FAI Surgery: What the Studies Don’t Tell You About Patient Satisfaction

Do you ever get the feeling that when you’re sitting in your doctor’s office talking about joint pain—hip, back, shoulder, whatever—you’re not quite getting the full story? Like maybe the incentives are just a little skewed and you’re not being told everything you actually need to know?

Well, I’m here to tell you: it’s not just a feeling. It’s real. And it goes way deeper than one well-meaning doc in a white coat.

Because even when a doctor genuinely wants to help you, the research they’re relying on—the stuff guiding their decisions—is often so broken, so deceptive, and so poorly constructed that they literally can’t give you good advice. And it’s not their fault. The system is messed up.

Today, we’re digging into one of the clearest examples of that broken system: hip impingement surgery. Specifically, the kind where surgeons shave down the bones in your hip joint because they think those bones are shaped wrong. Too long here, a little bulky there… supposedly, that bone-on-bone contact is causing your pain and arthritis.

This surgery exploded in popularity in the early 2000s thanks to a European surgeon who trained others to do it after claiming near-miraculous results. And ever since, it’s been hyped up as a cutting-edge solution. But here’s the thing…

The Research Is Rigged

Let’s rewind to a 2012 study. Not some fringe paper—this was legit research. And the conclusion?

“Expectations of surgery were overly optimistic.”

Translation: people thought they were going to feel a lot better, and most didn’t.

In fact, when you actually look at the data:

• 56% said the surgery didn’t meet their expectations for hip pain relief.
• 61% weren’t satisfied with their return to sports.
• 53% were disappointed with their overall function.

But fast forward to 2022 and boom—suddenly we’re seeing studies claiming things like:

“FAI surgery provides lasting improvement in function and a joint preservation rate of 90.4% at 10 years.”

Sounds amazing, right? Until you realize what that number actually means. Spoiler alert: it just means that 90.4% of people didn’t need a hip replacement within 10 years. It does not mean they felt better, were more mobile, or were actually happy with the results.

The Satisfaction Cover-Up

Let’s talk about a thing called PASS—the Patient Acceptable Symptomatic State. It’s a simple idea: are you satisfied with your symptoms now, yes or no?

Seems like a great way to measure whether surgery worked, right? But for years, surgeons didn’t even bother to ask patients if they were satisfied. Instead, they relied on a bunch of complex questionnaires (Modified Harris Hip Score, Hip Outcome Score, IHOT-33, etc.) and looked for “improvements” based on score changes—without checking if people actually felt good.

A 2015 study tried to fix that. They figured out what scores correlated with people saying “yeah, I feel okay now.” Great idea! Except… they never told us how many of their own patients actually hit that “okay” threshold.

Which is weird. If the number was high, you’d expect them to brag about it. But they didn’t. Probably because that number was embarrassingly low.

The Actual Numbers (Brace Yourself)

When researchers in Denmark finally did ask patients in a 2021 study whether they were satisfied after surgery, the result was clear:

Only 46.7% of patients said yes.

So more than half of patients who went through this major surgery were like, “Nah, this didn’t help me.”

And in that 2022 study touting the 90.4% joint preservation? The calculated (not even self-reported) satisfaction rate was only 47%.

Why This Matters

The reality is, most surgeons don’t have time to dig into the details of every study. They skim the abstracts, see “lasting improvement,” and move on. If the summary says it’s good, why wouldn’t they trust it?

But when you dig into the full data, you see how misleading those summaries are—and how deeply broken the system is.

This isn’t just about bad data. It’s about bad decisions being made based on that data. And it's about people like you and me being misled into surgeries that don’t help.

So What Should You Do?

If you’ve been told you have hip impingement and need surgery, don’t panic. There’s a lot you can do.

Start with movement. Start with muscles. Your hip joint is surrounded by over 20 muscles that affect how you move, how your bones interact, and how you feel.

Surgeons might blame your bone shapes, but those bones are being moved by muscles. Free those up—stretch, strengthen, massage—and you can change how your hips function and feel.

Your cookie-cutter physical therapy plan? Probably trash. But a thoughtful, well-designed movement approach can make a massive difference.

You can check out my free hip pain videos, my Healthy Hips program, or just find a coach or PT who’s actually going to help you experiment and figure out what works for you. Because your hips are specific. They need specific attention. 

Bottom Line

Don’t take research abstracts at face value. Don’t assume surgery is your only option. Dig deeper, ask better questions, and take ownership of your body.