Summary

There exists a large amount of variability in recommended follow-up physical therapy protocols for patients undergoing hip arthroscopy

Abstract

Introduction

Hip arthroscopy remains one of the fastest-growing procedures in orthopaedic surgery with an 85% increase in procedure frequency from 2011 to 2018. There is agreement on the need for physical therapy following hip arthroscopy and a strong literature base on various modalities that can be implemented to aid recovery. Yet, little continuity exists amongst institutions on rehabilitation prescriptions. This study aims to identify common trends and the vast variability in publicly available physical therapy protocols following hip arthroscopy.

Methods

Inclusion in protocol collection was based on the 175 Accreditation Council for Graduate Medical Education accredited orthopaedic surgery programs and their affiliated surgeons. Rehabilitation protocols were collected utilizing a web-based search engine (Google.com) using the input “[Insert Program Name] hip arthroscopy rehabilitation protocol.” Each protocol was analyzed for variability in brace utilization, weight-bearing restrictions, range of motion restrictions, exercise implementation, and duration for each phase and modality of rehabilitation.

Results

Of the 175 programs, only 36 unique rehabilitation protocols were publicly available from 41 programs (23.4%). Thirteen (36.1%) protocols required brace usage with an average duration of 3.2 weeks. Weight-bearing restrictions had the largest variability ranging from full body weight to just 20 pounds of pressure. Range of motion restrictions were inconsistent among the 36 protocols with varying views on duration and degree of range of motion restriction for various hip rotations. Exercise implementation varied from phase to phase of recovery with little agreement between protocols. Variability in time to return to various levels of activity also existed among the protocols analyzed.

Conclusion

Publicly available physical therapy protocols following hip arthroscopy are scarce in the public domain and are highly variable. Most notably, variations exist in brace utilization, weight-bearing restrictions, and exercise utilization and progression. Future research should focus on discerning the most effective physical therapy protocol following hip arthroscopy.