Acetabuloplasty
This protocol should be used as a guideline for progression and should be tailored to the needs of the individual patient.
- Weight bearing as tolerated - use crutches to normalize gait.
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- Crutches are usually discontinued at 5-7 days, once gait is normalized
- Strict impact precautions unnecessary, but functional progression may still be protracted because of severity of associated damage.
- Isometrics, co-contractions, closed chain exercises.
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- May still need to be delayed for 12 weeks to minimize exacerbation of symptoms.
- Always use pharmacologic prophylaxis against heterotopic ossification (unless contraindicated.)
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- Quiz patient
- Must initiate and maintain immediately postop
Week 1Phase 1
Initial Exercises (Weeks 1-3)
Other Exercises Week 1
- Seated heel lifts
- Standard stationary bike without resistance at 3 days post-op (10 min. if tolerated)
- Upper body ergometer, upper body strengthening
Weeks 2Phase 1
In Addition to Previous Exercises (Weeks 1-3)
Other Exercises Week 2
- Wall mini-squats
- Physioball mini-squats with cocontraction
- Pool exercises (water walking, range of motion, march steps, lateral steps, backward walking, mini-squats, heel raises, hamstring and hip flexor stretches)
Weeks 3Phase 1
In Addition to Previous Exercises (Weeks 1-3)
Other Exercises Week 2
- Continue stationary bike with minimal resistance - 5 min. increase daily
- Active range of motion with gradual end range stretch within tolerance
- Leg raise - Adduction
- Single leg sports cord leg press (long sitting) limiting hip flexion
Criteria for progression to Phase 2
Goals of Phase 1
Weeks 4-5Phase 2
Intermediate Exercises (Weeks 4-6)
Sidestepping with resistance (pause on affected limb), sports cord walking forward and backward (pause on affected limb)
Other Exercises Weeks 4-5
- Gradually increase resistance with stationary bike
- Initiate elliptical machine
- Pool water exercises - flutterkick swimming, 4 way hip with water weights, step-ups
Weeks 6Phase 2
Intermediate Exercises (Weeks 4-6)
Other Exercises Weeks 6
- Single leg balance - firm to soft surface with external perturbation (ball catch, sports specific/simulated ex.)
- Knee extensions, hamstring curls
Goals of Phase 2
Criteria for progression to Phase 3
Week 7-8Phase 3
Advanced Exercises (Weeks 7-8)
Other Exercises Week 7-8
- Full squats
- Single stability ball bridges
Goals for Phase 3
Criteria for Progression to Phase 4
Week 9-11Phase 4
Sports specific training rehab clinic based progression
Other Exercises Weeks 9-11
- All phase 3 exercises
- Pool running (progress from chest deep to waist deep), treadmill jogging
- Step drills, quick feet step-ups (4-6 inch box) forward, lateral, carioca
- Plyometrics, double leg and single leg shuttle jumps
- Theraband walking patterns 1 rep of six exercises x 50yds, progress to band at knee height and ankle height
Week 12 and BeyondPhase 4
Sports specific training rehab clinic based progression
Criteria for full return to competition
Other Exercises Weeks 12 & Beyond
- Running progression
- Sport specific drills
- Traditional weight training