This is a case presentation of a female patient who underwent a Girdlestone arthroplasty at age 10 years and a total hip arthroplasty at age 21. Despite early postoperative rehabilitation, the patient experienced increasing pain, progressive gait deviations, and functional limitations during the year after surgery. This course of care was initiated 1 year after surgery and focused on motor retraining to address pain and gait deviations. This case demonstrates that positive outcomes can be achieved after longstanding musculoskeletal dysfunction is corrected, but that prolonged rehabilitation may be necessary to produce changes in movement patterns at both the local (joint and muscle) and central (cortical) levels. Correction of both the structural problem and the learned movement patterns is necessary for a successful outcome.
Copyright © 2015 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.