Adult Gait Kinematics and Muscle Strength After Childhood Pemberton Osteotomy for Developmental Dysplasia of the Hip

Objective: This study aimed to evaluate the long-term functional and kinematic outcomes of patients with developmental dysplasia of the hip (DDH) who underwent Pemberton osteotomy (PO) during childhood and to compare their adult hip motion, muscle strength, and gait characteristics with those of healthy controls.

Methods: This retrospective cross-sectional study included 12 adult patients (mean age 18.6 years) who underwent PO for DDH (6 bilateral, 6 unilateral) and 15 healthy controls (mean age 17.1 years). Hip range of motion (ROM), Harris Hip Score (HHS), and isokinetic muscle strength were evaluated. Three-dimensional gait and running analyses were performed using a motion capture system at 3, 6, and 9 km/h.

Results: Mean HHSs were 92.8 Å} 4.2 and 92.7 Å} 5.1 in the bilateral and unilateral groups, respectively, and 100 in controls (P < .001). Hip ROM showed no significant inter- or intra-group differences. Isokinetic testing revealed reduced hip flexion total work in the bilateral (116 Å} 114 J) and unilateral (181 Å} 42 J) groups compared with controls (340 Å} 143 J; P = .007). Similarly, abduction strength in the bilateral group (75 Å} 52 J) was lower than in controls (143 Å} 73 J; P < .05). During slow walking (3 km/h), the unilateral group had a shorter stance time (0.30-0.32 s) than the healthy group (P < .01), while gait symmetry was comparable across all groups during fast walking and running.

Conclusion: Patients who underwent early PO and appropriate rehabilitation achieved normal gait and running kinematics in adulthood despite mild flexion and abduction strength deficits. These findings demonstrate successful long-term adaptation and highlight the importance of timely surgical correction in DDH for preserving functional capacity.

Cite this article as: Demirci A, Karabak B, Hoyur FY, Dzhumukov A, Aydın A, Karsan O. Adult gait kinematics and muscle strength after childhood Pemberton osteotomy for developmental dysplasia of the hip. Acta Orthop Traumatol Turc., 2026, 60(2), 0538,  doi: 10.5152/j.aott.2025.25538.