title: Rehabilitation Following Hip Arthroscopy - A Systematic Review.
abstract: BACKGROUND
  Rehabilitation following hip arthroscopy is an integral component of the clinical outcome of the procedure. Given the increase in quantity, complexity, and diversity of procedures performed, a need exists to define the role of rehabilitation following hip arthroscopy.
  
  
  OBJECTIVE
  (1) To determine the current rehabilitation protocols utilized following hip arthroscopy in the current literature, (2) to determine if clinical outcomes are significantly different based on different post-operative rehabilitation protocols, and (3) to propose the best-available evidence-based rehabilitation program following hip arthroscopy.
  
  
  METHODS
  Per PRISMA guidelines and checklist, Medline, SciVerse Scopus, SportDiscus, and Cochrane Central Register of Controlled Trials were searched.
  
  
  METHODS
  Level I-IV evidence clinical studies with minimum 2-year follow-up reporting outcomes of hip arthroscopy with post-operative rehabilitation protocols described were included.
  
  
  METHODS
  All study, subject, and surgery parameters were collected. All elements of rehabilitation were extracted and analyzed. Descriptive statistics were calculated. Study methodological quality was analyzed using the modified Coleman methodology score.
  
  
  RESULTS
  Eighteen studies were included (2,092 subjects; 52% male, mean age 35.1 ± 10.6 years, mean follow-up 3.2 ± 1.0 years). Labral tear and femoroacetabular impingement were the most common diagnoses treated and labral debridement and femoral/acetabular osteochondroplasty the most common surgical techniques performed. Rehabilitation protocol parameters (weight-bearing, motion, strengthening, and return to sport) were poorly reported. Differences in clinical outcomes were unable to be assessed given heterogeneity in study reporting. Time-, phase-, goal-, and precaution-based guidelines were extracted and reported.
  
  
  CONCLUSIONS
  The current literature of hip arthroscopy rehabilitation lacks high-quality evidence to support a specific protocol. Heterogeneity in study, subject, and surgical demographics precluded assimilation of protocols and/or outcomes to generate evidence-based guidelines. Strengths and limitations in the literature were identified. Future studies should recognize and report the essentials of rehabilitation following hip arthroscopy.
authors.affiliation: Hip Preservation Center, Department of Orthopedic Surgery, Rush University Medical Center , Chicago, IL , USA.
authors.forename: Jeffrey S
authors.initials: JS
authors.lastname: Grzybowski
authors.affiliation: Department of Physical Therapy, Marquette University College of Health Sciences , Milwaukee, WI , USA.
authors.forename: Philip
authors.initials: P
authors.lastname: Malloy
authors.affiliation: Hip Preservation Center, Department of Orthopedic Surgery, Rush University Medical Center , Chicago, IL , USA.
authors.forename: Catherine
authors.initials: C
authors.lastname: Stegemann
authors.affiliation: Hip Preservation Center, Department of Orthopedic Surgery, Rush University Medical Center , Chicago, IL , USA.
authors.forename: Charles
authors.initials: C
authors.lastname: Bush-Joseph
authors.affiliation: Houston Methodist Orthopedics and Sports Medicine , Houston, TX , USA.
authors.forename: Joshua David
authors.initials: JD
authors.lastname: Harris
authors.affiliation: Hip Preservation Center, Department of Orthopedic Surgery, Rush University Medical Center , Chicago, IL , USA.
authors.forename: Shane J
authors.initials: SJ
authors.lastname: Nho
keywords: arthroscopy; hip; physical therapy; rehabilitation