Hip Arthroscopy / Labral Repair — Hip Arthroscopy for FAI with Labral Repair — Pediatric

Massachusetts General Hospital · MGH Brigham Pediatric Sports Medicine

Weight-Bearing

PWB 20 lbs foot-flat step-to with bilateral crutches wks 0-3; WBAT wks 4-6; wean crutches by 6-8 wks

Key Restrictions

Hip ROM Phase I: flex 0-90/ext 0 (no beyond neutral)/ABD 0-30/ER 0-30/IR 0-30; no active SLR or hip flexion x 21 days (self-assisted only); no sitting >30 min wks 0-2; sit with hip angle <90 deg; prone lying 15 min 2-3x/day; no Grade III-IV mobs until wk 8; no long axis distraction until wk 8 (labral repair) or wk 12 (labral reconstruction); capsular repair: protect ER and extension; cam deformity resection increases femoral neck fracture risk; higher prevalence of cam deformities in adolescent athletes; pudendal nerve palsy risk; avoid hip flexor tendonitis/synovitis/trochanteric bursitis/SI pain throughout

Timeline & Phases

Phase I (0-3 wks): CPM 2 hrs/day, hip circumduction PROM, log rolls, quad/glute sets, hip isometrics (no flexion), stationary bike 20 min 2x/day; Phase II (4-6 wks): WBAT, elliptical 3-4 wks, aqua therapy wk 4, bilateral bridging, standing hip ABD/extension, clamshells; Phase III (7-12 wks): wean crutches 6-8 wks, partial squats to 90 deg, lateral band walks, SL balance with clock taps, swimming (flutter kick only); Phase IV (12-16 wks): treadmill running 14-16 wks if cleared, advanced balance, sport-specific plyometrics; Phase V (16+ wks): RTS, crossover triple hop >=90%, Y Balance >=80%, quad/HS/glut >90% HHD

Notes

Revised 3/2023; 5-phase protocol; labral repair vs reconstruction: reconstruction adds 4+ weeks to each phase; circumduction critical for adhesion prevention (early post-op); outcome measures: HOS or LEFS; pediatric-specific considerations: open apophyses, cam deformity prevalence in adolescent athletes, femoral neck fracture risk with head-neck resection. [Archived copy — original Massachusetts General Hospital URL retired in the Mass General Brigham site migration; Wayback snapshot 2026-01-17.]

Surgeon / Author

MGH Brigham Pediatric Sports Medicine

Published

2023-03