Evaluating a 3-Month Physical Impairment and Functional Performance-Based Rehabilitation Program After Hip Arthroscopy for Femoroacetabular Impingement (FAI) Syndrome.

After hip arthroscopy for femoroacetabular impingement syndrome, physical therapists want to know whether a structured rehabilitation program actually restores strength, movement, and function, not just how patients feel. This exploratory study, nested within a pilot randomized trial comparing hip arthroscopy to sham surgery, followed 29 people through a 3-month therapist-led rehabilitation program and tracked their adherence, pain, and outcomes over 6 months. Patients reported meaningful improvement in hip-related quality of life, and hip flexion range of motion improved significantly. However, most other physical impairments showed only non-significant changes, and functional performance measures like hopping and side bridge endurance did not improve.

Adherence appeared generally high among those with usable data, but many training diaries were incomplete, limiting confidence in that finding. The study's small size and missing adherence data mean these results should be read as preliminary, raising questions about what is really driving reported improvement after this kind of surgery and rehabilitation.

If you have had or are considering hip arthroscopy for femoroacetabular impingement syndrome, you might wonder whether a structured rehabilitation program afterward actually improves your strength and movement, not just how you feel day to day. This small study followed 29 people through a 3-month physical therapist-led rehabilitation program after hip arthroscopy, looking at their adherence to exercises, pain levels, and changes over 6 months. People reported notable improvement in hip-related quality of life, and their hip flexion movement improved as well.

But other measures, like hip strength in several directions and functional tests such as hopping and core endurance, did not show clear improvement. Many participants did not fully complete their exercise diaries, so it's hard to know exactly how consistently people followed the program.

Because this was a small, exploratory study, these findings give an early picture rather than a definitive answer about what rehabilitation changes after this surgery.

This is a summary of research, not medical advice. Talk to your own healthcare provider about anything affecting your care.

This paper speaks to a practical clinical question after hip arthroscopy for femoroacetabular impingement syndrome: does a structured postsurgical rehabilitation program produce measurable physical changes, or does reported improvement in hip-related quality of life occur somewhat independently of impairment and functional performance gains. Within a pilot randomized controlled trial comparing arthroscopy to sham surgery, this exploratory cohort of 29 participants completed a 3-month therapist-led program with weekly training diaries for adherence and pain. Among the 20 participants (69%) with usable diary data, 80% met the predefined adherence target of at least two sessions weekly, with acceptable average pain.

iHOT-33 scores improved significantly (+18.6, 95% CI 10.2 to 27.0), and hip flexion range of motion improved significantly (+6 degrees, 95% CI 2.14 to 9.60). Hip extension, adduction, and rotation strength changes exceeded the minimal detectable change but were not statistically significant, and functional performance (single-leg hop, side bridge endurance) showed no improvement, an isolated pattern that leaves open whether quality-of-life gains reflect true physical recovery.

The main limitation is substantial underreporting in adherence data, reducing confidence in adherence conclusions, alongside the small, exploratory, nested-cohort design, which means these findings describe associations within one rehabilitation protocol rather than establishing what drives outcome improvement or how it compares to other approaches.