The physiotherapeutic treatment of acetabular labral tears. A systematic review

Abstract

Abstract Aims: To review systematically the literature pertaining to the physiotherapy management of patients with acetabular labral tear (ALT). Methodology: A systematic review was undertaken of the electronic databases: Medline, Embase, CINAHL, the Cochrane Library and Sports Discus. All literature pertaining to the objective of the study was included. Data was extracted and narratively analysed to answer the research question. The methodological quality of the literature was assessed using the Critical Appraisal Skills Programme (CASP) Systematic Review tools, whereas single case study papers were assessed using a specific single case study appraisal instrument. Major findings: Thirteen papers were included: two case series and 11 review/commentary papers. There was limited evidence for the use of pre-operative physiotherapy. Physiotherapy regimes for the conservative and post-operative management of patients with ALT included the prescription of proprioceptive, muscle strengthening and stretching exercises, in addition to behaviour modification. Whilst post-operative physiotherapy was considered important, it has largely been directed by the operative procedure, requiring the construction of individualized rehabilitation regimes. Principal conclusions: There remains debate regarding the appropriateness of the physiotherapy management for the non-operative management of this patient group. Greater evidence is required related to the post-operative management of patients following ALT repair. Level of evidence: Level IV – Systematic review based on studies that did not include a comparison group to assess for the effect of chance results.