Early weight-bearing after periacetabular osteotomy leads to a high incidence of XXXX .

@entity1 @entity86 @entity571
BACKGROUND: It has not been shown whether accelerated rehabilitation following periacetabular osteotomy (PAO) is effective for early recovery. The purpose of this retrospective study was to compare complication rates in @entity1 with standard and accelerated rehabilitation protocols who underwent PAO. METHODS: Between January 2002 and August 2011, @entity1 with a lateral center-edge (CE) angle of   <   20  , showing good joint congruency with the hip in abduction, pre- or early stage of @entity571 , and age younger than 60 years were included in this study. We evaluated 156 hips in 138 @entity1 , with a mean age at the time of surgery of 30 years. Full weight-bearing with two crutches started 2 months postoperatively in 73 @entity1 (80 hips) with the standard rehabilitation protocol. In 65 @entity1 (76 hips) with the accelerated rehabilitation protocol, postoperative strengthening of the hip, thigh and core musculature was begun on the day of surgery as tolerated. The exercise program included active hip range of motion, and gentle isometric hamstring and quadriceps muscle sets; these exercises were performed for 30 minutes in the morning and 30 minutes in the afternoon with a physical therapist every weekday for 6 weeks. Full weight-bearing with two axillary crutches started on the day of surgery as tolerated. Complications were evaluated for 2 years. RESULTS: The clinical results at the time of follow-up were similar in the two groups. The average periods between the osteotomy and full-weight-bearing walking without support were 4.2 months and 6.9 months in @entity1 with the accelerated and standard rehabilitation protocols (P   <   0.001), indicating that the accelerated rehabilitation protocol could achieve earlier recovery of @entity1 . However, postoperative fractures of the ischial ramus and posterior column of the pelvis were more frequently found in @entity1 with the accelerated rehabilitation protocol (8/76) than in those with the standard rehabilitation protocol (1/80) (P   =   0.013). CONCLUSION: The accelerated rehabilitation protocol seems to have advantages for early muscle recovery in @entity1 undergoing PAO; however, @entity86 rates were unacceptably high in @entity1 with this protocol.
