Hip Arthroscopy / Labral Repair — Hip Arthroscopy with Labral Repair/Reconstruction

Dr. Bradley Smith MD (Intermountain Health) · Dr. Bradley Smith MD

Weight-Bearing

PWB 20 lbs foot-flat step-to gait with crutches wks 0-3; gradually increase to WBAT pain-free wks 4-6; wean from crutches (two, one, none) by 6-8 wks

Key Restrictions

Phase I limits: hip flexion 0-90 deg, extension 0 (none beyond neutral), ABD/ER/IR 0-30 deg; Phase II limits: extension 0-10, ABD/ER/IR 0-45 deg, flexion progressed pain-free; no active SLR for 8 wks; no active hip flexion days 0-21 (self-assisted only); no grade III-IV hip mobs for first 6-8 wks; no long-axis distraction for 8 wks (labral repair) or 12 wks (labral reconstruction); no crossing legs; avoid sitting >30 min first 2 wks; Phases III-IV: no extreme combined ROM, no plyometrics, no running, no squatting below 90 deg, no pivoting on operative leg; jogging at 16-18 wks per surgeon

Timeline & Phases

5 phases: Phase I (0-3 wks, immediate post-op, PWB 20 lbs, small-range PROM circumduction at 70 deg flexion, upright bike), Phase II (4-6 wks, WBAT, upright bike up to 20 min 2x/day, hip strengthening), Phase III (7-12 wks, wean crutches, normalize gait and ROM, flutter-kick swimming, no running or plyometrics), Phase IV (12+ wks, transitional, >=4/5 LE and trunk strength, Y Balance LSI 80% to progress), Phase V (about 4 months, early return to sport, jogging at 16-18 wks when cleared, crossover triple hop 90% and 30 min jog)

Notes

Checkbox format for procedures performed (acetabuloplasty, femoroplasty, labral repair/debridement/reconstruction, capsular repair, chondroplasty, microfracture, endoscopic trochanteric bursa excision, endoscopic abductor repair) and for routine vs less-aggressive pace; multi-page protocol with exercise lists per phase

Surgeon / Author

Dr. Bradley Smith MD