Immediate Weight Bearing after Hip Arthroscopy for Femoroacetabular Impingement is Similar to Non-Weight Bearing Protocol: A Comparative Case Series Study with Minimum 2 Year Follow-up

Introduction: Despite the increasing volume of arthroscopic hip preservation surgeries, there remains a paucity of evidence to guide post-operative weight bearing protocol after hip arthroscopy for femoracetabular impingement (FAI).

Purpose: To evaluate the mid-term outcome of immediate weight bearing following hip arthroscopy for FAI.

Methods: Between January 2011 and May 2016, patients who underwent hip arthroscopy for FAI and labral repair with minimum of 2-year follow-up were reviewed. Until September 2013, non-weight bearing (NWB) rehabilitation protocols were applied 3 weeks postoperatively, with weight bearing as tolerated (WBAT) thereafter. From October 2013 and on, all patients were allowed immediate weight bearing as tolerated postoperatively. 133 patients were included – 69 with NWB and 64 with immediate WBAT rehabilitation protocols. The groups did not differ significantly in terms of gender (P=.60) or age (P=.24). Patients were stratified into three age groups (<30,30-50,>50 y.o.). Patient reported outcome measures (PROMS) included the Modified Harris Hip Score (MHHS) and Hip Outcome Score (HOS). Rates of satisfaction and improvement were examined by asking patients whether, considering the outcome, they would undergo the surgery again.

Results: No significant differences between groups in pre-operative and post-operative scores were found. MHHS was 84.2±19.9 for NWB vs. 83.4±20.3 for WBAT (P=.84). HOS was 83.1±22.0 vs. 85.1±19.1 (P=.59). Score in all age groups did not differ significantly. Subjective rates of improvement were not significantly different (85% NWB vs. 79% WBAT, P=.31). 84.1±24.2% of NWB reported satisfaction vs. 78.6±27.9 in WBAT (P=.25). 58 of 69 NWB patients and 45 of 64 WBAT patients would undergo surgery again (P=0.7).

Conclusion: Mid-term PROMS and satisfactory rates with immediate weight bearing following hip arthroscopy do not differ significantly from strict non-weight bearing rehabilitation protocols. Revising rehabilitation protocols may allow a more comfortable rehabilitation process.