Hip Arthroscopy with Labral Repair - Postoperative Protocol | Jeremy M. Burnham, MD

Orthopedic Surgery, Sports Medicine, & Knee Doctor | Board Certified


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Hip Arthroscopy with Labral Repair – Postoperative Protocol

*Rehabilitation protocol adapted from Brian Busconi, MD

Bracing, Crutches, and CPM Machine

  • Crutches: 4 weeks
    • After arthroscopic hip surgery to repair a torn labrum, it is important to protect the repair while the labrum is healing. For this reason you will need to use crutches for 4 weeks.
  • Brace: 4-6 weeks
    • A brace is often used to help protect the repaired labrum and hip capsule.
  • Continuous Passive Motion (CPM)

Motion Restrictions

  • Days 0-10: Hip flexion of no more than 90 degrees
  • Weeks 0-3: Limit hip extension to 0 degrees, no internal or external rotation

Medications

  • Pain medications will be prescribed after your hip arthroscopy procedure.
    • It is very important to follow the directions exactly.
    • Your surgeon will work with you ensure optimal pain control.
  • Heterotopic Ossification Prophylaxis: Naproxen 500mg, twice a day, for 4 weeks.
    • Heterotopic ossification, or abnormal bone formation in the soft tissues.
    • It is a rare, but well-known, complication after hip arthroscopy.
    • Naproxen is a non-steroidal anti-inflammatory (NSAID) that helps to prevent heteropic ossification.
    • If Naproxen is prescribed for you, it is very important that this medicine is taken according to the instructions.

Weeks 0-2

Passive Range of Motion

  • Hip circumduction with hip in 70 degrees of flexion (3 sets for 5 minutes)
  • Flexion to 90 degrees for 20 reps
  • External Rotation in Flexion (70 degrees flexion, 20 reps)
  • Supine Abduction: 25 degrees for 20 reps
  • Side lying piriformis stretch
  • Quadriceps stretch (prone without hip extension)

Strengthening

  • Ankle pumps (progress to Theraband)
  • Isometrics: glutes, quads, abdominals, hip abductors and adductors
  • Gluteal slides (start at postoperative day #2-3, progress to standing by day 10)
  • Short arc quadriceps exercises
  • Side lying hip abduction
  • Bridge

Cardiovascular

  • Stationary bike (starting immediately)
  • Elliptical (with brace, starting at postoperative day #5)
  • Aqua jogging
  • Alter-G at 50% body weight (with brace)

Week 3

Passive Range of Motion

  • Hip Circumduction (with hip in 70 degrees of flexion, 3 sets for 5 minutes)
  • Flexion (to 90 degrees for 20 reps)
  • External Rotation in Flexion (hip flexed at 70 degrees, 20 reps)
  • Supine Abduction (limited to 25 degrees, 20 reps)
  • Side lying Piriformis Stretch
  • Quadriceps Stretch (prone without hip extension)
  • Prone Internal and External Rotation (with knee flexed to 90)

Strengthening

  • Ankle pumps (progress to Theraband)
  • Isometrics: glutes, quads, abdominals, hip abductors and adductors
  • Gluteal slides (start at postoperative day #2-3, progress to standing by day 10)
  • Short arc quadriceps exercises
  • Side lying hip abduction
  • Bridge

Cardiovascular

  • Stationary bike
  • Elliptical
  • Aqua jogging
  • Alter-G at 50% body weight