State of the Art in Rehabilitation Strategies After Hip Arthroscopy for Femoroacetabular Impingement Syndrome: A Systematic Review

: Background/Objectives: Femoroacetabular impingement (FAI) is a common cause of hip pain in athletes and active individuals, often requiring hip arthroscopy followed by a structured rehabilitation program. Effective rehabilitation is crucial for optimizing surgical outcomes and facilitating a return to sport. Methods: A systematic review following PRISMA guidelines was conducted to evaluate post-operative rehabilitation protocols after hip arthroscopy for FAI. Databases searched included PubMed, Embase, and Cochrane Library up to April 2024. Inclusion criteria focused on studies documenting rehabilitation post-arthroscopy for FAI, with a final selection of 14 studies encompassing 1105 patients. Data extraction focused on rehabilitation techniques, functional outcomes, and return-to-sport rates. The risk of bias was assessed using RoB2 and ROBINS-I tools. Results: Rehabilitation protocols were categorized into four phases, emphasizing manual therapy, strengthening, stretching, aquatic exercises, and sport-specific drills. The average return-to-sport rate was 90.3%. Manual therapy and aquatic programs were critical in early recovery, while strengthening and proprioception exercises were central to later stages. Variability in protocols across studies was noted. Conclusions: Post-operative rehabilitation following hip arthroscopy for FAI is essential for recovery. A phased, individualized approach, integrating manual therapy, aquatic exercises, and sport-specific training, yields positive outcomes. However, the heterogeneity of protocols suggests the need for standardized guidelines tailored to individual patient needs and activity levels.