Review Question - QID 2239

A 4 year-old male patient with cerebral palsy, GMFCS IV, presents for routine hip surveillance. On examination, the patient has bilateral hip abduction of 20 degrees. He has x-rays depicted in figure A. The patient undergoes bilateral hip adductor tenotomies to address hip subluxation on the right and a hip at risk on the left. For patients treated for this condition with adductor tenotomies, which of the following is associated with an increased risk of treatment failure?