Variability and Comprehensiveness of North American Online Available Physical Therapy Protocols Following Hip Arthroscopy for Femoroacetabular Impingement and Labral Repair

Published:September 29, 2017DOI:


      To assess comprehensiveness and variability of postoperative physical therapy protocols published online following hip arthroscopy for femoroacetabular impingement (FAI) and/or labral repair.


      Surgeons were identified by the International Society for Hip Arthroscopy “Find a Surgeon” feature in North America (, search August 10, 2016). Exclusion criteria included nonsurgeons and protocols for conditions other than hip arthroscopy for FAI and/or labral tear. Protocols were identified by review of surgeons' personal and departmental websites and evaluated for postoperative restrictions, rehabilitation components, and the time points for ending restrictions and initiating activities.


      Of 111 surgeons available online, 31 (27.9%) had postoperative hip arthroscopy physical therapy protocols available online. Bracing was used in 54.8% (17/31) of protocols for median 2-week duration (range, 1-6 weeks). Most protocols specified the initial postoperative weight-bearing status (29/31, 93.5%), most frequently partial weight-bearing with 20 pounds foot flat (20/29, 69.0%). The duration of weight-bearing restriction was median 3 weeks (range, 2-6) for FAI and median 6 weeks (range, 3-8) for microfracture. The majority of protocols specified initial range of motion limitations (26/31, 83.9%) for median 3 weeks (range, 1.5-12). There was substantial variation in the rehabilitation activities and time points for initiating activities. Time to return to running was specified by 20/31 (64.5%) protocols at median 12 weeks (range, 6-19), and return to sport timing was specified by 13/31 (41.9%) protocols at median 15.5 weeks (range, 9-23).


      There is considerable variability in postoperative physical therapy protocols available online following hip arthroscopy for FAI, including postoperative restrictions, rehabilitation activities, and time points for activities.

      Clinical Relevance

      This information offers residents, fellows, and established hip arthroscopists a centralized comparison of publicly available physical therapy protocols following hip arthroscopy. Practicing arthroscopists might find this analysis useful to compare various therapy strategies to their own recommendations. The variability we report can also provide inspiration for future efficacy research toward a more standard rehabilitation.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Arthroscopy
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Montgomery S.R.
        • Ngo S.S.
        • Hobson T.
        • et al.
        Trends and demographics in hip arthroscopy in the United States.
        Arthroscopy. 2013; 29: 661-665
        • Cvetanovich G.L.
        • Chalmers P.N.
        • Levy D.M.
        • et al.
        Hip arthroscopy surgical volume trends and 30-day postoperative complications.
        Arthroscopy. 2016; 32: 1286-1292
        • Colvin A.C.
        • Harrast J.
        • Harner C.
        Trends in hip arthroscopy.
        J Bone Joint Surg Am. 2012; 94: e23
        • Bozic K.J.
        • Chan V.
        • Valone 3rd, F.H.
        • Feeley B.T.
        • Vail T.P.
        Trends in hip arthroscopy utilization in the United States.
        J Arthroplasty. 2013; 28: 140-143
        • Byrd J.W.
        • Jones K.S.
        Prospective analysis of hip arthroscopy with 10-year followup.
        Clin Orthop Relat Res. 2010; 468: 741-746
        • Philippon M.J.
        • Briggs K.K.
        • Carlisle J.C.
        • Patterson D.C.
        Joint space predicts THA after hip arthroscopy in patients 50 years and older.
        Clin Orthop Relat Res. 2013; 471: 2492-2496
        • Philippon M.J.
        • Briggs K.K.
        • Yen Y.M.
        • Kuppersmith D.A.
        Outcomes following hip arthroscopy for femoroacetabular impingement with associated chondrolabral dysfunction: minimum two-year follow-up.
        J Bone Joint Surg Br. 2009; 91: 16-23
        • McCarthy J.C.
        • Jarrett B.T.
        • Ojeifo O.
        • Lee J.A.
        • Bragdon C.R.
        What factors influence long-term survivorship after hip arthroscopy?.
        Clin Orthop Relat Res. 2011; 469: 362-371
        • Casartelli N.C.
        • Leunig M.
        • Maffiuletti N.A.
        • Bizzini M.
        Return to sport after hip surgery for femoroacetabular impingement: a systematic review.
        Br J Sports Med. 2015; 49: 819-824
        • McDonald J.E.
        • Herzog M.M.
        • Philippon M.J.
        Return to play after hip arthroscopy with microfracture in elite athletes.
        Arthroscopy. 2013; 29: 330-335
        • Grzybowski J.S.
        • Malloy P.
        • Stegemann C.
        • Bush-Joseph C.
        • Harris J.D.
        • Nho S.J.
        Rehabilitation following hip arthroscopy: a systematic review.
        Front Surg. 2015; 2: 21
        • Cheatham S.W.
        • Enseki K.R.
        • Kolber M.J.
        Postoperative rehabilitation after hip arthroscopy: a search for the evidence.
        J Sport Rehabil. 2015; 24: 413-418
        • Voight M.L.
        • Robinson K.
        • Gill L.
        • Griffin K.
        Postoperative rehabilitation guidelines for hip arthroscopy in an active population.
        Sports Health. 2010; 2: 222-230
        • Malloy P.
        • Malloy M.
        • Draovitch P.
        Guidelines and pitfalls for the rehabilitation following hip arthroscopy.
        Curr Rev Musculoskelet Med. 2013; 6: 235-241
        • Spencer-Gardner L.
        • Eischen J.J.
        • Levy B.A.
        • Sierra R.J.
        • Engasser W.M.
        • Krych A.J.
        A comprehensive five-phase rehabilitation programme after hip arthroscopy for femoroacetabular impingement.
        Knee Surg Sports Traumatol Arthrosc. 2014; 22: 848-859
        • Domb B.G.
        • Sgroi T.A.
        • VanDevender J.C.
        Physical therapy protocol after hip arthroscopy: clinical guidelines supported by 2-year outcomes.
        Sports Health. 2016; 8: 347-354
        • Ellsworth B.
        • Patel H.
        • Kamath A.F.
        Assessment of quality and content of online information about hip arthroscopy.
        Arthroscopy. 2016; 32: 2082-2089
        • MacLeod M.G.
        • Hoppe D.J.
        • Simunovic N.
        • Bhandari M.
        • Philippon M.J.
        • Ayeni O.R.
        YouTube as an information source for femoroacetabular impingement: a systematic review of video content.
        Arthroscopy. 2015; 31: 136-142