week 3 · last reviewed 2026-06-11
PAO recovery: week 3
Clinical procedure: Periacetabular osteotomy (PAO).
Typical, evidence-anchored estimate only. It is not medical advice, not a prediction for your body, and not a substitute for your surgeon or clinician.
what's typical at week 3
typical pain · week 3
Around week 3, the typical pain band sits at 2/10 (range 0–4.6). This week was measured directly in the cited cohort.
weeks 2–8
Weeks 2-8 · the long protected stretch
This is the part nobody warns you about emotionally: pain drops to a 2-3/10 plateau by week three and mostly stays there, but you are still on two crutches at a quarter of your body weight, because the bone simply isn't ready. The diary cohort's averages fluctuated between 2.0 and 3.0 from day 20 through day 42 — recovery here is measured on the x-ray, not on the pain scale.
The Delphi consensus that North American hip-preservation physios published in 2022 keeps this phase deliberately boring: hip flexion limited to about 90 degrees and external rotation to about 20 for the first four to six weeks, a stationary bike from week six-ish, and no decisions about weight-bearing made by feel. The protected period ends when your surgeon sees consolidation — six weeks in about a fifth of published protocols, eight in another fifth.
Use the time for the things rehab can legitimately progress: upper body, the non-operative leg, core work within the motion limits, and sleep logistics. People who treat this stretch as a project tend to come out of it less deconditioned than people who treat it as a sentence.
documented at this week
This week
Foot-flat weight bearing, by consensus
The expert consensus is 25% foot-flat weight bearing for the first 6-8 weeks, with hip flexion limited to 90° and external rotation to 20° in the first 4-6 — the osteotomy needs time to unite.
Good to know
A small late bump is documented
Daily tracking shows pain falling from 5.9/10 on day one to 2.0 around day 20 — then drifting back up to 2.6-3.0 through weeks 4-6. The drift coincides with doing more, and it's in the published data.
The pattern
Pain medication tapers fast
In the diary cohort, opioid use fell from 5 tablets on day one to ~2 by day 14 and zero by week 6 — and patients used less than half (44%) of what was prescribed.
milestones around now
- wk 10 ·Full weight-bearing established (8-12 weeks, gated by x-ray consolidation; protocol-dependent)
- wk 11 ·Off crutches / normalized gait (Criterion-based during weeks 6-12 (symmetric gait, no Trendelenburg), not a fixed week)
- wk 12 ·Return to driving (brake reaction time normalized) (Most not yet safe at 6 weeks; normalized by 12 weeks (single n=26 study))
- wk 16 ·Return to work (Median 16 weeks, IQR 12-22 (n=242); 38.6% back by 12 wk, 85.7% by 24 wk (occupation split not reported))
sources
What this page is built from
- Postoperative weight-bearing restrictions and rehabilitation after PAO: systematic review (63 studies) meta-analysis · reliability 9/10
- Rehabilitation guidelines following PAO: North American Delphi consensus (Disantis et al., IJSPT 2022) society guideline · reliability 9/10
- Patient-reported outcomes of PAO: prospective ANCHOR cohort (Clohisy et al., JBJS 2017, n=391) prospective cohort · reliability 9/10
- Pain reduction up to two years after PAO, rest vs activity (Jakobsen et al., Aarhus, pain cohort n=299) prospective cohort · reliability 8/10
- Daily postoperative pain and opioid use after PAO via automated mobile messaging (Bryan et al. 2020, n=29) prospective cohort · reliability 8/10
- PAO activity levels and return to sport: systematic review (J Hip Preserv Surg 2024) meta-analysis · reliability 8/10
- Anticipating time taken off work after Bernese PAO (2025, n=242) prospective cohort · reliability 8/10
Track your own week-by-week so a flare doesn't erase the months behind it.
Start a recovery logThis is a typical, evidence-anchored reading of pao recovery at week 3 — not medical advice, not a prediction for your body, and not a substitute for your surgeon or clinician.