Prehabilitation before hip arthroscopy for femoroacetabular impingement syndrome: A randomised controlled trial

Design Pragmatic, two-arm, parallel-group, superiority randomised controlled trial with assessor-blinding and statistician-blinding. Setting Single orthopaedic centre in Shanghai, China. Participants One hundred and eighty adults (aged 18–50 years) with femoroacetabular impingement syndrome scheduled for hip arthroscopy were randomised to prehabilitation ( n = 90) or usual care ( n = 90). Intervention The prehabilitation group received 6 weeks of supervised exercise, education and home activity before surgery. Controls received standard preoperative advice. All patients received identical postoperative rehabilitation. Main measures The primary outcome was the Harris Hip Score at 24 weeks. Secondary outcomes included pain, maximal hip muscle strength, range of motion, dynamic balance, quality of life, mental health and cost. Results At 24 weeks, the Harris Hip Score did not differ significantly between groups (adjusted between-group difference 0.98 points [95% CI −0.11 to 2.07], p = 0.08). At 4 and 12 weeks, differences numerically favoured prehabilitation (1.52 points, uncorrected p = 0.02; 1.14 points, uncorrected p = 0.04) but did not reach significance after Bonferroni correction (threshold p < 0.0167). Secondary outcomes favoured prehabilitation, including pain, maximal hip strength, range of motion and dynamic balance, though all between-group differences were below published thresholds for clinically important change. Conclusions Prehabilitation before hip arthroscopy for femoroacetabular impingement syndrome was associated with small early improvements that did not reach statistical significance for the primary outcome after correction for multiple comparisons and were below clinically important thresholds. Total costs did not differ significantly between groups. Trial registration number ChiCTR2500113298 (Chinese Clinical Trial Registry, https://www.chictr.org.cn/ , date of registration: 26 November 2025). This trial was registered retrospectively.