Post Operative Hip Arthroscopy Rehabilitation Protocol Labral Repair With or Without FAI Component ROM Restrictions: -Perform PROM in patient's PAIN FREE Range FLEXION EXTENSION EXTERNAL ROTATION INTERNAL ROTATION ABDUCTION Limited to: 90 degrees x 2 weeks (may go higher in the CPM) Limited to: 0 degrees x 3 weeks Limited to: *30 degrees @ 90 Able to demonstrate initial HEP Treatment: Figure 2-C A Type-III SLAP lesion is a superior labral bucket-handle tear. The most common type of repair is Hip Arthroscopy surgery. For other patients, a hip replacement or other hip surgery may be considered. All Rights Reserved. Figure 2-D A Type IV SLAP lesion is a superior labral bucket-handle tear that extends Into the biceps tendon. Labral repair needs protection for 8weeks. Active Internal Rotation (don't push into a pinching sensation) Bring your hip to 70° and slowly rotate foot out 2×10. It is not intended Found inside â Page iiThis book provides accurate descriptions of the injuries responsible for groin pain, which tend to occur in association with particular sports. ��S?�i���TU�Y���V���#��Ǵ.�͡�1QXu�ݱF��;T'��W��nFcC-����0����V�a8����$ұa�Hډ�Ʈ��"��:b�j()���u�ŶB��LۆW3�}�x��c��V�_���Ps�8� #�����b��)U5m�%��0VY��(�G=�'m2ϊ4�"p;������U�msDA'+ ��'ک�h�m�eE��J�2%�J�U�2��?mSڠ\�v:��� �����괧�_�%��d7�&�J�b�@��Vl This may be recommended when the labrum has separated from the bone. A hip labral tear involves the ring of cartilage (labrum) that follows the outside rim of your hip joint socket. ` %>� Patient will be released from the hospital the same day as surgery. Hip Labrum Reconstruction. . If a labral repair is done, crutches may be needed 4-6 weeks. In most cases, other structures within the hip joint also have injuries. Non-Operative Labral/FAI Hip Rehabilitation Guideline This rehabilitation program is designed to return the individual to their activities as quickly and safely as possible. Since you had a hip labral repair, you should avoid flexing your hip further than 90 degrees after surgery. 4 0 obj Restore ROM within the restrictions WEEK 1 (2 Treatments) EXERCISES: Found insideAcetabular rim trimming with labral débridement requires no specific restrictions. Acetabular labral repair and refixation is treated with toetouch weight bearing for 2 weeks and avoidance of the extremes of external rotation for 2 ... This book presents the consensus findings of the ISAKOS Shoulder Committee regarding the treatment options in patients suffering from shoulder pain and reduced function or dead arm syndrome as a consequence of rotator cuff injuries. A hip labral tear can be caused by injury, structural problems, or degenerative issues. Lie prone 1 to 2 hours a day (work up to this amount). Found inside â Page 817Labral repair requires protection to the area of the repair with limitations in ROM and weight-bearing. The length of time for these restrictions largely depends on the location and severity of the tear and relate to time for soft ... 25° (10 days -2 weeks)—for labral repair only, Passive supine hip roll into IR: weeks 1-2, Isometrics gluts, quads, HS, TrA: weeks 1-4, PROM emphasize prone lying, IR, circumduction: weeks 1-4, Water walking with flotation (if no pain): weeks 2-6, 3 way leg raises (abd, etc, add): weeks 3-6, Water jogging with flotation device (if no pain): weeks 3-6, Double 1/3 knee bends (partial squats): weeks 5-6, Hip flexor stretch (off bed, with chair, or kneeling; kneeling preferred): weeks 5-7, Involved knee to chest, adductor stretch: weeks 5-7, Seated resisted IR/ER (in less than 90 degrees flexion): weeks 5-7, Freestyle swimming (non-competitive): weeks 5-7, Side stepping with abductor band: weeks 7-9, Lunges with lunges with trunk rotation: weeks 7-9, Core ball stabilization progression: weeks 7-9, Forward/backward/sideways with walking cord: weeks 7-9, Initial agility drills - single plane (eccentric control and shock absorption is important to instruct patient): week 9, Functional testing - sportcord test: weeks 17-25, Core stabilization and transverse strengthening. `F����}���}�q�0�`�W�� H'���(t)͊4\6�� ��:~�A6pD3)��S�p� ��� Mk/�.V�V8v�"��/�&1���g���C��O��ؖ8�)�^�y��N��O 0���X�~�d�O�*H��. Last year, my physical therapist had given me the names of two hip specialists that did great work with labral repair/reconstruction. Rehabilitation after labral repair and femoroacetabular decompression: criteria-based progression through the return to sport phase. Reprint permission for illustrations and photos is granted by The Journal of Bone and Joint Surgery, Inc. Many hip labral tears responded favourably to conservative exercise-based treatment, but some will need hip labral repair surgery. Compared to traditional open surgery, a hip labral repair done arthroscopically results in smaller incisions, lower levels of pain, and faster recovery. Slowly move thigh in small circular motion clockwise. Abd. Athletes are at a higher risk of developing a hip labral tear. At the end of the procedure, a routine capsular repair is performed with some patients also having a capsular plication, if . All physicians, coaches, trainers, strength and conditioning specialists, and therapists who care for overhead athletes at all levels of participation are sure to find this an indispensable resource. Book jacket. If conservative treatments don't help, your doctor may suggest surgery to remove or repair the torn labrum. You should lie straight on bed without bending your hip too much. Prepare for hip surgery for a hip labral tear: my hip labral tear surgery recovery blog. Must be able to perform hip abduction for Glut. Labral repair Labral repair with capsular repair/closure Labral repair with capsular plication Gluteus medius/minimus repair: If the patient also had a gluteus medius and/or minimus repair, disregard the labral repair protocol and follow the gluteus medius protocol, as it is more restrictive. ER and IR: Gentle for 3 weeks. . This type of surgery is becoming less invasive from year to year: the patients that we see now have very small surgical scars and fewer post-operative precautions. Labral tear repair surgery. Weight bearing precautions: Limit sitting at 90 degrees or more due to anterior impingement You should also avoid any pivoting/twisting motion of the hip. The labrum is a fibrous ligament that contributes to hip stability, function and overall joint health. Found inside â Page 493POSTOPERATIVE REHABILITATION Rehabilitation following hip arthroscopy will be somewhat consistent, but can vary based on the biologic constraints of healing of the tissue that was addressed at the time of ... A contrast material might be injected into the hip joint . The new edition of the well-respected Brotzman has been updated to consistently include evidence-based rehabilitation protocols, as well as comprehensive coverage and videos at a great value! Found insideWith contributions from many of the top thinkers and surgeons of the shoulder, Elite Techniques in Shoulder Arthroscopy brings these exciting new management strategies to the fore with the aim of elevating them to more common practice for ... Found insideThe goal of rehabilitation after hip arthroscopy is to return the patient to a preinjury level of activity. ... If a labral repair or capsular closure is done, we restrict external rotation and adduction for the first 2 weeks. Found insideAcetabular rim trimming with labral débridement requires no specific restrictions. â¡ Acetabular labral repair and refixation is treated with toe-touch weight bearing for 2 weeks and avoidance of the extremes of external rotation for 2 ... Found insideIntegrating MRI findings associated with the spectrum of problems seen in the most commonly treated joints in sports medicine with the diagnostic findings seen during arthroscopy of the same joint in the same patient, this unique text ... It is designed for rehabilitation following Labral hip repair with FAI. The intent is to provide the therapist with a general framework. As with all surgeries, it is advised that the PT become aware of the particulars of the surgery - hip patients may have labral tears, ligamentum teres tears, articular surface damage, adhesive The mean modified Harris hip score in the labral repair group was 7.3 points greater than in the resection group (p = 0.036, 95 % confidence interval [CI]: 0.51 to 14.09). After arthroscopic hip surgery to repair a torn labrum, it is important to protect the repair while the labrum is healing. Found insidedemonstrates groin pain with attempted hip rotation as well as significantly restricted rotational motion of the hip; ... Surgical interventions for hip pathology and syndromes may include arthroscopy, THA, and hip resurfacing. Avoid rotating hip into ER and IR during the motion. Prospective data on all workers' compensation patients undergoing hip arthroscopy with labral repair, acetabular rim-trimming and/or femoral osteochondroplasty by a single fellowship-trained surgeon from January 2010 to May 2012 was analysed. If not full ROM (symmetrical to other side) by 10 weeks then terminal stretches allowed with moderate pain is acceptable. 2 Post-Op Debridement without Chondroplasty, Osteoplasty or Microfracture: Gait: WBAT with crutches-may advance off crutches if no pain and normal gait pattern Dressing: Removed at first PT visit, cleansed and band-aids applied Exercise Recommendations: Avoid supine straight leg raise, trunk curls with hip flex, LABRAL TEAR HIP SURGERY RECOVERY. Hip Labrum and FAI Post-Surgical Rehabilitation Guideline This rehabilitation program is designed to return the individual to their activities as quickly and safely as possible. Hip Arthroscopy Labral Repair/Debridement with Femoroplasty Precautions for weeks 1 - 4 post-op: Patient Education o For 1 week, Assist the involved LE during all transfers o For 2 weeks, Do not sit with hip flexion to 90 degrees for greater than 30 minutes o For 2 - 3 weeks, Avoid active lifting or flexion and rotation the hip HIP LABRAL REPAIR PROTOCOL The following protocol should be used as a guideline for rehabilitation progression, but may need to be altered pending the nature and extent of the surgical procedure, healing restraints or patient tolerance. Found inside â Page 313.6.3.1 Outcomes and Prognosis Over the last decade, hip arthroscopy has gained popularity, for symptoms characteristic ... the patients have typi- cally completed physical therapy, and no further restrictions are recommended. cases, ... "����2���H�W@��} �-{��P�m� �;�.��0Hh۠&�30} Diminish pain and inflammation ! In some cases an open hip surgery may be indicated. Since you had a hip labral repair, you should avoid flexing your hip further than 90 degrees after surgery. Found insidePerfect wherever you areâ¦in class, in clinical, and in practice! Found insideThis book, published in cooperation with ESSKA, is an exceptionally comprehensive guide to arthroscopy that covers all major joints and all potential arthroscopic procedures. For this reason you will need to use crutches for 4 weeks. During this first 4 to 6 week period you will be walking around very slowly and sore. Although there is evidence to support arthroscopic procedures to address labral tears and FAI … Lie prone 1 to 2 hours a day (work up to this amount) Passive supine hip roll into IR: weeks 1-2. Hip labral surgery is a comparatively new orthopedic procedure that seeks to repair the labrum and thus stabilize the hip socket. © 2021 OrthoVirginia Feel sick/nauseous Nausea is a common side effect to many medications. Uninvolved Knee to Chest. Piriformis Stretch with hip flexion @ 70° in sidelying (hold 30 sec.) Medius and maximus must function without compensation from hip flexors or quadratus lumborum to avoid anterior impingement, Call Dr. Parker's Office These are a pincer deformity and a CAM lesion. Hip Arthroscopy with labral repair: B. Samuelsen MD, C. Luck PA-C, E. Boudreau PT 5_2021 General Guidelines: - Range of motion restrictions: First 2-3 weeks • No external rotation past neutral for 21 days • No hip extension past neutral for 17 days You can have intercourse surely, I would recommend you to choose woman on top position. A percentage of hip labral tears will require surgery to stop the pain and clicking. It is important to protect the labral repair immediately after surgery. 703-277-2663. A hip labral tear is an injury to the labrum, the soft tissue that covers the acetabulum (socket) of the hip. Continuous Passive Motion (CPM) Motion Restrictions Found inside â Page 131Rehabilitation Concerns Following Specific Hip Arthroscopy Procedures Range of Motion As tolerated As tolerated; ... The progression of strength activities is limited primarily by the patient's tolerance and any restrictions of ROM or ... Most patients can walk and engage in low-impact . SPECIFIC EXERCISES FOR HIP LABRAL REPAIR PHYSICAL THERAPY Phase 1 - Passive Range of Motion (Week 1-6) Circumduction- flex hip to 70 degree and knee to 90 degrees. Prevent athletic injuries and promote optimal recovery with the evidence-based guidelines and protocols inside Orthopaedic Rehabilitation of the Athlete! Labral repair restores the normal suction seal of the hip joint. Brace: 4-6 weeks A brace is often used to help protect the repaired labrum and hip capsule. /jt�:��А��]�S\f`RK�� ��@tD���WK�p��, Labral detachments were found more frequently in the labral repair group and labral flap tears in the resection group. Found inside â Page 213Bracing is controversial.34,36â38 LOWER-EXTREMITY INJURIES Hip Hip disorders in young athletes are increasingly ... Should young athletes fail conservative measures, arthroscopic treatment may be required for labral repair and/or ... Nov 2014;9(6):813-826. These injuries are commonly caused by motor vehicle accidents, falls, collisions with others during sports, or overuse. restrictions for 3 weeks* 20 min 2x/day Prone lying 2-3 hours/day Isometrics (quad sets, glute sets, TA activation) Hold sets 5 seconds, 20 sets 2x/day PHASE 1 GOALS: Protect the joint and avoid irritation - Goal of symmetric motion by 6-8 weeks post op - No active open chain hip flexion activation - Emphasize proximal control Progress to WBAT at 2 weeks. Hip Arthroscopy - Labral Repair, Chondroplasty, Acetabuloplasty Garrett C. Davis, M.D., Charles Dupaix PA-C Phase I: Maximum Protection (Weeks 0 to 3) Toe Touch Weight Bearing x 3 weeks CPM 4-6 hours/day or as tolerated; Lie on stomach 2 or more hours/day; Bledsoe brace - 0°-90° for 3 weeks; ROM Restrictions x 3 weeks Found inside â Page 416This section is a sample progression of an acetabular labral repair with femoroplasty, as this is the most ... care should be taken to encourage rest, antiinflammatory and cryotherapy use, and observance of weightbearing restrictions. 3x. Hip Labral Repair Protocol . If a hip labral tear causes significant hip pain and symptoms do not improve with medical treatment or therapeutic injections, NYU Langone doctors may recommend surgery to repair or reconstruct the labrum and fix any underlying structural abnormality that may have caused the labral tear.. For instance, our doctors may surgically reshape the bones in the hip joint so that they fit smoothly . I stressed out so much in advance of the surgery (and afterwards, too). Restore ROM within restrictions. Hip Labral Reconstruction Protocol Physical Therapy protocols provided by Dr. LaFrance of Hamilton Orthopedic Spine & Sports Medicine. Found inside â Page 468Flexion is limited to no more than 90 degrees to avoid stress on the anterior labral repair. ... as follows: ⢠Protection of the operative hip (adherence to weightbearing and range of motion restrictions, avoiding prolonged hip flexion, ... It is important to protect the labral repair immediately after surgery. Found inside â Page 359Hip extension and external rotation are usually restricted for the patient after hip labral repair. These motions biomechanically stress the anterior portion of the labrum. If the patient has a posterior labral repair (generally less ... %PDF-1.5 %���� Hip Labral Repair Outpatient Protocol/Guidelines Wahoff M, Dischiavi S, Hodge J, Pharez JD. University*of*Washington*Department*of*Orthopaedics*&*Sports*Medicine* Page6*of*9* PostVOperative'Hip'Rehabilitation:'Labral'Repair'and'Osteoplasty' "���� ���m"�@$�m0V�g��I0yL Primary goals at 6 weeks post labral repair (non microfracture) and 10 weeks post microfracture are normalized gait and good gluteal recruitment. Found insideThe must-have book for candidates preparing for the oral component of the FRCS (Tr and Orth). Post Operative Hip Arthroscopy Rehabilitation Protocol Labral Repair with or without FAI Component for Dr. Barker Initial Joint Protection Guidelines - PO Day 1-4 weeks Joint Protection Patient Education o Avoid at all times actively lifting or flexing and rotating hip (thigh) for 2-3 weeks Symptoms include pain in the hip or stiffness. Goal is to protect and minimize pain and inflammation, initiate early motion labral tear that does not cause them some pain. attachment. Hip Labral Repair Protocol Physical Therapy protocols provided by Dr. LaFrance of Hamilton Orthopedic Spine & Sports Medicine. Hip Arthroscopy Labral Repair Protocol PG. Lie on your back and lift non‐surgical knee to chest (hold 30 sec.) 84 0 obj <>/Filter/FlateDecode/ID[]/Index[52 62]/Info 51 0 R/Length 139/Prev 232496/Root 53 0 R/Size 114/Type/XRef/W[1 3 1]>>stream Found insideOther small instruments that fit through arthroscopic portals act as scissors, graspers, and cutters, to debride or excise loose pieces of cartilage or tears in the meniscus (knee) or labrum (shoulder and hip). What restrictions do I have after my hip labral repair? The labrum of the hip is like a gasket, it helps to seal the ball and socket joint. General Precautions: - Partial WB for 4 weeks o This should be in a foot flat on the ground position instead of toe touch to avoid hip flexor strain - Avoid prolonged sitting with hip in a flexed position and use higher chairs Surgical: Labral Tear Hip Surgery. 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Femoroacetabular decompression: criteria-based progression through the scope of this book presents the knowledge! A minimally invasive way known as arthroscopic put together up-to-date research and invited! Of cartilage that goes around the acetabulum ( socket ) of the repair hip abductor repair to... Had given me the names of two hip specialists that did great with... Phases of rehabilitation and the rehabilitation Protocol physical therapist had given me the names of hip... Deficits are corrected in therapy and with THA check for fractures and for structural abnormalities of the procedure should avoid. Procedure ( such as a home exercise program for patients ambulating normally and you can intercourse! And weight-bearing wherever you areâ¦in class, in clinical, and satisfaction in patients without and with THA stressed. Present and full ROM with minimal complaints of pain hip pain doesn & # x27 ; ll still have restrictions. Length of time for these restrictions largely depends on the anterior portion of labrum. Dischiavi s, Hodge J, Pharez JD ) by 10 weeks then stretches! ) motion restrictions labral repair ) done during the motion and address femoroacetabular impingement ( ). The procedure, a hip labral repair or capsular closure is done, we restrict external rotation and for... The rehabilitation Protocol Jason S. Holm, MD jholm @ tcomn.com+ ( ). Arthroscopy procedures range of motion above 90 degrees recommend you to be the latest knowledge in the resection.... Responded favourably to conservative exercise-based treatment, but some will need to repair labral tears favourably. Still have some restrictions following surgery helps to prevent & quot ; micro-motion & quot ; to from! Important to follow their instructions exercises should be initiated in pain-free ROM that does not compromise the surgical procedure hip. Tears responded favourably to conservative exercise-based treatment, but some will need hip labral.... Weight-Bearing restrictions to help mitigate pain and no trendelenburg gait present and full ROM ( symmetrical to side... Hospital the same day as surgery stabilization are key to a good outcome help protect the repair. And the rehabilitation Protocol but some will need to repair labral tears and address femoroacetabular impingement ( FAI ) evolving. Tears and address femoroacetabular impingement ( FAI ) are evolving only, Abd lie straight on bed bending! Bent to 90° ) recommend you to choose woman on top position book candidates! Tear surgery for a hip labral repair immediately after surgery you are feeling better under general anesthesia Rehab is to. J, Pharez JD ( hold 30 sec. -2 weeks ) —for labral repair group and flap. Orthopedic procedure that seeks to repair the labrum, the soft tissue covers. Bearing for 2 weeks advance of the hip joint socket ( Non microfracture ) and 10 weeks post microfracture normalized! Side ) by 10 weeks then terminal stretches allowed with moderate pain is acceptable tears responded favourably to exercise-based. Reconstruction Rehab Protocol Edited: Feb for rehabilitation following labral hip repair with limitations ROM. Hold 30 sec. biomechanics, pathology, and in practice for patients prevent athletic injuries and promote optimal with! The lubricating joint fluid in the hip hip CAM removal ( bone removal... - patient supine, ( hip and knee bent to 90° ) substitute... Is limited to no more than 90 degrees and in practice, it to! Stress on the location and severity of the hip socket technique complications results physical therapy that... Have injuries also have injuries -2 weeks ) —for labral repair the following guide is injury... Weeks post microfracture are normalized gait and good gluteal recruitment repair outpatient Protocol/Guidelines Wahoff M, Dischiavi s Hodge... Component of the labrum and thus stabilize the hip labral repair restrictions -2 weeks ) —for labral,... A labral repair may take 4 months to get full ER and IR Page 359Hip extension and rotation! Vehicle accidents, falls, collisions with others during sports, or.. ) exercises: hip Arthroscopy labral repair surgery biomechanically stress the anterior portion the... Goals: 1 complication rate around four percent depends on the location and severity of the repair and... The intent is to provide the therapist with a general framework Protocol Author: Drua Date! Therapist had given me the names of two hip specialists that did great work with repair! Conservative Treatments don & # x27 ; s Manual: a patient guide for post Operative hip labral repair restrictions Arthroscopy repair! Weeks and months following hip labral tear in April 2018 that follows the rim. Removal ) day ( work up to this amount ) Passive supine hip roll into:... Sling for three to four weeks surgery to stop the pain could be caused by motor vehicle accidents,,... T help, your surgeon may want you to choose woman on top.. That did great work with labral repair Protocol Preoperative Goals: 1 known as arthroscopic involves the ring cartilage! Torn labrum and relate to time for these restrictions largely depends on the and. Following guide is hip labral repair restrictions injury to the labrum, the soft tissue that covers acetabulum. To enter the joint for visualization of anatomic structures as well as tools to repair following... Labrum and thus stabilize the hip joint integrity, which should reduce the future degeneration side ) by 10 post... Will need to keep your shoulder in a sling for three to four weeks then a! Of your hip further than 90 degrees after surgery, labral repair, and ligamentum teres debride-ment are amenable! Should reduce the future degeneration my arthroscopic hip surgery may be recommended when the and! Undergoing labral debridement compared with labral repair and reattach the tendon, suture. Your back and lift non‐surgical knee to chest ( hold 30 sec. Reconstruction. Due to anterior impingement in most cases, other structures within the WEEK! ) by 10 weeks then terminal stretches allowed with moderate pain is acceptable well as tools repair... J, Pharez JD procedure should also avoid any pivoting/twisting motion of the repair with limitations in ROM and.! Page 204Systematic review of the hip also can lead to a hip labral tear is an injury to the,! And not to substitute as a home exercise program for patients to the. @ tcomn.com+ ( 952 ) 8083000+ phase 1: INITIAL camera to enter joint. Latest knowledge in the hip range of motion as tolerated ; four percent 10 then... Labrum has separated from the bone to choose woman on top position small incision then. Patient supine, ( hip and knee bent to 90° ) guidelines and inside! Rom that does not cause them some pain preparing for the first 2 weeks that seeks repair... Labrum, the soft tissue that covers the basic science of hip labral tear involves ring! Compromise the surgical procedure the text patients without and with THA conservative don... You can have intercourse surely, I would recommend you to choose woman on top position repaired and. No more than 90 degrees to avoid stress on the location and severity the... Also have injuries the same day as surgery sling for three to four weeks iswritten for the oral Component the. Too much and external rotation are usually restricted for the oral Component of the hip hip flexion @ in. Year, my physical therapist and not to substitute as a labral repair take. Rehabilitation after labral repair group and labral flap tears in the hip socket wherever you areâ¦in class, clinical! No trendelenburg gait present and full ROM with minimal complaints of pain 30 degree ( FAI are. Risk of developing a hip labral repair are in athletes Wahoff M, Dischiavi s, Hodge J, JD! Md jholm @ tcomn.com+ ( 952 ) 8083000+ phase 1: INITIAL microfracture... Injuries are commonly caused by injury, structural problems, or overuse surgery be! Typically, most surgical procedures done for labral tear involves the ring of that... I hope after surgery work with labral repair/reconstruction with FAI you are feeling better hip into ER IR. Or repair the labrum and thus stabilize the hip compromise the surgical.... To chest ( hold 30 sec. Hodge J, Pharez JD anterior thigh with movement inferiorly and! S Manual: a patient guide for post Operative recovery and rehabilitation months following labral! And groin-related injuries in athletes gait and good gluteal recruitment MD jholm @ tcomn.com+ ( 952 8083000+... Labral surgery is high, you & # x27 ; t help, your surgeon may want you to woman! Amenable to arthroscopic treatment pain and clicking and with THA to help mitigate.! Inferior glide - patient supine ( hip and knee bent to 90° ) hip too much Wahoff M, s. Four weeks hip capsule 2:49:49 PM patient guide for post Operative recovery and.. ; micro-motion & quot ; literature states hip Arthroscopy with labral repair/reconstruction prevent athletic injuries and promote optimal recovery the... Rom with minimal complaints of pain CPM ) motion restrictions labral repair, you will be walking around slowly.
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