PROOF You Need Surgery for Hip Impingement (FAI)
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Hip Impingement Surgery: Does It Actually Work?
If you’re considering surgery for hip impingement (FAI), you’ve probably been told it’s effective and safe—especially over the long term. Surgeons, medical websites, and even research summaries may claim high success rates. But what happens when you actually read the full research papers? What do patients themselves say about their results? Let’s take a closer look.
The 10-Year Study That Sounds Great… At First
A commonly cited study on hip impingement surgery reports that after 10 years, over 90% of patients had not needed a total hip replacement. That might sound promising. But this statistic alone doesn’t tell the whole story. It only tells us that the joint didn’t degrade enough to need replacing—not whether people actually felt better after surgery. And that’s where patient-rated outcomes come in.
Why Patient-Rated Outcomes Matter
Instead of just measuring things like joint angles, imaging results, or cartilage wear, some studies ask patients how they feel post-surgery:
- How painful is sitting or walking?
- Can you return to sports or daily activities?
- Are your current symptoms acceptable?
One of the most useful metrics is PASS—Patient Acceptable Symptom State. It simply asks: “Do you feel like your symptoms are now acceptable?” Yes or no. PASS is a clear, patient-centered way to evaluate whether a surgery helped someone function better and feel better.
What This Study Actually Found
When you dig deeper into the study (beyond the summary), you find that less than 50% of patients achieved PASS. That means less than half of the people who had surgery were satisfied with their results 10 years later.
Despite the surgery being labeled a "success" by other metrics, the majority of patients did not feel like their pain or function had improved enough to be considered acceptable.
This Pattern Isn’t Unique
This isn’t a one-off result. At least two other studies on FAI surgery also show patient satisfaction rates below 50%.
- Danish Study 2021: https://journals.sagepub.com/doi/10.1177/2325967121995267
- 2013 Study: https://www.oarsijournal.com/article/S1063-4584(12)00988-0/fulltext
That means the majority of patients who undergo hip surgery for impingement do not feel that it worked for them—and they say so when directly asked. Yet this reality is rarely communicated in the informed consent process before surgery.
Why the Numbers Can Be Misleading
Surgeons and clinics often cite “success rates” of 80–90%, but those numbers are usually based on some combination of:
- Imaging results
- Arbitrary questionnaire scores
- “Improvements” defined by researchers (not patients)
These can be massaged to show progress, even if patients don’t feel better. In contrast, patient satisfaction scores—like PASS—cut through the noise.
Exercise First: A Low-Risk, High-Reward Option
To be clear, some people do benefit from surgery. But if more than half don’t, it makes sense to try conservative methods first. That means:
- Exploring strength and mobility exercises
- Learning how to move and use your hips differently
- Trying multiple exercise approaches to see what your body responds to
Even though there’s no published study showing the exact success rate of exercise for FAI (likely because it’s hard to dispense and monetize), anecdotal evidence suggests many people can get significant relief. And unlike surgery, exercise carries far fewer risks and no permanent structural changes.
What the Research Tells Us—If You Look Closely
Let’s summarize the key takeaways:
- Headline stats can be misleading. A low hip replacement rate does not equal patient satisfaction.
- Less than 50% of patients report acceptable results after surgery, according to their own ratings.
- These poor satisfaction rates are consistent across multiple studies.
- Surgeons rarely share this reality as part of the informed consent process.
- Conservative care—like exercise—is worth trying first, especially since some research shows surgery may accelerate cartilage damage if it fails.
What You Can Do Instead of Surgery
Start by exploring movement-based solutions. That might mean:
- Looking up mobility and strength exercises on YouTube or Instagram
- Learning about how muscle coordination affects hip function
- Trying the Healthy Hips program
There are many paths to improving your hips—and you don’t need to jump straight to surgery. Give yourself the chance to rebuild your body and avoid unnecessary risks.
Read Up On More FAI Research
- FAI Bone Shapes and Hip Pain: https://www.uprighthealth.com/fai-bone-shapes
- FAI and Labral Tears: https://www.uprighthealth.com/fai-labral-tears
- Hip Impingement Tests: https://www.uprighthealth.com/fai-tests
- Surgery for Hip Impingement: https://www.uprighthealth.com/fai-surgery
