Hip Procedures

Dr. Boyle performs the following hip procedures:

Periacetabular Osteotomy (PAO / Ganz Osteotomy)

Periacetabular osteotomy (PAO) — also known as the Ganz osteotomy after its pioneer, Professor Reinhold Ganz of Bern, Switzerland — is the gold standard surgical treatment for hip dysplasia in adolescents and adults. The procedure involves making precise cuts around the hip socket (acetabulum) to free it from the pelvis, reorienting it into a more favourable position to provide better coverage of the femoral head, and securing it in its new position with screws.

By correcting the underlying bony anatomy, PAO redistributes load more evenly across the hip joint, relieves pain, repairs or prevents labral damage, and — in appropriately selected patients — significantly delays or prevents the progression to hip arthritis. The procedure preserves the native hip joint and is most effective when performed before significant cartilage damage has occurred.

Dr. Boyle has extensive fellowship training in PAO surgery, undertaken at Harvard University and Boston Children's Hospital in Boston, USA, and has personally performed over 410 Bernese PAOs for patients referred from throughout New Zealand. For detailed information about the PAO procedure, visit the dedicated PAO page.

Arthroscopic Hip Surgery

Hip arthroscopy is a minimally invasive procedure in which a small camera and surgical instruments are introduced into the hip joint through small portals, avoiding the need for a large open incision. It is used to treat a range of hip conditions including femoroacetabular impingement (FAI), labral tears, loose bodies, and cartilage damage. Hip arthroscopy is performed under general anaesthetic and is typically a day procedure, with recovery significantly faster than open hip surgery.

Arthroscopic Labral Repair

The hip labrum is a ring of cartilage that seals and stabilises the hip joint. Labral tears cause deep groin pain, a catching or clicking sensation, and pain with prolonged sitting or pivoting. During arthroscopic labral repair, the torn labrum is reattached to the rim of the acetabulum using small suture anchors, restoring the seal of the joint and relieving symptoms. Where the labrum is too damaged to repair, labral reconstruction using a tendon graft may be performed. Labral tears resulting from an acute injury may be eligible for ACC cover — visit the ACC page for further information.

Arthroscopic Osteoplasty

Arthroscopic osteoplasty involves reshaping the bony abnormalities that cause femoroacetabular impingement — either the cam deformity on the femoral head and neck (femoroplasty), or the over-prominent acetabular rim (acetabuloplasty) — using a small motorised burr introduced through the arthroscopic portals. By correcting the bony anatomy, osteoplasty eliminates the impingement that damages the labrum and cartilage, and is almost always performed in combination with labral repair. Precise restoration of normal hip geometry is critical to achieving a good outcome and preventing recurrence.

Loose Body Removal

Loose bodies are fragments of bone or cartilage that have detached from the joint surface and are floating freely within the hip joint. They cause pain, locking, and catching sensations, and can cause further cartilage damage if left untreated. Arthroscopic removal of loose bodies is a straightforward and effective procedure — the joint is inspected thoroughly, all loose fragments are identified and removed, and the source of the fragments is addressed where possible. ACC cover may apply when loose bodies resulted from an acute injury.

Surgical Hip Dislocation

Surgical hip dislocation is an open procedure in which the hip joint is carefully and safely dislocated under direct vision to allow comprehensive access to all surfaces of the femoral head and acetabulum. It was developed by Professor Ganz and provides 360-degree access to the hip joint — superior to what can be achieved arthroscopically — making it the preferred approach for complex hip pathology that cannot be fully addressed through keyhole techniques alone. The procedure is performed through a lateral incision with careful preservation of the blood supply to the femoral head.

Osteochondral Autograft Transfer (OATS)

Osteochondral autograft transfer (OATS) involves harvesting a plug of healthy cartilage and underlying bone from a non-weight-bearing area of the hip and transplanting it into a cartilage defect on the femoral head or acetabulum. It is used to treat focal full-thickness cartilage defects that are too large or too deep to be managed arthroscopically, restoring a durable cartilage surface to the damaged area. Surgical hip dislocation provides the access required to perform this procedure safely and precisely.

Osteoplasty (Open)

Open osteoplasty through surgical hip dislocation allows reshaping of the femoral head and acetabulum under direct vision — providing more comprehensive correction of complex or severe bony deformity than is achievable arthroscopically. It is indicated for patients with significant cam or pincer deformity, previous Perthes disease, SUFE sequelae, or other conditions that have resulted in complex hip geometry requiring meticulous surgical correction.

Femoral Neck Lengthening

Femoral neck lengthening is a procedure to restore the normal length and offset of the femoral neck — the segment of bone connecting the femoral head (ball) to the femoral shaft. It is performed in patients whose femoral neck has become shortened or deformed as a result of conditions such as Perthes disease, SUFE, or previous surgery. Restoring normal femoral neck geometry improves the mechanical function of the hip, reduces impingement, and improves the efficiency of the surrounding muscles. It is typically performed through surgical hip dislocation to allow safe and precise correction.

Proximal Femoral Osteotomy

A proximal femoral osteotomy involves making a controlled cut in the upper femur (thighbone) and repositioning it to correct abnormal alignment of the femoral head and neck. It may be used to address conditions including coxa vara (an abnormally reduced angle between the femoral neck and shaft), excessive anteversion (forward twist) of the femoral neck, or residual deformity following childhood hip conditions such as Perthes disease or SUFE. By restoring normal femoral anatomy, the procedure improves joint mechanics, reduces impingement, and redistributes load more evenly across the hip joint. It is often performed in combination with PAO or other hip preservation procedures when both the socket and femoral side require correction.

To arrange a specialist assessment, ask your GP or physiotherapist to refer you to Dr. Matthew Boyle at Auckland Bone and Joint Surgery. Referrals can be sent via HealthLink EDI: drmboyle, or by calling 09 281 6733. Dr. Boyle consults at AUT Millennium, 17 Antares Place, Rosedale, North Shore Auckland.