Division of Sports Medicine, Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, U.S.A.
Wayne State University School of Medicine, Detroit, Michigan, U.S.A.; Department of Orthopaedic Surgery, Henry Ford Hospital Detroit, Detroit, Michigan, U.S.A.
Arthroscopy. 2017 Nov;33(11):1998-2005. doi: 10.1016/j.arthro.2017.06.045. Epub 2017 Sep 29.
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 (http://www.isha.net/members/, 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.
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.
评估在线发表的髋关节镜检查治疗股骨髋臼撞击症（FAI）和/或盂唇撕裂后的术后物理治疗方案的全面性和变异性。
通过国际髋关节镜学会的“寻找外科医生”功能（http://www.isha.net/members/，搜索于 2016 年 8 月 10 日）确定外科医生。排除标准包括非外科医生和不符合髋关节镜检查治疗 FAI 和/或盂唇撕裂的其他条件的方案。通过审查外科医生的个人和部门网站来确定方案，并评估术后限制、康复内容以及结束限制和开始活动的时间点。
在 111 名可在线获得的外科医生中，有 31 名（27.9%）在线提供髋关节镜检查术后物理治疗方案。54.8%（17/31）的方案中使用了支具，中位数使用时间为 2 周（范围，1-6 周）。大多数方案都规定了术后最初的负重状态（29/31，93.5%），最常见的是部分负重，负重 20 磅，足平放在地面上（20/29，69.0%）。FAI 的负重限制时间中位数为 3 周（范围，2-6 周），微骨折的负重限制时间中位数为 6 周（范围，3-8 周）。大多数方案都规定了最初的活动范围限制（26/31，83.9%），中位数为 3 周（范围，1.5-12 周）。康复活动和开始活动的时间点存在很大差异。20/31（64.5%）的方案规定了恢复跑步的时间中位数为 12 周（范围，6-19 周），13/31（41.9%）的方案规定了重返运动的时间中位数为 15.5 周（范围，9-23 周）。
髋关节镜检查治疗 FAI 后，在线提供的术后物理治疗方案存在很大差异，包括术后限制、康复活动以及活动开始的时间点。
该信息为住院医师、研究员和经验丰富的髋关节关节镜医师提供了髋关节镜检查治疗 FAI 后在线提供的物理治疗方案的集中比较。执业关节镜医师可能会发现这项分析有助于将各种治疗策略与自己的建议进行比较。我们报告的这种差异也可以为未来更标准康复的疗效研究提供灵感。
