Periacetabular Osteotomy — San Diego/Degas Pelvic Osteotomy (Pediatric Neurological Impairment)

Children's Colorado / Center for Gait and Movement Analysis (CGMA) · CGMA Physical Therapy Team, Children's Colorado

Weight-Bearing

NWB x 3-6 weeks in hip spica cast; progressive TTWB after cast removal per MD with good active LE control

Key Restrictions

NWB 3-6 weeks; WB based on bony healing/bone density/x-ray per MD; spasticity complications; bivalved cast for transition; osteopenic precautions; minimize fall risk

Timeline & Phases

Phase 1 (days 1-7): splinting/positioning/assistive device needs, mobility/transfer training, pain management, balance for transfers; Phase 2 (days 8-21): pain management, safe mobility; Phase 3 (day 22+): avoid impact/torque, full AROM with active LE control, return to pre-op mobility, functional balance, total LE endurance/strengthening (abdominals/glutes/calves), bracing assessment, scar mobility

Notes

Pediatric (neurological impairment/cerebral palsy); indication is hip subluxation/dislocation with acetabular dysplasia; periarticular osteotomy above acetabulum into tri-radiate cartilage with acetabular roof shifted laterally and distally; iliac or femoral interpositional bone graft; healing 6-8 weeks; Children's Colorado CGMA

Surgeon / Author

CGMA Physical Therapy Team, Children's Colorado

Published

October 2007