Hip Arthroscopy / Labral Repair — Labral Repair with Capsular Plication

Orthopedic & Sports Medicine Specialists (OSMS)

Weight-Bearing

50% WB first 2 wks (non-WB if microfracture noted in op report); WBAT with bilateral AD at 2 wks, unilateral crutch possible at wk 5, progressing to no AD at wk 6 if appropriate

Key Restrictions

No straight leg raises Phase I; PROM: extension 0 deg x4 wks, abduction 25-30 deg x3 wks, IR 0 deg x3 wks, ER 0 deg x4 wks then gentle progression; avoid forced/aggressive stretching Phase II; avoid SLR initially (psoas irritation risk); no contact activities Phase III

Timeline & Phases

Phase I, Immediate Rehabilitation (wks 1-4, begin POD 1-7): protect repaired tissue, restore ROM within guidelines, prevent muscular inhibition/gait abnormalities, diminish pain/inflammation, caregiver circumduction 1x/day; wks 1-2: PROM/manual treatment (circumduction, gentle PROM abduction/flexion pain-free), HEP (seated hamstring stretch, single knee to chest, prone quad stretch, quad/glute sets, ankle pumps), scar massage/STM to TFL/ITB/psoas/iliacus/adductors/piriformis/QL/paraspinals; wks 3-4: PROM within guidelines (circumduction, gentle abduction/flexion), add IR at wk 3 and extension/ER at wk 4, stationary bike without resistance at wk 3, SAQs, transverse abs isometrics, hip abduction/adduction isometrics, bent knee fallout stretch at wk 4, progress off bilateral crutches/walker if not already done; Phase II, Intermediate Rehabilitation (wks 4-12, criteria: low pain, minimal irritation, appropriate ROM progression): restore full hip ROM before strengthening, restore normal gait, progressive hip/pelvis/LE strengthening; continue PROM/stretches, add piriformis and FABER stretches at wk 6, progress to normal gait before strengthening, stationary bike resistance increase (elliptical at wk 8), clams, bridges, shallow squatting, step-ups, lateral step-ups, balance, medial step-down, avoid SLR (use step-ups/isometric SL holds/marching/prone planks/steamboats for psoas strengthening instead), core and gluteus medius/maximus focus to address FAI movement patterns; Phase III, Advanced Rehabilitation/Return to Sport (wks 12-18, criteria: symmetrical AROM, normalized gait, hip flexor strength >4/5, hip abd/add/ext/ER/IR strength >4+/5, SLS 30 sec, medial tap down without valgus collapse): full symmetrical muscular strength, restore pre-op cardiovascular endurance; squat progression, jump progression, hop progression, jog progression via ladder drills/carioca/slide board/elliptical then 5-phase walk-to-run program; no contact activities throughout

Notes

OSMS Rehabilitation Guidelines; one of three distinct OSMS labral repair protocols (capsulotomy, capsular plication, capsular repair/closure) — always refer to operative note for exact procedure; if gluteus medius/minimus repair also performed, follow the more restrictive gluteus medius protocol instead; walk-to-run progression sourced from OSU Sports Medicine (2012)