Journal of the Pediatric Orthopaedic Society of North America (May 2024)
Rehabilitation and return to play following hip arthroscopy in young athletes
Abstract
ABSTRACT: Hip arthroscopy is a hip preservation surgery used to manage acute pain and injury while attempting to preserve the hip joint and prevent or delay the progression of degenerative changes by restoring stability, reducing pathologic stress and instability, and preventing continued joint incongruity and impingement [1–4]. Research supports a high likelihood of return to a prior level of athletic participation in athletes of all ages after hip arthroscopy with especially favorable results in athletes under the age of 18 [3–5]. The postoperative rehabilitation process is vital to correct impairments and compensatory strategies. Unfortunately, there is great variability in current rehabilitation protocols.Adolescent athletes returning to activity after hip arthroscopy may be at an increased risk of reinjury and continued pain if return to sport occurs too early [6]. Inconsistencies exist with current protocols and return to sport testing. For instance, assessing readiness for return to sport is often based upon tests and measures utilized for anterior cruciate ligament reconstruction. These tests and measures may not effectively isolate or address hip function and readiness to return to play after hip arthroscopy. This current concept review presents existing literature and a standardized rehabilitation process to restore normal function and maximize a safe return to athletics after hip arthroscopy in the young athlete. Key Concepts: (1) There are few evidence-based postoperative rehabilitation programs for the young athletic population to effectively guide progress toward return to play readiness. (2) Continued hip and core strengthening exercises should be implemented after the return to play to maintain hip and core strength, improve neuromuscular control, and address additional functional impairments that may lead to repeat injury and dysfunction. (3) Patient-reported outcome (PRO) measures are correlated with higher postoperative improvement and should be utilized to assess psychological and physical readiness for return to play.
