Rush University.
Arthroscopy. 2020 Jan;36(1):165-166. doi: 10.1016/j.arthro.2019.10.015.
Hip arthroscopy is the surgical treatment of choice for the treatment of femoroacetabular impingement syndrome and hip labral tears. Current guidelines on postoperative rehabilitation protocols are based on expert opinion, and evidence-based protocols are scarce. Previously, a non-weight-bearing protocol for several weeks after surgery was thought to prevent axial-load damage to the newly repaired labrum. However, there is a trend toward using immediate weight bearing as tolerated for early joint mobilization and pressurization. Strict weight-bearing restrictions may not be as necessary as once thought. We recommend that the first phase of rehabilitation prioritize joint protection to prevent joint inflammation and tissue irritation with a gradual increase in mobility exercises to restore range of motion. However, rehabilitation protocols should be tailored to address specific surgical findings, procedures, patient characteristics, and athletic goals. It is wise to be more conservative in older patients with poor bone quality. Bearing in mind this caveat, weight-bearing restrictions after hip arthroscopy may not improve outcomes and instead may have the negative effect of preventing patients from re-establishing a normal gait pattern.
髋关节镜检查是治疗股骨髋臼撞击综合征和髋关节盂唇撕裂的首选手术治疗方法。目前关于术后康复方案的指南是基于专家意见制定的，缺乏基于证据的方案。以前，人们认为手术后数周内采用非负重方案可以防止新修复的盂唇受到轴向负荷的损伤。然而，目前有向早期关节活动和加压时即开始耐受负重的趋势。严格的负重限制可能不像以前认为的那么必要。我们建议康复的第一阶段侧重于关节保护，以防止关节炎症和组织刺激，同时逐渐增加活动度练习以恢复活动范围。然而，康复方案应根据具体的手术发现、手术程序、患者特征和运动目标进行调整。对于骨质较差的老年患者，更为保守是明智的。考虑到这一警告，髋关节镜检查后限制负重可能不会改善结果，反而可能会产生负面影响，使患者无法重新建立正常的步态模式。
