Summary

Immediate Weight Bearing after Hip Arthroscopy for FAI has similar outcomes at 2 year follow-up when compared to non-weight bearing protocols. With limited evidence-based rehabilitation protocols available, these findings allow for a safe and more comfortable post-operative rehabilitation period.

Abstract

Purpose

To evaluate the effects of immediate postoperative weight bearing protocols following hip arthroscopy for femoracetabular impingement (FAI) with minimum two years follow-up.

Methods

Between January of 2011 and June of 2016, 133 patients who underwent arthroscopic surgery for FAI and/or labral tears met the inclusion criteria. Patients who were operated on before September of 2013, were treated with 3 weeks of postoperative non-weight bearing (NWB), with weight bearing as tolerated (WBAT) thereafter. From October of 2013 until June 2016, patients were allowed immediate postoperative weight bearing as tolerated. Of the 133 included patients, 69 were given NWB instructions and 64 were given immediate WBAT rehabilitation protocols. The patient reported outcome measurements (PROMS) used in this study were the Modified Harris Hip Score (MHHS) and Hip Outcome Score (HOS). Patient satisfaction was determined by whether or not the patient would retrospectively elect to undergo the same procedure.

Results

The demographics of the two groups did not differ significantly in terms of gender (P=.60) or age (P=.24). No significant differences were found between the two groups in post-operative scores (MHHS was 84.5 (79-89) for NWB vs. 86.7 (78-89) for WBAT (p=0.52) and HOS was 83.1 (78-88) vs. 88.4 (80-90) p=0.13). There was no significant difference in scores across age groups. Subjective rates of improvement did not differ significantly (85% NWB vs. 93.8% WBAT, p=0.67). The mean satisfaction score was 84.2 (78-90) for NWB patients vs. 84.7 (71-86) for WBAT patients (p=0.88). 84% of NWB patients and 91.5% of WBAT patients would elect to undergo surgery again (p=0.73). There were no reported complications.

Conclusion

PROMS (2-year follow-up) and satisfactory rates resulting from postoperative immediate weight bearing protocols do not differ significantly from those recorded after strict non-weight bearing rehabilitation protocols. Revising rehabilitation protocols based on this result may allow for a more comfortable rehabilitation process.