Return to Work After Periacetabular Osteotomy (PAO)

A periacetabular osteotomy (PAO) is a surgical treatment for hip dysplasia that has been shown in adult patients to delay the onset of hip arthritis and improve functional outcomes. It is a complex procedure that requires a prolonged period of recovery for the patient.  

In the April 20, 2022 issue of JBJS, Fujita et al. report the results of their recent study in Japan. They sought to determine the rate of return to work at 1 year after PAO and its influencing factors.   

  • The authors retrospectively reviewed the cases of patients who had undergone PAO over a 4.5-year period. Of the 126 hips in 119 patients identified, 85 hips in 83 patients were ultimately included in the analysis.  
  • The mean age of patients at the time of PAO was 41.2 years (range, 20 to 60 years). There were 4 male patients (4 hips) and 79 female patients (81 hips). Patients with light-intensity work (such as deskwork) were allowed to return at 3 months postoperatively, while those with heavy-work-intensity jobs were allowed to return at 6 months. 
  • A total of 68 patients (70 hips, 82.4%) had returned to work at 1 year. Of these, 63 patients (65 hips) returned to their original job and 5 patients (5 hips) changed jobs (3 because of hip symptoms).   
  • Of the 15 patients who did not return to work (15 hips, 17.6%), 8 did not return because of their hip (hip subgroup).  

Further Findings 

The researchers found that age, body mass index, and postoperative radiographic measurements did not differ significantly between the patients who returned to work and the hip subgroup in the non-returning cohort. There were also no differences between the 2 groups in terms of patient-reported outcomes (preop. or at 1 year postop.) or type of work.  

This study indicates that patients undergoing a PAO have a high likelihood of returning to work. This is in line with work we have done at our institution showing that 85% of active-duty military personnel were able to return to duty, with 1 in 3 returning to full duty without restrictions¹. These findings can help inform our discussions with patients who work and are considering this major operation for hip dysplasia.  

Access the full JBJS report here. 

Matthew R. Schmitz, MD 

JBJS Deputy Editor for Social Media 


  1. Murtha AS, Schmitz MR. Periacetabular Osteotomy in United States Military Personnel: Results From an Interservice Hip Preservation Practice. Orthop J Sports Med. 2022 Feb 15;10(2):23259671211072564.

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