Key Restrictions:

• Flexion 0-90 degrees and no adduction beyond midline for 6 weeks.
• No passive external rotation until Week 4.

Phase I: Immediate Post-Surgical Phase (Week 1–4)

Goals:

• Protect the surgical repair.
• Prevent excessive loading.
• Minimize swelling and inflammation.

Guidelines:

• Weight-Bearing: Flat foot weight bearing (no more than 20 lbs).
• Biking: No more than 20 minutes at a time.
• Activity Restrictions: No active abduction.
• Exercises:
  • Quad and hamstring isometric and open-chain strengthening.
  • Pelvic clock exercises.
  • Begin extension and adduction isometrics at 2 weeks.

Phase II: Progressive Weight Bearing Phase (Week 5–11)

Goals:

• Prepare for gait and weight bearing.
• Protect the repair while promoting optimal healing.

Guidelines:

• Add 25% bodyweight per week to progress weight bearing.
• Begin full weight bearing (FWB) by Week 8.
• ROM Progression:
  • Progress to full passive ROM and active ROM by the end of Phase II.
• Strengthening:
  • Begin concentric adduction and isometric abduction.
  • Core strengthening focus.
  • Bridging activity.

Phase III: Strengthening and Proprioceptive Phase (Week 12–15)

Goals:

• Build equal strength.
• Improve gait and proprioceptive ability.
• Eliminate Trendelenburg gait.
• Optimize core and hip strength.

Guidelines:

• Begin concentric abduction strengthening.
• Proprioceptive activity (double-leg and single-leg), using uneven surfaces as appropriate.
• Progress open-chain abduction to closed-chain abduction.

Patient Education Tips

• Follow all restrictions carefully to avoid complications or re-injury.
• Communicate with your physical therapist about any pain, swelling, or difficulty progressing through the exercises.
• Stay consistent with your physical therapy schedule to maximize recovery.

Progress Monitoring

• For Progression to Full Weight Bearing: Assess for proper gait mechanics without compensation or pain.
• For Proprioceptive Activities: Ability to maintain balance on single-leg tasks or uneven surfaces.
• For Strengthening: Ensure proper activation and control of the hip abductors during exercises, with no compensatory trunk lean or Trendelenburg sign.