The Use of Manual Therapy Post Hip Arthroscopy When an Exercise Based Therapy Approach Has Failed: A Case Report.

J Orthop Sports Phys Ther. 2014 Aug 6;:1-29

Authors: Le Beau RT, Nho SJ

Abstract
Study Design Case report. Background Although there is a growing body of literature on both surgical intervention and post-surgical rehabilitation of acetabular labral repairs and femoroacetabular impingement (FAI), there is a paucity of information on how to manage individuals with lack of progress post-surgery. Case Description A 30 year old female underwent surgical labral repair with FAI osteochondroplasty. Post-surgery, she was initially treated with an exercise-based approach, but experienced an increase in hip pain and further decline in function. Her primary functional deficits were difficulty standing and pain (6/10) with ambulation. A combination of soft tissue mobilization and trigger point dry needling were used to address perceived muscle dysfunction and non-thrust manipulation to address perceived hip joint hypomobility. Outcomes Following 12 therapy sessions over 120 days, the patient returned to her demanding occupation with minimal residual symptoms. By the end of the period of care, the Harris Hip Score had improved from 56 to 96 and the lower extremity functional scale from 26 to 70. Discussion This case describes a multimodal manual therapy approach used to improve outcomes of a patient post labral repair with FAI decompression who did not respond to an initial exercise-based post-surgical rehabilitation approach. Level of Evidence Therapy, level 4. J Orthop Sports Phys Ther, Epub 6 August 2014. doi:10.2519/jospt.2014.5047.

PMID: 25098193 [PubMed – as supplied by publisher]