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

Massachusetts General Hospital · MGH Sports Medicine

Weight-Bearing

PWB 20 lbs foot-flat step-to with crutches wks 0-2; wean crutches wk 3+

Key Restrictions

No active SLR; no active hip flexion x 21 days (self-assisted only); hip flexion 0-90 deg, ext 0 deg (no beyond neutral), ABD 0-30, ER 0-30, IR 0-30 Phase I; no grade III-IV hip mobs; no long axis hip distraction (labral repair or reconstruction); avoid sitting >30 min x 2 wks; sit with hip angle <90 deg; prone lying 15 min 2-3x/day to avoid hip flexor contracture; capsular closure: protect ER and extension; labral reconstruction: stricter timeline than repair; avoid hip flexor tendinitis, synovitis, trochanteric bursitis, LBP/SI pain throughout

Timeline & Phases

5 phases: Phase I (0-2 wks, PWB 20 lbs foot-flat with crutches, hip flexion 0-90 deg, extension 0, ABD/ER/IR 0-30 deg, circumduction, upright bike), Phase II (3-5 wks, progress weight bearing, non-antalgic gait without device), Phase III (6-11 wks, normalize hip ROM, flutter kick swimming, strengthening without pain), Phase IV (12+ wks, transitional, Y Balance LSI 80% and hip strength 90% to progress), Phase V (4+ months, early return to sport, jogging when cleared by surgeon)

Notes

Criterion-based; capsular closure discussed as a special post-op consideration; labral repair vs reconstruction differentiated (reconstruction = longer timeline); small-range PROM circumduction at 70 deg hip flexion to avoid post-op adhesions; progression to return to sport: Y Balance LSI 80%, operative hip strength 90% of uninvolved side, jogging when cleared by surgeon; revised 07/2024.

Surgeon / Author

MGH Sports Medicine