# Longitudinal Biomechanics and Patient-Reported Outcomes after Periacetabular Osteotomy for Developmental Dysplasia of the Hip

> **NIH NIH R01** · WASHINGTON UNIVERSITY · 2024 · $614,875

## Abstract

PROJECT SUMMARY / ABSTRACT
 Developmental dysplasia of the hip (DDH) is a life-long disorder that alters joint biomechanics and increases
the risk of early osteoarthritis. The most common treatment for DDH is periacetabular osteotomy (PAO), which
surgically reorients the abnormally shaped acetabulum to better cover and stabilize the femoral head. After PAO,
patient reported outcome measures (PROMs) improve for many, but not all, patients, and PROMs for most
patients remain below the levels of their healthy peers. Recent work has shown that aberrant biomechanical
variables, including disproportionate joint reaction forces, high acetabular edge loads, and low abductor muscle
strength, are related to specific geometric deformities in DDH prior to PAO. These altered biomechanics are also
related to worse PROMs. The current project seeks to optimize surgical care for DDH by determining the effects
of, and relationships among, PAO-induced changes to hip geometry, biomechanics, and PROMs. Aim 1 will
assess how PAO-induced changes in bony geometry alter hip biomechanics. Geometric and biomechanical
profiles for patients (N=60) undergoing PAO will be established before surgery using magnetic resonance
imaging, motion capture, and musculoskeletal modeling. Changes to patients’ biomechanical profiles resulting
from PAO-induced changes to geometry will be determined at 6 and 12 months post-PAO. Aim 2 will establish
target ranges for PAO surgical correction based on the sensitivity of biomechanical outcomes to variability in
acetabular reorientation. Surgically feasible combinations of changes to patients’ acetabular geometry will be
tested using probabilistic analysis, musculoskeletal models, and high-throughput computing to predict the
resultant changes to biomechanics. Aim 3 will determine the relationships among PROMs, activity levels, and
biomechanics pre-PAO and over the first 12 months post-PAO. Electronic questionnaires and wearable sensors
will be used to monitor PROMs and activity changes as patients recover from surgery. From these data, we will
demonstrate how hip biomechanics and activity levels differ in patients with improved PROMs compared to those
with unresolved symptoms. Results from the project will inform customized surgical plans according to patients’
initial bony geometry and help surgeons and patients focus on modifiable treatment factors that are associated
with improved outcomes. Likewise, new information about variables such as post-PAO activity levels and muscle
strength will inform rehabilitation to further improve outcomes. Finally, this project will pave the way for long-term
longitudinal analyses of PROMs, biomechanics, and joint structure to inform surgical and rehabilitation
approaches that predictably mitigate early hip osteoarthritis.

## Key facts

- **NIH application ID:** 10782466
- **Project number:** 5R01AR081881-02
- **Recipient organization:** WASHINGTON UNIVERSITY
- **Principal Investigator:** Michael D Harris
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $614,875
- **Award type:** 5
- **Project period:** 2023-02-10 → 2028-12-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10782466

## Citation

> US National Institutes of Health, RePORTER application 10782466, Longitudinal Biomechanics and Patient-Reported Outcomes after Periacetabular Osteotomy for Developmental Dysplasia of the Hip (5R01AR081881-02). Retrieved via AI Analytics 2026-06-12 from https://api.ai-analytics.org/grant/nih/10782466. Licensed CC0.

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