Rehabilitation Following Hip Arthroscopy
R Villar, The Wellington Hospital
A Manos, Pure Sports Medicine, London
Hip arthroscopy rehabilitation overview
- No hip arthroscopy is complete without a comprehensive post-operative physiotherapy program.
- It takes approx three months for your hip to recover from hip arthroscopy (procedure dependent) and for you to judge the results of surgery, though improvement may still be gained up to one year from surgery.
- A skilled sports physiotherapist who is familiar with hip arthroscopy rehabilitation is a real bonus, however, the following rehabilitation programs aim to guide all interested physiotherapists and help you achieve the optimal recovery after hip arthroscopy.
- Simple exercises are permitted on the day of surgery, but you should aim to meet your physiotherapist a week after discharge to start a formal program.
- Aim to meet initially 2-3 times per week at the beginning of the program stretching reviews out to once every 2-3 weeks by the end of the program.
The Aims of Rehabilitation
- Ensure good pre-hab (education, motor control, active ROM, relative strength)
- Maintain and improve active ROM at hip, lumbar spine.
- Ensure good lumbo-pelvic dissociation and good abdominal and hip motor control.
- Improve strength, power, balance and function of larger muscle groups.
- Return to previous level of function within a suitable time.
Grades of Arthroscopy
- Simple : labral debridement, clean out, removal of loose bodies, small FAI = ‘Fast Track’
- Advanced : labral repair, large FAI, subchondral microfracture, ligamentum teres tears, acetabular rim recession, iliopsoas decompression and release = ‘Slow Track'
Guidelines for Rehab
- Weight-bearing status is a significant factor in determining the stage and rate of progression for rehab.
- Simple : the rehab is very much guided by pain as there is no structural damage/repair. Toe-touch weight-bearing for four days.
- Advanced : hip rotation and extremes of flexion may be restricted to protect the ligamentum teres/labral repair, while the chondral surfaces are protected by toe-touch weight-bearing for four weeks.
- Is a guideline only – clinician assessment and judgement is the most important aspect.
- The timescales are estimates – but more important for advanced hip arthroscopy – safety aspect to certain exercises.
- The exercises cover all aspects of rehab – active ROM, motor control, cardiovascular exercise, function, return to sport and manual therapy.
- It is not a recipe, but allows for the clinician to highlight problem areas and progression.
Fast track Programme Table
Click to see table
Slow Track Programme Table
Click to see table