My hip arthroscopy improved my motion and decreased my pain. Thanks for my life back — Garret. I am sure glad I found Dr. Van Thiel.
My surgical procedure improved my quality of life. Read about Jack a multi-sport athlete, who suffered from a multi-ligament tear in his knee. Life changing stories of patients healed by Dr. Geoffrey Van Thiel. Van Thiel Dr. Hip Arthoscopy Specialization Matters The management of patients with hip pain requires complex decision making and innovative treatment from a team of nurses, surgeons, and therapists.
Is Hip Arthroscopy for you? Nevertheless, most patients that experienced a hip fracture due to early weight bearing after hip arthroscopy had no precipitating traumatic event. Less common causes of hip fracture after hip arthroscopy were also identified, including over-resection during femoral osteochondroplasty and intensive exercise. This systematic review included basic science studies that regularly demonstrated there was a connection between increasing depth or resection and risk of fracture of the femoral neck.
Complications in Hip Arthroscopy
Surgeons should be able to restore full range of motion of the hip without causing an increased risk of femoral neck fracture. Results from the biomechanical studies must be interpreted with caution given the limitations of these types of studies and the fact that they did not take into consideration a number of patient factors, including varying bone densities. Many studies did not specify the demographics of the patients that experienced a hip fracture as a complication, but the age factor appeared to correlate with increased risk of this complication.
There was no agreement in the literature as to whether males or females experienced higher rates of hip fractures as a complication of hip arthroscopy, just as there was no correlation between the number of hip arthroscopies a surgeon had performed and the rate of hip fractures as a complication. The available literature lacked demographic information regarding the patients who had experienced this complication, which made it difficult to conclude exactly which populations were most at risk for post-operative hip fractures. Through this study, it was clear that early weight bearing after femoral osteochondroplasty was a large risk factor for hip fracture after a hip arthroscopy.
Clinical outcomes and causes of arthroscopic hip revision surgery
Classical risk factors for hip fractures such as osteoporosis and rheumatoid arthritis are likely to be conditions that increase the risk of this complication and surgeons should bear this in mind when operating their patients. Furthermore, the rate of hip fractures being caused by over-resection may have been underestimated. Orthopedic Surgery. Do not lean away from the moving limb. With the core tight engage the gluts and slowly lift the knee while keeping the heels together. Avoid rotating the back while lifting the knee. Begin at 3 weeks post op or after patient is clear to perform hip external rotation.
Activate the gluts of the surgical limb to begin hip extension lifting the knee off the table without lifting the toes. Focus on activation of the gluts before the quads to initiate the hip and knee extension. Begin at 3 weeks post op or after the patient is clear to perform hip extension.
Double Limb Bridging: In supine with the hips and knees bent hook lying position to degrees, keep the core tight while slowly raising the buttocks off the table with focus on glut activation during the exercise. Stop lifting the hips once in a neutral pelvic position. Avoid over extending the hips and or back. Begin at 3 weeks post op.
Quad Rocking: Kneeling in quadruped position and core tight begin rocking backwards onto the heels. Do not push through a pinch in the groin. Then rock forward dropping the hips into a half plank position while keeping the core tight. Avoid extension of the hips or back. Aquatics: Begin at 3 weeks post op.
Must cover the incision sites with waterproof dressing for at least 1 week after suture removal or unit wounds are completely closed. Can swim with pull-buoy. Walking: Begin in chest deep water and progress slowly to waist deep water as tolerated. Perform walking backwards and laterally for 4 min each. Avoid forward walking and marching type activities Standing Abduction: Standing in at least waist deep water and hold on to the side of the pool.
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May discharge from home exercise program at 6 weeks post op. Stationary Bike: Up-Right bike only. Flexion may pass 90 degrees as tolerated. Avoid pinching and do not push through pinch or pain. Walking: Once pain free FWB has been achieved, may begin ambulation on treadmill. No incline and do not exceed 3.
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Perform 3 reps of holding 30 sec. Standing IT Band: Surgical limb crossed behind the non-surgical limb. Lean upper body away from the side to be stretched. Avoid pinch in the groin of the surgical limb.
Perform 3 reps of hold for 30 sec. Keeps foot and ankle relaxed. Engage the TA, then activate hip flexors to flex the hip. Slowly bring the knee towards the chest. Avoid pinching in the groin. Then slowly return to the start position. Perform 3 sets of 10 reps. Keeping the ankle together open the knees pressing out into the resistance band. Focus on glut and hip external rotator activation. Perform 3 sets for 10 reps. Have the patient place a hand on the iliac crest to stabilize the pelvis to prevent the QL from performing a hip hike.
The patient then lifts the surgical leg with focus on glut activation. Try to prevent any hip flexion as this is from hip flexor compensation and unwanted. Do not add weights to the ankle for increased resistance. Perform 3 sets of 10 reps or as able. Only perform the number of reps that can be performed with correct form and progress as able. Place feet wide apart and use the quad and gluts to extend the legs.
Do not squat below 90 degrees hip flexion. Without twisting the pelvis, rotate the surgical hip into internal and external rotation. The hip should neutral not flexed.
Perform 3 sets of 10 reps Unilateral Bridging: Progression from double limb bridging. Perform bilaterally. Active knee flexed at degrees with non-active limb crossed over in Figure 4 position. Avoid hyper extension of the hip or back.