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

OBJECTIVE: To evaluate a three-month post-hip arthroscopy rehabilitation program within a randomized controlled trial (RCT) comparing hip arthroscopy to sham surgery for femoroacetabular impingement (FAI) syndrome (HIPARTI trial) by describing: exercise adherence, type and pain; six-month changes in international Hip Outcome Tool-33 (iHOT-33); physical impairments and functional performance. DESIGN: Exploratory cohort study nested in a pilot RCT. METHODS: Participants aged 18-50 years with FAI syndrome completed a three-month, physiotherapist-led, post-surgical rehabilitation program, self-reporting rehabilitation adherence and pain levels on the Visual Analogue Scale using weekly training diaries. Baseline to six-month changes in quality-of-life (iHOT-33), physical impairment (hip strength, range of motion [ROM]) and functional performance (single-leg hop, side bridge endurance) were reported as mean (SD). RESULTS: Twenty-nine people (37% female; 29.9 ± 7.9 years) participated. Hip extension, abduction and functional exercises were performed most often. Exercise adherence analysis was limited by underreporting. Training diary data adequate to assess adherence were available for 20 participants (69%). Among those with available data,16 (80%) met the predefined adherence target of ≥2 sessions per week, average pain remained acceptable (<2 VAS); iHOT-33 (+18.6 ± 22.5; 95% CI: 10.2 to 27.0) and hip flexion ROM (+6°; 95% CI: 2.14 to 9.60) improved significantly. Hip extension, adduction, external-and-internal rotation strength improvements exceeded the Minimal Detectable Change (MDC), though were not significant. CONCLUSION: Adherence was generally high among participants with available data, though limited by underreporting. Hip-related quality of life (iHOT-33) improved despite limited changes in physical impairments, and no improvement in functional performance.