Research Summary: Rehabilitation Guidelines for Use Following a Periacetabular Osteotomy (PAO): A North American Based Delphi Consensus

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Periacetabular (PAO) surgery is often performed to treat hip dysplasia in adolescents and adults who do not have significant arthritis. Rehabilitation is important so patients can regain function and return to daily activities and recreational activities after surgery. However, little is known about rehabilitation for patients who have PAO surgery.

Purpose of Study
To provide consensus recommendations based on expert physical therapists’ experiences and practices treating patients after PAO surgery. This can reduce variability in post-operative rehabilitation and optimize rehabilitation outcomes.

The researchers provide PAO surgery rehabilitation guidelines that include therapy goals, therapy precautions, and therapy exercises that can be performed during different stages of recovery (with pictures). Recommendations for return to running and sports participation are also provided.

Summary / How can this information be used?
This article provides consensus recommendations for PAO surgery rehabilitation based on experiences and insights of 16 physical therapists who have experience treating patients following PAO surgery. The information in this article may be helpful to hip preservation surgeons and physical therapists who treat
patients after PAO surgery. These recommendations should be shared with patients, and can be helpful in communicating and setting expectations for recovery. PAO surgery rehabilitation needs to be a team effort between patients, physical therapists, and surgeons. Frequent communication between all team members throughout recovery can optimize outcomes.

What are limitations of this study and should be considered when using this information?
This article provides recommendations for PAO surgery rehabilitation based on expert consensus of physical therapists who have experience treating patients after PAO surgery. There is limited research and knowledge around PAO surgery rehabilitation, and the researchers note the importance of future research to learn more about best practices for PAO surgery rehabilitation.

These guidelines may not be generalizable to all patients. Patients should not use these rehabilitation guidelines without guidance from their physical therapist and surgeon. Surgeons may have different rehabilitation protocols for their patients based on differences in their PAO surgery techniques. Rehabilitation protocols may also vary for patients depending on other procedures that may be performed at the same time as PAO surgery. Individual patient characteristics also need to be taken into account by physical therapists and surgeons when developing individual rehabilitation programs after PAO surgery. Rehabilitation guidelines may need to be modified based on individual patient characteristics like age, tissue healing, surgery complications, baseline level of function, and short- and long-term functional and recreational goals.

Summarized by Nancy Muir, PT, DPT