Return to Function Implications After Periacetabular Osteotomy

Periacetabular osteotomy (PAO) is a well-established surgical intervention for symptomatic acetabular dysplasia in young, active patients. While radiographic and clinical outcomes are well documented, less is known about functional return to daily and athletic activities postoperatively. This study aimed to assess post-PAO return to activity, including sport, school, work, driving, and sexual activity.

A survey was distributed to 276 patients (348 hips) who underwent PAO in the last 10 years at a single institution, with 85 respondents (118 hips), and a response rate of 31%. Patients were asked about their activity levels and daily life preoperatively and postoperatively.

The average age at surgery was 25 years (SD = 6.5), with a mean follow-up of 5.1 years (range, 0.4 to 11.2). Return to school (n = 35) and work (n = 62) occurred within 12 weeks for the majority of patients. Driving (n = 54) resumed within 6 weeks for 55% of patients. Sexual activity (n = 49) resumed within 9 weeks for 61.3% of patients, with hip pain (94.6%) and muscle weakness (54.1%) being the most common challenges. Among preoperative athletes, 70.1% returned to sport, primarily at a recreational level, while 27.3% of those who did not play sports preoperatively initiated a sport postoperatively.

Most patients successfully returned to daily activities following PAO within 3 months, though many experienced moderate difficulties, particularly due to hip pain and muscle weakness. While return to sport was less frequent and often at a lower level of competitiveness, improvements in physical function were evident through patient-reported outcomes. These findings offer valuable guidance on expected recovery following PAO for both patients and providers, while underscoring the importance of targeted rehabilitation to address persistent functional limitations and promote return to daily life.