue irritation and the need for secondary removal procedures. Bioabsorbable implants may mitigate these issues. This study reviews the current literature on bioabsorbable fixation in pelvic osteotomies and describes our surgical technique for bioabsorbable screw fixation in PAO. Methods: A literature review was performed evaluating the use of bioabsorbable implants in pelvic osteotomies and related orthopedic procedures. Studies assessing biomechanical performance, radiographic outcomes, complications, and implant resorption were reviewed. In addition, the authors describe their technique for fixation of PAO using polylactic-co-glycolic acid (PLGA) screws, including implant placement, screw length determination, tapping technique, and intraoperative confirmation of implant positioning. Results: Prior studies demonstrated comparable biomechanical stability between bioabsorbable and metallic fixation constructs for acetabular osteotomies. Clinical studies reported reliable osteotomy healing, maintenance of correction, and low complication rates. Reported advantages include elimination of routine implant removal, decreased long-term implant prominence, and reduced imaging artifact. Conclusion: Bioabsorbable screw fixation represents a promising alternative to metallic screws in PAO. Early clinical outcomes are encouraging, but specific surgical techniques and further long-term clinical studies are needed to define optimal indications and outcomes.