How to Rehab After PAO Surgery (Evidence-Based Strategies)

By dpope2020

October 10, 2025

adult hip dysplasia, dan pope, developmental hip dysplasia, fitness pain free, hip dysplasia, hip dysplasia causes, hip dysplasia diagnosis, hip dysplasia exerciese, hip dysplasia exercises, hip dysplasia in adults, hip dysplasia surgery, hip dysplasia symptoms, hip dysplasia treatment, hip dysplasia treatment options, hip pain, orthopedic surgery, pao surgery, periacetabular osteotomy, physical therapy for hip dysplasia, signs of hip dysplasia, treating hip dysplasia

How to Rehab After PAO Surgery (Evidence-Based Strategies)

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In today's video we go over, How to Rehab After PAO Surgery (Evidence-Based Strategies) - FPF Show Episode 181:

0:00 Introduction
1:32 Do we have any clear research to guide our rehabilitation of patients following PAO surgery?
2:57 What exactly is a PAO (periacetabular osteotomy) surgery and why would you need it?
5:41 What other surgeries & concomitant pathologies often go hand and hand with PAO?
10:21 What are weight bearing guidelines for patients following PAO surgery?
13:16 What range of motion (ROM) restrictions should your patients follow after PAO surgery and for how long?
18:57 Why protecting the hip flexors is imperative after PAO surgery and how to go about doing it
21:49 How to safely introduce and advance hip flexor exercises over time
33:00 How to introduce & advance strength exercises for patients with PAO and which exercises are recommended
38:59 How to introduce & advance cardiovascular fitness (Biking, elliptical, running timelines)
43:04 Return to sport criteria following PAO surgery
52:31 What are the average return to sport timeline following PAO surgery?
53:39 What are the phases of rehab and when should each phase begin and end?
59:22 Hip Labral Repair Rehabilitation [Guide for Physical Therapists]

Feeling pretty smart about PAO rehab now...

- Dan Pope DPT,OCS,CSCS

Show Notes / Relevant Articles:

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Dan Pope DPT, OCS, CSCS

References:

Disantis AE, Ruh E, Martin R, Enseki K, McClincy M. Rehabilitation Guidelines for Use Following a Periacetabular Osteotomy (PAO): A North American Based Delphi Consensus. Int J Sports Phys Ther. 2022 Oct 2;17(6):1002-1015. doi: 10.26603/001c.38043. PMID: 36237641; PMCID: PMC9528724.
Fortier LM, Popovsky D, Durci MM, Norwood H, Sherman WF, Kaye AD. An Updated Review of Femoroacetabular Impingement Syndrome. Orthop Rev (Pavia). 2022 Aug 25;14(3):37513. doi: 10.52965/001c.37513. PMID: 36034731; PMCID: PMC9404268
Early weight-bearing after periacetabular osteotomy leads to a high incidence of postoperative pelvic fractures. Ito Hiroshi, Tanino Hiromasa, Sato Tatsuya, Nishida Yasuhiro, Matsuno Takeo. Jul 11;2014 BMC Musculoskeletal Disorders. 15(1):234. doi: 10.1186/1471-2474-15-234. doi: 10.1186/1471-2474-15-234.
Return to Play After Periacetabular Osteotomy for Treatment of Acetabular Dysplasia in Adolescent and Young Adult Athletes. Heyworth Benton E., Novais Eduardo N., Murray Kerri, Cvetanovich Gregory, Zurakowski David, Millis Michael B., Kim Young-jo. Mar 11;2016 The American Journal of Sports Medicine. 44(6):1573–1581. doi: 10.1177/0363546516632743. doi: 10.1177/0363546516632743.

Image References:

Hip Labrum: Image Source, License, Attribution: OpenStax College – Edited by Fitness Pain Free LLC
Lateral center edge angle: Source: https://upload.wikimedia.org/wikipedia/commons/b/bf/Center-edge_angle_of_Wiberg.jpg attribution: Article authors: Ruiz Santiago, Fernando; Santiago Chinchilla, Alicia; Ansari, Afshin; Guzmán Álvarez, Luis; Castellano García, Maria del Mar; Martínez Martínez, Alberto; Tercedor Sánchez, Juan, CC BY 4.0 <https://creativecommons.org/licenses/by/4.0>, via Wikimedia Commons
Tonnis Angle: Source: https://upload.wikimedia.org/wikipedia/commons/d/d9/T%C3%B6nnis_angle_of_the_hip.jpg attribution: Article authors: Article authors: Ruiz Santiago, Fernando; Santiago Chinchilla, Alicia; Ansari, Afshin; Guzmán Álvarez, Luis; Castellano García, Maria del Mar; Martínez Martínez, Alberto; Tercedor Sánchez, Juan, CC BY 4.0 <https://creativecommons.org/licenses/by/4.0>, via Wikimedia Commons
Normal Hip Image source: https://upload.wikimedia.org/wikipedia/commons/e/e3/Biomechanik-H%C3%BCftdysplasie-Normalstellung.svg Attribution: Original: Redlinux Vector: Anka Friedrich, CC BY 3.0 <https://creativecommons.org/licenses/by/3.0>, via Wikimedia Commons
Dysplasia Hip Image source: https://upload.wikimedia.org/wikipedia/commons/6/65/Biomechanik-H%C3%BCftdysplasie-dysplastisch.svg Attribution: Original: Redlinux Vector: Anka Friedrich, CC BY 3.0 <https://creativecommons.org/licenses/by/3.0>, via Wikimedia Commons
PAO Source: https://upload.wikimedia.org/wikipedia/commons/b/bd/PAO_after.jpg attribution: Hip2PAOFO, Public domain, via Wikimedia Commons
PAO picture: Source: https://upload.wikimedia.org/wikipedia/commons/1/16/Acetabuloplastik-Schritt2.svg attribution: Hk kng nach Vorlage von de:Benutzer:OrthoPat, CC BY-SA 3.0 <https://creativecommons.org/licenses/by-sa/3.0>, via Wikimedia Commons
Coxa Valga: Image source: https://upload.wikimedia.org/wikipedia/commons/6/62/Coxa-valga-norma-vara-000.png Attribution: Addingrefs, CC BY-SA 3.0 <https://creativecommons.org/licenses/by-sa/3.0>, via Wikimedia Commons