The hip joint contains the labrum, a specialized ring of cartilage that deepens the socket and provides stability. A tear in this structure, often caused by femoroacetabular impingement (FAI), is commonly repaired using hip arthroscopy. Successfully healing the labrum and associated repairs requires a highly controlled recovery period. For many patients, a brace is utilized as part of this post-operative care, though not every surgeon follows this protocol.
Why a Brace is Necessary After Surgery
The primary purpose of a post-operative hip brace is to provide mechanical protection to the surgical repair site. During hip arthroscopy, the surgeon repairs the labrum and may also perform a capsular closure or plication to tighten the joint capsule. These repaired soft tissues are most vulnerable in the immediate weeks following the procedure.
The brace functions by physically restricting movements that place excessive stress on the healing tissues. The brace is designed to limit hip flexion, adduction, and internal rotation. These movements generate forces that can disrupt the labral repair or stretch the newly tightened joint capsule, potentially leading to instability or surgical failure.
Beyond physical limitation, the brace serves as a proprioceptive reminder for the patient. It provides continuous feedback that discourages sudden or uncontrolled movements of the hip joint, even during simple daily activities. This awareness helps patients maintain the prescribed range of motion limits, ensuring the muscles surrounding the hip remain relaxed and do not strain the repair.
How Long and When to Wear the Brace
The brace used is typically a rigid, hinged orthosis extending from the waist to the thigh. This design allows the medical team to set specific motion limits programmed into the hinges to control the angle of movement. A common setting limits hip flexion to between 70 and 90 degrees, while extension is restricted to 0 degrees.
Brace wear duration is highly individualized but typically ranges from three to six weeks following the procedure. Patients who have undergone a more extensive procedure, such as a capsular plication to address joint laxity, may be prescribed a longer period of bracing.
During the initial phase, the brace is often worn full-time, including while standing, walking, and sleeping, to ensure continuous protection. The brace is generally allowed to be removed for showering and during prescribed physical therapy sessions where movement is carefully controlled. It may also be removed when using a continuous passive motion (CPM) machine, as this device guides the joint through a safe range of motion.
The specific degree settings of the brace, such as the flexion limit and the amount of abduction (moving the leg away from the body), are determined by the surgeon. This decision is based on the complexity of the labral tear and the extent of the surrounding tissue repair. For example, the brace might be set to maintain 10 degrees of hip abduction to keep the hip protected while healing. Adherence to this timeline and the specific settings is crucial for proper tissue integration.
When Bracing Protocols Differ
The use of a post-operative hip brace is not a universal practice across all surgical protocols. Some surgeons choose not to prescribe a brace for routine labral repairs, particularly if the procedure did not involve extensive capsular work. This variability exists because current research has not established a consensus that bracing definitively improves long-term outcomes compared to protocols relying solely on crutches and physical therapy restrictions.
Recent studies suggest that eliminating the routine use of a brace for standard hip arthroscopy may not increase the rate of complications or negatively affect patient outcomes. However, in cases involving significant joint instability or when the surgeon performs an aggressive capsular plication, mechanical support from a brace is often considered necessary to ensure the integrity of the repair.
When a brace is prescribed, failure to adhere to the wearing schedule and motion limits presents a considerable risk to the surgical outcome. Non-compliance can lead to premature stress on the healing labrum or capsular tissues, potentially resulting in re-injury, capsular laxity, or hip subluxation. If a brace is included in the recovery plan, the surgeon’s instructions regarding its use, duration, and removal times must be followed exactly.