Susan Dirocco, Joseph C. McCarthy, Brian D. Busconi, Bruce Dick, and Kevin Flaherty
The primary goals for many patients undergoing hip arthroscopy are relief of pain and a return to their premorbid level of activity. Oftentimes these patients have a history of pain, muscle inhibition, altered gait, and impaired function for varying lengths of time. As the hip is an integral part of the lumbo-pelvic-hip complex, dysfunction or derangement of the hip can also lead to compensatory lumbar movements. Typically, candidates for hip arthroscopy have undergone some form of preoperative treatment intervention directed toward relief of pain and restoration of mobility, strength, and function. For those patients whose symptoms have not responded to conservative care, hip arthroscopy has been shown to be effective in both the diagnosis and treatment of hip articular pathology. Whether the pain is due to synovitis, septic arthritis, early osteoarthritis, or chondral pathology can be determined through arthroscopy. Surgical removal of a loose body or a torn labrum can then be performed to alleviate pain.1 To fully rehabilitate these patients to their highest possible functional level, rehabilitation must address not only the postoperative sequelae but also the patient's preoperative compensations and faulty movement patterns.
Common key impairments following joint arthroscopic procedures are: inflammation, pain, swelling, decreased joint mobility, altered muscle extensibility, impaired muscle strength, altered proprioception, and decreased muscle endurance. These impairments result in reduced functional abilities, whereas studies have shown the efficacy of physical therapy intervention for postoperative arthroscopic menis-cectomy patients.2,3 Vervest et al found rehabilitated patients had improved performance on such functional measures as distance jumping and hopping.2 St. Pierre showed that physical therapy intervention accelerated the recovery of muscle strength to preoperative levels.3 Currently there are no studies investigating the effects of rehabilitation following hip ar-throscopy. This chapter will provide clinical guidelines for the rehabilitation of patients who have undergone hip arthroscopy.
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