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A comprehensive five-phase rehabilitation programme after hip arthroscopy for femoroacetabular impingement

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

Recent advancements in the understanding of hip biomechanics have led to the development of techniques to remove bony impingement and repair and/or preserve the labrum during hip arthroscopy. Although much attention in the literature is devoted to diagnosis and treatment, there is little information about post-operative rehabilitation. Therefore, the purpose of this review is to (1) provide a five-phase rehabilitation protocol following arthroscopic treatment for FAI and (2) report clinical and functional outcomes of patients following this protocol at minimum 1-year follow-up, in order to provide the surgeon and therapist with a protocol that is supported by clinical data.

Methods

All consecutive patients undergoing hip arthroscopy and subsequent five-phase rehabilitation protocol at a single institution from 1 April 2011 to 1 April 2012 were analysed. Inclusion criteria were as follows: no prior ipsilateral hip surgery, completion of the five-phase rehabilitation protocol, minimum 1-year follow-up, and documented outcome scores. Prospective outcomes were assessed with modified Harris hip score (MHHS) and hip outcome score (HOS).

Results

Fifty-two patients (19 male and 33 female) met the inclusion criteria with a median age of 42 (range 16–59) years. Mean MHHS, HOS-ADL, and HOS-sport scores at a mean 12.5 (range 12–15) months were 80.1 ± 19.9 (0–100), 83.6 ± 19.2 (13.2–100), and 70.3 ± 27.0 (0–100), respectively.

Conclusion

This five-phase rehabilitation programme provides a framework where progression from surgery to increasing post-operative activity level can take place in a predictable manner. Patients following this rehabilitation protocol after hip arthroscopy demonstrated satisfactory clinical and functional outcomes, validating its implementation.

Level of evidence

Case series, Level IV.

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Conflict of interest

Dr. Bruce Levy is a consultant and receives royalties from Arthrex inc. and serves on the editorial board for Knee Surgery, Sports Traumatology, Arthroscopy.

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Correspondence to Aaron J. Krych.

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Spencer-Gardner, L., Eischen, J.J., Levy, B.A. et al. A comprehensive five-phase rehabilitation programme after hip arthroscopy for femoroacetabular impingement. Knee Surg Sports Traumatol Arthrosc 22, 848–859 (2014). https://doi.org/10.1007/s00167-013-2664-z

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  • DOI: https://doi.org/10.1007/s00167-013-2664-z

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