Hip arthroscopy versus best conservative care for the treatment of femoroacetabular impingement syndrome (UK FASHIoN): a multicentre randomised controlled trial

If you work, as I do with a lot of Young hip pain, then this is an excellent read.  The number of patients in this trail makes it a great resource to help make decisions to show if this type of surgery works, as it becomes more and more common.  I do believe that Surgery is necessary in a lot of these cases, but patient selection ( as well and Surgeon selection) is key as is pre-hab and the post-op rehab is vital to get the most out of this procedure.

I feel that everything should be done pre- op to make these patients stable in a multi-planar way at the pelvis and femur.  Patients should be as stable as they can get before even considering surgery, as the rehab is difficult, involved and long.  This is in a different league from a knee arthroscopy for lots of reasons the main one being- the knee is a hinge simple joint- the hip is not- its a ball and socket joint with a need for multi-planar control.

If you are considering having surgery or one of your patients is- then stop, pause, work hard to get everything right before jumping in.  Get the functional stability elements sorted and then the outcome will be quicker and better. The outcomes can be good- as you can see from the Lancet article.

Pick your Physio well- find someone who does a lot of this- it is not straight forward, get the right post op rehab – and it dedicate 12 months to get back in shape, its not a quick process.