CPM and Hip Abduction Brace Are NOT Medically Necessary After Hip Arthroscopy for Labral Repair
Neither continuous passive motion (CPM) devices nor hip abduction braces should be used following hip arthroscopy for labral tear repair, as there is no evidence supporting their effectiveness for this indication and they are considered experimental/investigational.
Continuous Passive Motion (CPM) - NOT Recommended
Evidence Against CPM Use
The evidence consistently demonstrates that CPM provides no clinically meaningful benefit in postoperative orthopedic rehabilitation:
Strong evidence from multiple high-quality guidelines shows CPM does not improve outcomes after knee arthroplasty, with no clinically important effects on range of motion, pain, function, or quality of life 1, 2.
The British Journal of Sports Medicine guidelines specifically state that continuous passive motion is NOT recommended for postoperative rehabilitation, with only one guideline suggesting it "may be used" in the immediate postoperative period for ACL reconstruction 1.
CPM after knee arthroplasty increases active knee flexion ROM by only 2 degrees (absolute improvement of 2%), which is not clinically significant 2.
Multiple studies found no benefit of CPM in the rehabilitation setting, with no significant difference in passive range of motion or length of stay 3, 4.
Specific to Hip Arthroscopy
No evidence exists supporting CPM use after hip arthroscopy for labral repair - the available guidelines and research focus on knee and other joint surgeries 1, 2.
The clinical practice guidelines you referenced correctly identify CPM for hip arthroscopy rehabilitation as experimental, investigational, or unproven due to insufficient scientific evidence.
Potential Harms
- CPM may actually prolong postoperative knee swelling 4.
- CPM does not reduce the risk of venous thromboembolism after total knee arthroplasty 5.
Hip Abduction Brace - NOT Recommended
Evidence Against Hip Abduction Brace Use
The American Academy of Orthopaedic Surgeons (AAOS) guidelines provide clear direction:
No clinical data supports or refutes the use of abduction pillows or braces after rotator cuff repair, with an inconclusive recommendation due to lack of evidence 1.
No studies were found addressing the use of hip braces for acetabular labral tears or femoroacetabular impingement 1.
The clinical practice guidelines you referenced correctly classify hip braces for acetabular labral tears as experimental, investigational, or unproven.
Lack of Evidence for Hip Arthroscopy
There is no published evidence demonstrating that hip abduction braces improve outcomes, protect the repair, or prevent complications after hip arthroscopy for labral tears.
The 2019 American College of Rheumatology guidelines recommend braces only for specific indications in osteoarthritis (tibiofemoral knee braces for ambulation/stability issues), not for postoperative protection 1.
What SHOULD Be Recommended Instead
Based on high-quality rehabilitation guidelines, the following interventions ARE supported by evidence:
Immediate Postoperative Phase (Week 1)
Early mobilization should begin on the day of surgery to reduce length of hospital stay and improve pain/function 1, 6.
Cryotherapy should be applied in the first postoperative week for pain control 1, 6.
Immediate range of motion exercises should be initiated within the first week 6.
Weeks 1-4
Supervised physical therapy is strongly recommended, though home-based rehabilitation may be appropriate for highly motivated patients 1, 6.
Progressive weight-bearing as tolerated should be implemented 1, 6.
Common Pitfalls to Avoid
Do not delay mobilization - this can lead to stiffness and poor functional outcomes 6.
Do not use CPM thinking it will prevent stiffness - the evidence shows it provides no benefit and may prolong swelling 2, 4.
Do not prescribe hip abduction braces routinely - there is no evidence they protect the repair or improve outcomes 1.
Clinical Decision
For this 37-year-old female with right hip labral repair:
Deny the CPM device (E0936) - it is not medically necessary and is considered experimental/investigational for hip arthroscopy rehabilitation.
Deny the hip abduction brace (L1686) - it is not medically necessary and is considered experimental/investigational for acetabular labral tears.
Recommend instead: supervised physical therapy with early mobilization, cryotherapy, and progressive range of motion exercises as supported by evidence-based guidelines 1, 6.