Seventy-two patients with Crowe IV developmental dysplasia of the hip (DDH) undergoing THA were randomized to receive either chiropractic rehabilitation therapy (n=36) or traditional rehabilitation therapy (n=36). The primary outcome of interest was improvement in postoperative functional recovery, measured by walking gait, muscle strength, pain (VAS score), disability (ODI score), hip function (Harris Hip Score), and pelvic tilt. Secondary outcomes included the reduction in the shortened length of the affected limb. Outcomes were assessed preoperatively and at 1, 3, and 6 months postoperatively. Overall, the results revealed that patients in the chiropractic rehabilitation group had significantly greater improvements in limp gait reduction, shortened limb length, pain relief, disability scores, hip function scores, and pelvic tilt at the final follow-up compared to the control group (P < .05 for most measures). However, improvements in muscle strength were not statistically significant between groups. These findings suggest that chiropractic rehabilitation therapy can be an effective adjunct in accelerating recovery after THA in Crowe IV DDH patients.