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Variability in Physical Therapy Protocols After Hip Arthroscopy.

Jacques Van Zyl1, Mathew Hargreaves2, Clay A Rahaman2

  • 1Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA.

Orthopaedic Journal of Sports Medicine
|October 13, 2025
PubMed
Summary

Physical therapy protocols after hip arthroscopy show significant variability in brace use, weight-bearing, and range-of-motion restrictions. Standardization is needed to improve patient hip recovery outcomes.

Keywords:
hip arthroscopyphysical therapyrehabilitation variabilitystandardized protocol

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Area of Science:

  • Orthopaedic Surgery
  • Physical Therapy
  • Rehabilitation Medicine

Background:

  • Hip arthroscopy is a rapidly growing surgical procedure, increasing by 85% from 2011 to 2018.
  • While physical therapy is crucial for post-hip arthroscopy recovery, rehabilitation protocols lack institutional consistency.
  • Existing literature offers various recovery modalities, but standardized prescriptions are absent.

Purpose of the Study:

  • To identify common trends and significant variability in publicly accessible physical therapy protocols following hip arthroscopy.
  • To analyze the heterogeneity of rehabilitation strategies implemented across different orthopaedic programs.

Main Methods:

  • A cross-sectional study analyzed publicly available rehabilitation protocols from 175 Accreditation Council for Graduate Medical Education-accredited orthopaedic surgery programs.
  • Protocols were identified using web searches and evaluated for variations in brace utilization, weight-bearing, range of motion (ROM) restrictions, exercise progression, and rehabilitation duration.
  • Analysis focused on 36 unique protocols obtained from 41 programs.

Main Results:

  • Only 36 unique hip arthroscopy rehabilitation protocols were found publicly available.
  • Significant variability was observed in brace usage (36.1% of protocols), weight-bearing (ranging from full to 20 lbs), and ROM restrictions.
  • Inconsistent exercise implementation and differing timelines for return to activity were noted across protocols.

Conclusions:

  • Substantial variability exists in post-hip arthroscopy rehabilitation protocols regarding brace use, weight-bearing, ROM, and exercise prescriptions.
  • Standardization of rehabilitation protocols based on defined criteria is necessary.
  • Further research should identify factors influencing patient recovery to optimize outcomes.