Pre- and Post-Periacetabular Osteotomy Physical Therapy Treatment in an Individual with Developmental Dysplasia of the Hip: A Case Report

Introduction: Developmental dysplasia (DDH) is a condition where poor formation of the hip joint leads to malalignment of the femoral head within the acetabulum, resulting in abnormal joint loading and instability. First line treatment consists of conservative interventions focused on improving external stability of the joint; if conservative options are unable to improve patient function, surgical interventions are then utilized to preserve joint health. The purpose of this case report is to highlight the conservative and surgical interventions that can help optimize function and minimize pain in individuals with dysplastic hips. Case Description: The intervention and rehabilitation process of a 24-year-old female who was seen in physical therapy for worsening hip pain in addition to having a diagnosis of bilateral DDH. From their clinical presentation, they were initially ruled to be a good candidate for conservative management through a course of physical therapy. Intervention: The patient’s course of conservative intervention consisted of patient education for appropriate sitting posture at home and work, corticosteroid injections, activity modification to avoid time spent participating in pain producing activities, and physical therapy focused on strengthening and stabilization. Their course of surgical intervention consisted of periacetabular osteotomy paired with hip arthroscopy to address anatomical malalignment and articular surface damage. Discussion: The patient discussed in this report underwent both conservative and surgical interventions due to lack of significant improvements in pain and decreased tolerance for functional activity over time. This case report highlights the role that physical therapy has in identifying, examining and treating DDH while also placing emphasis on the role of surgical intervention for promoting and preserving joint health.