Rehabilitation Following Hip Arthroscopy: Takla-O’Donnell Protocol (TOP) for Physical Therapy

  • Amir Takla


Assessment and treatment of hip pathology have been revolutionized with hip arthroscopy. In turn, surgical assessment and treatment via hip arthroscopy have therefore progressed significantly over the past decade. Physiotherapists will need to be aware of such advances as this will have significant implications on the rehabilitation process. The Takla-O’Donnell Protocol (TOP) provides a pre-/postoperative program to the patient regarding the surgical procedure and strengthening of the deep hip muscles to facilitate local muscular control followed by global retraining. The TOP will provide a process by which physiotherapist could guide, monitor, and advance patients in the rehabilitation process.


Hip Femoroacetabular impingement FAIS Rehabilitation Takla-O’Donnell Protocol Hip arthroscopy 

Supplementary material

462715_1_En_15_MOESM1_ESM.docx (18 kb)
Data 15.1 (DOCX 17 kb)


  1. 1.
    Shindle M, Ranawat A, Kelly M. Diagnosis and management of traumatic and atraumatic hip instability in the athletic patient. Clin Sports Med. 2006;25:309–26.CrossRefGoogle Scholar
  2. 2.
    Kallas KM, Guanche CA. Physical examination and imaging of hip injuries. Oper Tech Sports Med. 2002;10:176–83.CrossRefGoogle Scholar
  3. 3.
    Anderson K, Strickland S, Warren R. Hip and groin injuries in athletes. Am J Sports Med. 2001;29:521.CrossRefGoogle Scholar
  4. 4.
    Clohisy J, Keeney J, Schoenecker P. Preliminary assessment and treatment guidelines for hip disorders in young adults. Clin Orthop Relat Res. 2005;441:168–79.CrossRefGoogle Scholar
  5. 5.
    Griffin K. Rehabilitation of the hip. Clin Sports Med. 2001;20(4):837–50.CrossRefGoogle Scholar
  6. 6.
    Rooks DS, Huang J, Bierbaum BE, Bolus SA, Rubano J, Connolly CE, Alpert S, Iversen MD, Katz JN. Effect of preoperative exercise on measures of functional status in men and women undergoing total hip and knee arthroplasty. Arthritis Rheum. 2006;55(5):700–8.CrossRefGoogle Scholar
  7. 7.
    Enseki K, Martin R, Draovitch P, Kelly B, Philippon M, Schenker M. The hip joint: arthroscopic procedures and postoperative rehabilitation. J Orthop Sports Phys Ther. 2006;36(7):516–25.CrossRefGoogle Scholar
  8. 8.
    Philippon M, Stubbs A, Schen M. Arthroscopic management of femoroacetabular impingement: osteoplasty technique and literature review. Am J Sports Med. 2007;35:1571–80.CrossRefGoogle Scholar
  9. 9.
    Kinnaman K, Mabrey JD. Arthroscopy of the hip joint: an overview. Orthop Nurs. 2006;25(2):93–7.CrossRefGoogle Scholar
  10. 10.
    Bennell KL, Spiers L, Takla A, et al. Efficacy of adding a physiotherapy rehabilitation programme to arthroscopic management of femoroacetabular impingement syndrome: a randomised controlled trial (FAIR). BMJ Open. 2017;7:e014658. Scholar
  11. 11.
    Barker PJ, Briggs CA, Bogeski G. Tensile transmission across the lumbar fasciae in unembalmed cadavers: effects of tension to various muscular attachments. Spine (Phila Pa 1976). 2004;29(2):129–38.CrossRefGoogle Scholar
  12. 12.
    Stracciolini A, Meehan WP III, d’Hemecourt PA. Sports rehabilitation of the injured athlete. Clin Ped Emerg Med. 2007;8(1):43–53.CrossRefGoogle Scholar
  13. 13.
    Austin A, Souza R, Meyer J, Powers C. Identification of abnormal hip motion associated with acetabular labral pathology. J Orthop Sports Phys Ther. 2008;38(9):558–65.CrossRefGoogle Scholar
  14. 14.
    Bharam S. Labral tears, extra-articular injuries, and hip arthroscopy in the athlete. Clin Sports Med. 2006;25:279–92.CrossRefGoogle Scholar
  15. 15.
    Pua Y, Wrigley T, Cowan S, Bennell K. Intrarater test-retest reliability of hip range of motion and hip muscle strength measurements in persons with hip osteoarthritis. Arch Phys Med Rehabil. 2008;89:1146–54.CrossRefGoogle Scholar
  16. 16.
    Konin J, Nofsinger C. Physical therapy management of athletic injuries of the hip. Oper Tech Sports Med. 2007;15:204–16.CrossRefGoogle Scholar
  17. 17.
    Bennell KL, O’Donnell JM, Takla A, Spiers L, Hunter D, Staples M, Hinman R. Efficacy of a physiotherapy rehabilitation program for individuals undergoing arthroscopic management of femoroacetabular impingement—the FAIR trial: a randomised controlled trial protocol. BMC Musculoskelet Disord. 2014;15:58.CrossRefGoogle Scholar
  18. 18.
    Grant L, Cooper D, Conway L. The HAPI ‘hip arthroscopy pre-habilitation intervention’ study: does pre-habilitation affect outcomes in patients undergoing hip arthroscopy for femoro-acetabular impingement? J Hip Preserv Surg. 2017;4(1):85–92.PubMedPubMedCentralGoogle Scholar
  19. 19.
    Aung H, Sakamoto H, Sato H. Anatomical study of the obturator internus, gemelli and quadratus femoris muscles with special reference to their innervation. Anat Rec. 2001;263:41–52.CrossRefGoogle Scholar
  20. 20.
    Delp S, Hess W, Hungerford D, Jones L. Variation of rotation moment arms with hip flexion. J Biomech. 1999;32:493–501.CrossRefGoogle Scholar
  21. 21.
    Debevec H, Mavcic B, Cimerman M, Tonin M, Kralj-Igli V, Daniel M. Acetabular forces and contact stresses in active abduction rehabilitation. In: IFMBE Proceedings MEDICON, Vol. 16; 2007. p. 915–918.Google Scholar
  22. 22.
    Stalzer S, Wahoff M, Scanlan M. Rehabilitation following hip arthroscopy. Clin Sports Med. 2006;25:337–57.CrossRefGoogle Scholar
  23. 23.
    Mendelsohn M, Overend T, Petrella R. Effect of rehabilitation on hip and knee proprioception in older adults after hip fracture: a pilot study. Am J Phys Med Rehabil. 2004;83(8):624–32.CrossRefGoogle Scholar
  24. 24.
    Byrd T, Jones W. Diagnostic accuracy of clinical assessment, magnetic resonance imaging, magnetic resonance arthrography, and intra-articular injection in hip arthroscopy patients. Am J Sports Med. 2004;32:1668.CrossRefGoogle Scholar
  25. 25.
    Torry M, Schenker M, Martin H, Hogoboom D, Philippon M. Neuromuscular hip biomechanics and pathology in the athlete. Clin Sports Med. 2006;25:179–97.CrossRefGoogle Scholar
  26. 26.
    Kelly B, Weiland D, Schenker M, Philippon M. Current concepts arthroscopic labral repair in the hip: surgical technique and review of the literature. Arthroscopy. 2005;21(12):1496–504.CrossRefGoogle Scholar

Copyright information

© ISAKOS 2019

Authors and Affiliations

  • Amir Takla
    • 1
  1. 1.Australian Sports PhysiotherapySwinburne University of Technology/The University of MelbourneMelbourneAustralia

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