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Returning to sports after periacetabular osteotomy for developmental dysplasia of the hip.

BACKGROUND
A periacetabular osteotomy,indicated for adults or adolescents requiring correction of congruency and containment of the femoral head, is a common surgical procedure to address developmental dysplasia of the hip.


OBJECTIVES
To describe developmental hip dysplasia, a surgical procedure performed to address the condition, as well as therapeutic exercise and functional progression principles utilized to return a patient to tennis following periacetabular osteotomy.


CASE DESCRIPTION
The patient was a 14 year-old female who underwent a Ganz periacetabular osteotomy of the right pelvis due to developmental dysplasia of the hip. Post-operative outpatient physical therapy consisted of strengthening of the hip, thigh, and core musculature, as well as activities to increase muscular and cardiovascular endurance, anaerobic conditioning, lower extremity proprioception, and soft tissue length. A functional progression program to return to tennis was also provided.


OUTCOMES
The patient was seen in outpatient physical therapy for a total of 34 visits over the course of 42 weeks. Results of a Lower Extremity Functional Scale (LEFS) indicated that heavy activities of daily living, as well as recreational and sporting activities, were improved following the post-operative rehabilitation program.


DISCUSSION
The role of the physical therapist is vital in prescribing and progressing activity levels to facilitate return of function following this periacetabular osteotomy. Surgery that is technically well performed followed by a comprehensive rehabilitation program can allow for resumption of pre-morbid activities, enhancement of the quality of life, and return to sports activities.