Exposing the Truth About FAI Surgery Research

Today, I want to talk about something that should make you angry. It’s about research that’s supposed to guide decisions around hip surgery — specifically for femoroacetabular impingement (FAI), or hip impingement. But when you look closely, what you actually find is a stunning lack of transparency, questionable reporting, and what some might even call intellectual dishonesty.

This post breaks down a 2015 study that has some major red flags you need to know about — especially if you’re considering hip surgery for FAI.

Let’s Talk About the Study

The paper is titled: "The Patient Acceptable Symptomatic State for the Modified Harris Hip Score and Hip Outcome Score Among Patients Undergoing Surgical Treatment for Femoroacetabular Impingement."

Catchy, right? Here’s what it’s trying to do: figure out what score on popular hip outcome questionnaires (like the Modified Harris Hip Score and the Hip Outcome Score) corresponds to a patient saying, “Yeah, I’m satisfied with my hip after surgery.” That "yes or no" marker is called the PASS — Patient Acceptable Symptom State.

Sounds Useful — Until You Look Deeper

In theory, this should be helpful. If we know what a “satisfactory” score is, we could go back through other studies that only reported scores and estimate how many people were actually satisfied with surgery.

But there’s a major issue. Actually, a few.

The Missing Piece: Satisfaction Rates

This paper had 130 patients who had surgery. At one year post-op, they used PASS to ask patients if their symptom state was acceptable — a simple yes or no.

They reported what average scores seemed to correlate with saying “yes.” What they didn’t tell you? How many people actually said “yes.”

They don't give the raw number. Not in the text. Not in the tables. Not in the footnotes. Nowhere.

Think about that. They want to show which scores predict satisfaction... but they won’t tell you how many were actually satisfied.

Why This Matters

If most people were happy with their surgery, the study would shout it from the rooftops. But they don’t. And the most logical reason for omitting that number is... it was low. Like, really low. Embarrassingly low.

And that would destroy the premise of the whole study — that you can correlate satisfaction with certain scores — because the analysis wouldn’t be statistically valid with so few “satisfied” patients.

Other Studies Tell the Real Story

Other research paints a clearer (and more honest) picture:

• A 2013 study found that 56% of patients said their expectations for pain relief were not met after FAI surgery.
• 61% were disappointed with their return to sports.
• 53% were disappointed with general function.

And in a 2021 Danish study, only 46.7% of patients reported being satisfied with their outcome.

Those are not good numbers. And they’re a far cry from what you might assume if you just looked at Harris Hip Scores or HOS data in isolation.

What You Should Take Away From This

If you're thinking about surgery for hip impingement, take a breath. Do your research. Look at multiple studies. And most importantly, look for the actual satisfaction rates — not just score improvements on questionnaires that may not even matter to how you feel in real life.

And if a study doesn’t give you the full picture? That’s a red flag.

What to Do Instead

Explore non-surgical options first. Look at programs that focus on improving hip strength and mobility. Look at how your muscles interact. I’ve worked with many people who were told surgery was the only option — and who found significant relief through consistent, targeted movement strategies. I've seen similar stories all over the internet. 

I’m not saying I have all the answers. I’m saying don’t assume surgery is the best answer just because a scientific-sounding paper said so. Especially when that paper isn’t telling you the whole story.

Want Help Right Now?

I’ve built a comprehensive Healthy Hips program that’s designed to help you address hip pain without surgery. It’s backed by a 60-day money-back guarantee. If it doesn’t feel like the right fit for you, you can get your money back — no questions asked.

And if you don’t want to try my program, that’s totally fine. Find someone who makes sense to you and whose approach aligns with your values. Just make sure you’re looking at real outcomes — not just manipulated data.