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Postoperative Rehabilitation for Arthroscopic Management of Femoroacetabular Impingement Syndrome: a Contemporary Review

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Abstract

Purpose of Review

Femoroacetabular impingement syndrome (FAIS) is a common cause of hip pain that may potentially lead to osteoarthritis. Operative management of FAIS seeks to arthroscopically reshape the abnormal hip morphology and repair the labrum. For rehabilitation following operative management, a structured physical therapy program is unanimously recommended for the patient to return to their previous level of physical activity. Yet, despite this unanimous recommendation, significant heterogeneity exists among the current recommendations for postoperative physical therapy programs.

Recent Findings

A four-phase postoperative physical therapy protocol is favored among current literature, with each phase being comprised of its own goals, restrictions, precautions, and rehabilitation techniques. Phase 1 aims to protect the integrity of the surgically repaired tissues, reduce pain and inflammation, and regain ~ 80% of full ROM. Phase 2 guides a smooth transition to full weightbearing, so the patient may regain functional independence. Phase 3 helps the patient become recreationally asymptomatic and restores muscular strength and endurance. Finally, phase 4 culminates in the pain-free return to competitive sports or recreational activity.

Summary

At this time, there exists no single, unanimously agreed upon postoperative physical therapy protocol. Among the current recommendations, variation exists regarding specific timelines, restrictions, precautions, exercises, and techniques throughout the four phases. It is imperative to reduce ambiguity in current recommendations and more specifically define postoperative physical therapy following operative management of FAIS to more expeditiously return patients to functional independence and physical activity.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, University of Missouri School of Medicine, Columbia, MO, USA

    Stefan Hanish, Maaz Muhammed, Shayne Kelly & Steven DeFroda

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  1. Stefan Hanish
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  2. Maaz Muhammed
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Correspondence to Steven DeFroda.

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Conflict of Interest

Stefan Hanish, Maaz Muhammad, and Shayne Kelly declare that they have no conflict of interest.

Steven DeFroda receives research support from Arthrex. He is an editorial board member for Arthroscopy Journal. He is a speaker for AO North America.

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Hanish, S., Muhammed, M., Kelly, S. et al. Postoperative Rehabilitation for Arthroscopic Management of Femoroacetabular Impingement Syndrome: a Contemporary Review. Curr Rev Musculoskelet Med 16, 381–391 (2023). https://doi.org/10.1007/s12178-023-09850-2

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  • DOI: https://doi.org/10.1007/s12178-023-09850-2

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