Hip Arthroscopy / Labral Repair — Hip Arthroscopy for FAI / Labral Repair or Reconstruction

SOMOS (Society of Military Orthopaedic Surgeons) · Tri-Service Orthopedics & Physical Therapy Consultants

Weight-Bearing

WBAT with assistive device (dual crutches or rolling walker); D/C when pain controlled, gait normalized, and cleared by Ortho/PT; avoid toe-touch WB

Key Restrictions

No hip hyperext >10°; no combined hip rotation + flexion; no pivoting on operative extremity; no active hip ER for 4 weeks; passive hip ER ≤20° wks 0-4; no SLRs Phase 1 (iliopsoas tendonitis risk); 4 hrs continuous PROM/day (CPM or bike) days 1-7; no plyometrics/running until Phase 4; RTS contact/collision sports 6-9 months

Timeline & Phases

Phase 1 (wks 0-2): WBAT with assist, ROM precautions — 4 hrs PROM/day (CPM or bike without resistance), calf pumping, heel slides, quad/glute sets; days 8-14: passive IR/ER log rolling, AAROM/AROM, stationary bike, graded hip mobilizations, core → bridging, hip isometrics all planes, SAQ/LAQ, heel raises bilateral → unilateral; Phase 2 (wks 3-6): no active ER until 4 wks — bike progressive resistance, standing hip strengthening all planes with resistance, CKC (sit↔stand from elevated mat, wall slides, step-ups/downs multidirectional), pool if healed, gait training; Phase 3 (wks 6-12): full mobility goal, no jumping/running — LE stretching (adductor, ITB, hip flexor, HS, child's pose, calf), seated ER → theraband resistance, gluteal training, OKC strengthening, aerobic (bike/elliptical/stairmaster, non-impact intervals), pool PT, progressive balance (body blade, Romanian DL, plyoball), core progression (prone/side planks, dead bug, bridging → quadruped bird dog, cable chops), monster walks, leg press DL→SL; wks 11-12: AlterG/pool running; Phase 4 (months 3-6): jogging when able to hop without pain (10-20%/wk), agility (ladder drills), plyometrics, sport-specific; RTS contact/collision sports 6-9 months

Notes

Tri-Service guidelines (Army/Navy/Air Force); published May 2020; 4 hrs PROM/day (CPM or bike) during days 1-7; no SLRs Phase 1 (increases anterior hip joint force with inhibited iliopsoas); no active hip ER for 4 weeks; pass service fitness test 6 months; RTS aggressive military training 6-9 months

Surgeon / Author

Tri-Service Orthopedics & Physical Therapy Consultants

Published

2020