Protected Weight-Bearing and Early Passive Mobilization Are Common Components of Rehabilitation After Hip Arthroscopy With Labral Reconstruction.

Purpose: To perform a systematic review of postoperative rehabilitation protocols after hip arthroscopy with labral reconstruction. Methods: A systematic review was conducted by searching PubMed, the Cochrane Library, and Embase databases for studies reporting postoperative rehabilitation protocols after hip arthroscopy with labral reconstruction. Inclusion criteria were clinical studies detailing rehabilitation protocols after hip arthroscopy with primary labral reconstruction. Studies were excluded if they involved revision procedures, lacked rehabilitation protocols, or were nonclinical reports. The search terms used were: hip labral reconstruction. Extracted data included initial weight-bearing (WB) status, time to full WB, use of continuous passive motion (CPM), initial range of motion limitations, brace use and duration, physical therapy modalities, return-to-sports timing, patient-reported outcome measures, and reoperation rates, defined as the need for revision arthroscopy or conversion to total hip arthroplasty. Results: Twenty studies, including 641 patients, met inclusion criteria. The mean patient age ranged from 32.0 to 43.7 years, with mean follow-up durations ranging from 0.6 years to 6.4 years. Four studies allowed WB as tolerated, one required non-WB, whereas 15 studies implemented protected WB (i.e., partial WB or touch-down WB) postoperatively, with all studies allowing full WB within 8 weeks. CPM was initiated within 12 to 24 hours postoperatively in 6 studies. Hip immobilization devices were used in 6 studies. Five studies reported range of motion restrictions, limiting hip flexion anywhere from 30° to 90°. Fourteen studies reported 11 unique patient-reported outcome measures and 55% of all studies reported reoperation rates. Among 5 studies that reported return-to-sport timelines, 4 (80%) permitted return by 6 months. Although most protocols discussed physical therapy and strength progression, considerable variability existed regarding exercise timing and initiation. Conclusions: This systematic review highlights the heterogeneity in postoperative rehabilitation protocols after hip arthroscopy with labral reconstruction, reflecting a lack of standardized, evidence-based guidelines. Level of Evidence: Level V, systematic review of Level II-V studies.