Weight Bearing Strategies for Post-Hip Arthroscopy Recovery

Overseen By David J Spaeder

Age: Any Age

Sex: Any

Trial Phase: Academic

Sponsor: University of Pittsburgh

Disqualifiers: Msk tumor, Hypermobility, Revision, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 12

Duration: 6 weeks

80 Participants Needed

Trial Summary

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What data supports the effectiveness of the treatment Flat foot weight bearing (FFWB) for post-hip arthroscopy recovery?

Research suggests that allowing patients to bear weight as tolerated (WBAT) after certain hip surgeries, like labral resection, can be effective and is commonly practiced by surgeons. Additionally, studies on other conditions, like subtrochanteric femur fractures, show that early weight bearing can lead to shorter hospital stays without increasing complications. ^{1 2 3 4 5}

Is weight bearing after hip surgery generally safe?

Research shows that allowing patients to put weight on their leg as tolerated after hip surgery, like hip arthroscopy, does not lead to more complications or pain compared to restricting weight bearing. This suggests that it is generally safe for patients to bear weight as they feel comfortable after such procedures. ^{1 2 5 6 7}

How does the treatment 'Weight Bearing Strategies for Post-Hip Arthroscopy Recovery' differ from other treatments for hip conditions?

This treatment is unique because it focuses on allowing patients to bear weight as tolerated (WBAT) immediately after certain hip arthroscopy procedures, which can lead to quicker recovery and return to activities compared to traditional methods that often restrict weight bearing for extended periods. ^{1 2 3 6 8}

What is the purpose of this trial?

This study is being proposed to examine weight bearing precautions following hip arthroscopic labral repair, femoroplasty, and capsular closure. Standard post operative protocols limit weight bearing for 2-6 weeks depending on individual surgeons. Cadaveric studies demonstrate that minimal force during weight bearing is distributed through labrum. Therefore, progressing weight bearing earlier in these patients post operatively may help progress faster and improve outcomes. Data collected will include demographic information, radiological data, operative procedures and PRO data.

Eligibility Criteria

This trial is for individuals aged 12 or older with hip impingement syndrome or a hip labral tear, who will undergo or have undergone hip arthroscopy with femoroplasty and labral repair at UPMC Children's or St. Margaret's Hospital. Both unilateral and bilateral cases are accepted. Those with musculoskeletal tumors, generalized hypermobility, or needing revision surgeries cannot participate.

Inclusion Criteria

I have had hip surgery to reshape the femur and repair the labrum.

Unilateral and bilateral hip patients

I am 12 years old or older.

Exclusion Criteria

I have had surgery to correct or improve a previous procedure.

I am extremely flexible or have very loose joints.

I have a hip joint condition related to my cancer.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants undergo hip arthroscopic labral repair and femoroplasty with randomized weight-bearing protocols

6 weeks

Post-operative follow-ups at 6 weeks, 3 months, and 6 months

Follow-up

Participants are monitored for safety and effectiveness after treatment, including ultrasound evaluations and strength measures

6 months

Regular follow-ups up to 6 months post-operative

Treatment Details

Interventions

• Flat foot weight bearing (FFWB)
• Hip Arthroscopy
• Weight Bearing as tolerated (WBAT)

Trial Overview The study compares two post-surgery approaches to weight bearing: 'Weight Bearing as Tolerated' (WBAT) allows patients to put as much weight on the foot as comfortable immediately after surgery; 'Flat Foot Weight Bearing' (FFWB) means only the sole of the foot may bear weight right away.

Participant Groups

Group I: Weight bearing as tolerated (WBAT) immediately following surgery. Experimental Treatment 1 Intervention

Subjects will be able to self-select weight bearing based on pain and confidence in surgical hip.

Group II: Flat foot weight bearing (FFWB) for 2 weeks after surgery. Active Control 1 Intervention

Subjects will be limited to FFWB, approx 20lbs through the surgical hip.

Who Is Running the Clinical Trial?

University of Pittsburgh

Lead Sponsor

Trials

1,820

Recruited

16,360,000+

Findings from Research

A multicenter study involving 441 patients with subtrochanteric femur fractures found that allowing weight bearing as tolerated (WBAT) post-surgery significantly reduced the length of hospital stay from 9.7 days to 7.4 days without increasing re-operation rates.

The study suggests that immediate WBAT is safe and effective for patients treated with intramedullary fixation, particularly benefiting those aged 41-80 and with specific fracture characteristics, making it a recommended practice if no contraindications exist.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Immediate weight bearing as tolerated (WBAT) correlates with a decreased length of stay post intramedullary fixation for subtrochanteric fractures: a multicenter retrospective cohort study. Cunningham, BP., Ali, A., Parikh, HR., et al.[2021]

Immediate unrestricted weight bearing (UWB) after uncemented total hip arthroplasty (THA) is safe, showing no adverse effects on femoral stem micromotion or increased risks of surgical revision compared to partial weight bearing (PWB).

While UWB did not demonstrate superior outcomes compared to PWB, patients showed a better Harris hip score at one year post-surgery, suggesting that UWB may enhance patient compliance and rehabilitation.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Early unrestricted vs. partial weight bearing after uncemented total hip arthroplasty: a systematic review and meta-analysis. Huang, L., Han, W., Qi, W., et al.[2023]

A survey of 75 Dutch orthopedic surgeons revealed significant variability in postoperative weight-bearing instructions for patients with periprosthetic femoral fractures (PPFF), indicating a lack of consensus on best practices.

The study highlights the need for further research to establish effective guidelines for permissive weight bearing (PWB) after surgical treatment of PPFF, as current practices differ widely among surgeons.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Postoperative Load Bearing in Periprosthetic Femoral Fractures Around Hip Arthroplasty: A Survey Among Orthopedic Surgeons in the Netherlands. Vesseur, MAM., Jelsma, J., Most, J., et al.[2023]

References

1. England pubmed.ncbi.nlm.nih.gov

Hip arthroscopy protocol: expert opinions on post-operative weight bearing and return to sports guidelines. [2020]

2. France pubmed.ncbi.nlm.nih.gov

Immediate weight bearing as tolerated (WBAT) correlates with a decreased length of stay post intramedullary fixation for subtrochanteric fractures: a multicenter retrospective cohort study. [2021]

3. Germany pubmed.ncbi.nlm.nih.gov

The influence of weight-bearing status on post-operative mobility and outcomes in geriatric hip fracture. [2022]

4. United States pubmed.ncbi.nlm.nih.gov

Postoperative Weightbearing Protocols After Arthroscopic Surgery for Femoroacetabular Impingement Does Not Affect Patient Outcome: A Comparative Study With Minimum 2-Year Follow-up. [2020]

5. Czech Republic pubmed.ncbi.nlm.nih.gov

Weight-Bearing Restrictions after Acetabular Fracture, Necessity or False Hope? A Brief Observational Study. [2022]

6. Switzerland pubmed.ncbi.nlm.nih.gov

Early unrestricted vs. partial weight bearing after uncemented total hip arthroplasty: a systematic review and meta-analysis. [2023]

7. United States pubmed.ncbi.nlm.nih.gov

Change in Postoperative Weightbearing Protocol Does Not Increase Postoperative Complications Following Hip Arthroscopy for Femoroacetabular Impingement Syndrome. [2023]

8. United States pubmed.ncbi.nlm.nih.gov

Postoperative Load Bearing in Periprosthetic Femoral Fractures Around Hip Arthroplasty: A Survey Among Orthopedic Surgeons in the Netherlands. [2023]