EP1.97 Functional and Gait Outcomes Following Periacetabular Osteotomy and Structured Postoperative Rehabilitation

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ID: 331251
2026
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Abstract
Abstract Introduction Hip dysplasia (HD) is characterized by insufficient acetabular coverage, leading to increased joint stress, labral and chondral injury, and functional impairment. Bernese periacetabular osteotomy (PAO) restores acetabular coverage and improves load distribution across the hip joint. Methods This single-case analysis evaluated spatiotemporal gait parameters, quality of life, and function in a 37-year-old female with symptomatic hip dysplasia (LCEA 6°, Tönnis angle 18°, extrusion index 44%, VAS = 8) preoperatively and at 4 months following PAO and structured postoperative rehabilitation. Radiographic parameters were consistent with acetabular undercoverage and hip instability. Gait analysis was performed using a Vicon® motion capture system, with 3D reconstruction via Motion Monitor (Innovative Sports Training®, Inc.). Patient-reported outcomes included HAGOS and iHOT-33. Results At 4 months postoperatively, gait analysis demonstrated a slower yet more symmetric pattern. Walking speed decreased by 20% (1.32 to 1.05 m/s), accompanied by reduced cadence (143.0 to 118.5 steps/min, −17.1%) and increased bilateral cycle and step times. Despite reduced performance, inter-limb symmetry improved substantially. Step length absolute asymmetry decreased from 0.055 to 0.001, and step time asymmetry from 0.041 to 0.001, indicating near-normalization of step mechanics. In contrast, cycle time asymmetry increased from 0.002 to 0.045, suggesting a residual temporal discrepancy in the operated limb. Radiographic correction was achieved, with LCEA improving from 6° to 34°, Tönnis angle from 18° to 8°, and extrusion index from 44% to 12.5%. Postoperative values fall within ranges reported as adequate for acetabular coverage restoration. The achieved LCEA may suggest slight overcorrection, although still within acceptable ranges. Patient-reported outcomes improved markedly, with iHOT-33 increasing from 20% to 33.5%, and HAGOS subscales improving, particularly in sport/recreation (+252%), quality of life (+133%), pain (+106%), and activities of daily living (+100%), although physical activity decreased by 20%. Conclusion At 4 months after PAO, gait performance remains reduced, reflecting early postoperative adaptation. However, improvements in inter-limb symmetry and patient-reported outcomes indicate functional recovery and improved load distribution. Structural correction appears to precede full restoration of gait performance, reinforcing the importance of comprehensive rehabilitation following surgery.
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Authors Bruno Arruda, Vinicius Taboni Lisboa, Júlia Silva e Lima Schleder, Miguel Santana Costa, Mustafa Ahmad Zoghbi, Diógenis Rodrigues Machado, MSc Keelan Ryan Enseki, Alberto Cliquet Jr Prof
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Journal Journal of hip preservation surgery
Year 2026
DOI
10.1093/jhps/hnag043.281
URL
https://doi.org/10.1093/jhps/hnag043.281
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