Post-Operative Recovery Concerns After Hip Arthroscopy Surgery

Regarding the recovery issues after minimally invasive hip arthroscopy?

Hello, doctor.
I underwent hip arthroscopy on September 8, 2021.
The procedure included suturing a labral tear (using a bone anchor), removal of loose bodies from the ligaments, and addressing femoroacetabular impingement (by shaving down the prominent area of the femoral head).
According to the doctor's instructions, I need to use crutches for walking for four weeks post-surgery.
I have a few minor questions:
1.
I generally use two crutches for walking, but sometimes at home, for shorter distances, I use a single crutch.
Additionally, in the office, I sometimes carry items (like a cup of water), making it inconvenient to use two crutches, so I also use a single crutch for distances of about 150 meters.
Will this affect the recovery of my hip joint? Or is it acceptable as long as there is no discomfort? Is it easy for the sutured labrum to tear again?
2.
I came across foreign literature that provided postoperative rehabilitation methods, but it specifically mentioned that the affected limb should not perform straight leg raises while lying in bed.
Why is that? (I ask this because I had actually attempted this movement before reading the literature, but due to postoperative weakness in my leg and discomfort even with slight elevation, I found it difficult to lift my leg at all.)

Wang Qiaoxi, 30~39 year old female. Ask Date: 2021/09/13

Dr. Zhan Xian reply Orthopedics

Hello Ms.
Wang, I am unable to answer your questions due to a lack of understanding of your surgical situation.
Please return for a follow-up appointment to consult with your attending physician and follow the post-operative instructions.
Lifting your leg straight may involve hip joint movement and exertion, which could potentially affect the healing of the labrum.

Reply Date: 2021/09/13

More Info

Post-operative recovery after hip arthroscopy can be a complex process, and it is essential to follow your surgeon's recommendations closely to ensure optimal healing. Based on your description of the surgery you underwent on September 8, which involved labral repair, removal of loose bodies, and treatment for femoroacetabular impingement, I will address your concerns regarding recovery and rehabilitation.

1. Use of Crutches: It is understandable that you might find it inconvenient to use crutches, especially when carrying items. However, it is crucial to adhere to the recommendation of using crutches for the first four weeks post-surgery. Using a single crutch for short distances may not significantly impact your recovery, but it is essential to listen to your body. If you experience any discomfort or pain while using a single crutch, it is advisable to revert to using both crutches. The primary goal during this initial recovery phase is to minimize weight-bearing on the affected hip to allow the labrum to heal properly. The labrum is a fibrocartilaginous structure, and while it is designed to withstand some stress, excessive weight-bearing or improper movement can jeopardize the healing process, potentially leading to re-injury or complications.

2. Concerns About Labral Repair: The concern about the labral repair tearing again is valid. The labrum can be vulnerable during the early stages of recovery, especially if subjected to excessive forces. If you are cautious and avoid movements that cause pain or discomfort, you are less likely to experience complications. It is essential to communicate any unusual symptoms or pain to your surgeon during follow-up visits.

3. Restrictions on Straight Leg Raises: The restriction against performing straight leg raises in bed is likely due to the potential strain this movement places on the hip joint and surrounding structures. This exercise can engage the hip flexors and may inadvertently put stress on the healing labrum and surrounding soft tissues. After surgery, the hip joint is still in a vulnerable state, and movements that require significant engagement of the hip flexors can lead to discomfort or even re-injury. It is common for patients to experience weakness and discomfort in the operated leg, making such movements challenging. Instead, your rehabilitation program should focus on gentle range-of-motion exercises and strengthening activities that do not compromise the surgical site.

4. Rehabilitation and Follow-Up: It is crucial to follow a structured rehabilitation program tailored to your specific needs. This program should include physical therapy, which can help you regain strength and mobility while ensuring that you do not overexert yourself. Your physical therapist can guide you through appropriate exercises that promote healing without risking injury. Regular follow-ups with your surgeon are also essential to monitor your progress and make any necessary adjustments to your rehabilitation plan.

In summary, while it is understandable to have concerns about your recovery, adhering to your surgeon's advice and being mindful of your body's signals is vital. Using crutches as instructed, avoiding certain movements, and engaging in a structured rehabilitation program will significantly contribute to a successful recovery. If you have any further questions or experience any concerning symptoms, do not hesitate to reach out to your healthcare provider for guidance. Your proactive approach to your recovery will serve you well in the long run.

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