Capsule Repair Plicationcapsulorraphy

The focus of rehabilitation following a capsular procedure is to protect the integrity of the repair following surgery. Exercise progression must limit capsule stress throughout the rehabilitation program. Motion restrictions are determined by the location of the repair (anterior verses posterior). The majority of capsule repairs seen by the authors involve the anterior capsule. The following rehabilitation guidelines are specific to these repairs (Table 4).

Following an anterior capsule repair, extension and external rotation are limited to neutral for 3 weeks, followed by 3 weeks of gentle motion. At 4 weeks, it is felt that the cicatrix in the hip is formed and will not be subject to significant elongation [18-21]. Foot wraps are used for 3 weeks to maintain neutral hip rotation while the patient is in a supine position and not in the CPM. Flexion ROM is limited to 90° to protect the joint from impingement for 10 days. Weight bearing is limited to foot-flat weight bearing (20 lbs.) for 4 weeks. To avoid capsular stretch, neutral rotation during ambulation in emphasized. A continuous passive motion machine is used for 4 weeks. Care should be taken to avoid capsule stresses with rotational activities. Achieving a balance of joint stability and mobility is essential for successful return to competition. Patients typically initiate phase I immediately following surgery, phase II at week 5, phase III at week 9, and phase IV at week 13.

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