Hip Labral Repair Physical Therapy Guidelines | FAI Surgery Rehabilitation | CAM Reduction – FPF Show Episode 45

By dpope2020

August 12, 2022

arthroscopic hip repair, dan pope, fai surgery, fitness pain free, hip arthroscopy, hip arthroscopy surgery, hip impingement, hip impingement surgery, Hip Labral Tear, hip labral tear physical therapy, hip labral tear surgery, hip labral tear surgery recovery, hip labrum repair surgery, hip labrum tear, hip pain, hip surgery, hip surgery labral tear, labral tear, labral tear hip, labrum tear, physical therapy, torn hip labrum, torn labrum, torn labrum hip

Hip Labral Repair Physical Therapy Guidelines | FAI Surgery Rehabilitation | CAM Reduction

To go along with today's episode I have a nice infographic to share...

Sign up to receive FREE: The Evidence Based FAI Cheat Sheet

Click HERE to Download FREE

In today's episode we go over Hip Labral Repair Physical Therapy Guidelines | FAI Surgery Rehabilitation | CAM Reduction:

  • 0:00 Introduction
  • 1:36 What is the surgery for femoral acetabular impingement syndrome?
  • 3:21 What are the surgical goals of hip labral (labrum) repair?
  • 4:59 What does surgery for CAM morphology (CAM reduction) look like?
  • 8:10 What does surgery for Pincer Morphology look like?
  • 9:34 What is the surgical goal behind femoral arthroplasty?
  • 10:20 When is surgery appropriate for femoral acetabular impingement syndrome?
  • 13:10 What do physical therapists NEED to know before starting therapy with hip labral repair patients?
  • 14:35 How the size of the hip labral tear and the patient's tissue quality effect physical therapy progression.
  • 15:28 How hip labral tear location and degree of cartilage damage influence physical therapy progression and weight bearing status
  • 18:24 What red flags to be on the lookout for after hip labral repair surgery
  • 21:19 What post-surgical restrictions in range of motion are expected after hip labral repair surgery?
  • 25:22 What weight bearing restrictions are expected after hip labral repair surgery?
  • 27:39 What are the most important questions for the physical therapist to ask the surgeon prior to starting physical therapy?
  • 31:44 What medications are hip labral repair patients taking after surgery?
  • 32:25 Why physical therapists should follow the surgeon's post-operative protocol
  • 33:18 What to do if you disagree with the surgeon's post-operative protocol
  • 36:00 What physical therapists need to be on the lookout for in the early stages of hip labral repair surgery

Listen and Subscribe to the Podcast

You can listen to the podcast and subscribe with any of the links below. 

Spotify -  Apple podcasts - Youtube 

Want to support me and decide topics for future episodes?  Click HERE to sign up for FPF "Insiders" for just a dollar. You'll gain access to 100+ webinars, e-books and complete guides.  Plus, you'll get private access to the "Insiders" Facebook group where you can have all of your questions answered by me.  

Looking for other ways to support me that are 100% free?

  • Like, comment and share on youtube, facebook and instagram 
  • Leave a 5-star review on apple podcasts

Thank you!

Dan Pope DPT, OCS, CSCS

References:

  1. Cheatham SW, Kolber MJ. Rehabilitation after hip arthroscopy and labral repair in a high school football athlete. Int J Sports Phys Ther. 2012 Apr;7(2):173-84. PMID: 22530192; PMCID: PMC3325633.
  2. Shenoy K, Dai AZ, Mahure SA, Kaplan DJ, Capogna B, Youm T. Arthroscopic Repair of Hip Labrum With Suture Anchors. Arthrosc Tech. 2017 Nov 13;6(6):e2143-e2149. doi: 10.1016/j.eats.2017.08.007. PMID: 29349010; PMCID: PMC5766290.
  3. Griffin DR, Dickenson EJ, O'Donnell J, et alThe Warwick Agreement on femoroacetabular impingement syndrome (FAI syndrome): an international consensus statement British Journal of Sports Medicine 2016;50:1169-1176.
  4. Ganz R, Parvizi J, Beck M, et al. Femoroacetabular impingement: a cause for osteoarthritis of the hip. Clin Orthop Relat Res 2003;417:112–20. doi:10.1097/01.blo.0000096804.78689.c2
  5. The Prevalence of Cam and Pincer Morphology and Its Association With Development of Hip Osteoarthritis. Van Klij, P., Heerey, J., Waarsing, J. H., & Agricola, R. (2018). Journal of Orthopaedic & Sports Physical Therapy, 48(4), 230–238.doi:10.2519/jospt.2018.7816
  6. Casartelli NC, Maffiuletti NA, Item-Glatthorn JF, Staehli S, Bizzini M, Impellizzeri FM, Leunig M. Hip muscle weakness in patients with symptomatic femoroacetabular impingement. Osteoarthritis Cartilage. 2011 Jul;19(7):816-21. doi: 10.1016/j.joca.2011.04.001. Epub 2011 Apr 12. PMID: 21515390.
  7. Pålsson A, Kostogiannis I, Ageberg E. Combining results from hip impingement and range of motion tests can increase diagnostic accuracy in patients with FAI syndrome. Knee Surg Sports Traumatol Arthrosc. 2020 Oct;28(10):3382-3392. doi: 10.1007/s00167-020-06005-5. Epub 2020 Apr 25. PMID: 32335699; PMCID: PMC7511272.
  8. Zhu Y, Su P, Xu T, Zhang L, Fu W. Conservative therapy versus arthroscopic surgery of femoroacetabular impingement syndrome (FAI): a systematic review and meta-analysis. J Orthop Surg Res. 2022 Jun 3;17(1):296. doi: 10.1186/s13018-022-03187-1. PMID: 35659016; PMCID: PMC9166461.
  9. Pennock AT, Bomar JD, Johnson KP, Randich K, Upasani VV. Nonoperative Management of Femoroacetabular Impingement: A Prospective Study. Am J Sports Med. 2018 Dec;46(14):3415-3422. doi: 10.1177/0363546518804805. Epub 2018 Nov 6. PMID: 30398893.
  10. Kemp JL, Mosler AB, Hart H, et al Improving function in people with hip-related pain: a systematic review and meta-analysis of physiotherapist-led interventions for hip-related pain British Journal of Sports Medicine 2020;54:1382-1394.
  11. Kruger PC, Eikelboom JW, Douketis JD, Hankey GJ. Deep vein thrombosis: update on diagnosis and management. Med J Aust. 2019 Jun;210(11):516-524. doi: 10.5694/mja2.50201. Epub 2019 Jun 2. PMID: 31155730.
  12. Zabaglo M, Sharman T. Postoperative Wound Infection. [Updated 2021 Dec 12]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK560533/
  13. Philippon MJ, Briggs KK, Carlisle JC, Patterson DC. Joint space predicts THA after hip arthroscopy in patients 50 years and older. Clin Orthop Relat Res. 2013 Aug;471(8):2492-6. doi: 10.1007/s11999-012-2779-4. PMID: 23292888; PMCID: PMC3705033.

Image References:

14. Hip Anatomy - Image Source, License, Attribution: OpenStax College – Edited by Fitness Pain Free LLC