FP16.2 Treatment of patients with femoroacetabular impingement syndrome using a pelvic-tilt focused exercise program - a prospective cohort

Abstract ICLA16 - Beyond the Operating Room: Value-Based Healthcare, Large Registries, and Predicting Failures, Auditorium B (BMCC Level 1), October 9, 2026, 14:00 - 16:00 Background The rates of hip arthroscopy are increasing worldwide for femoroacetabular impingement syndrome (FAIS). There is a lack of literature examining outcomes of modern non-operative treatment of patients with FAIS. Purpose To develop and assess the effectiveness of a pelvic-tilt focused exercise program for non-operative management for patients with FAIS. Methods A prospective, non-operative cohort of patients with FAIS was assembled. Eligible patients included those aged 16-55 who met radiographic and clinical criteria for FAIS. Enrolled patients participated in a 10-minute standardized pelvic-tilt-focused, home exercise program (HipFit10) at least 4 times per week over 6 months. Self-reported adherence was tracked weekly. Patient-reported outcomes were collected at baseline, 3 and 6 months. The International Hip Outcome Tool-33 (iHOT-33) was measured at baseline, 3 and 6 months, with the primary outcome being the iHOT-33 change scores between baseline and 6 months. Secondary outcomes included Hip Outcome Score – Activities of Daily Living (HOS-ADL), pain visual analogue score (Pain VAS), crossover to surgical management and complications. Results A total of 214 patients enrolled between August 2020 and October 2021. Mean age was 34.2 years (+10.2), and 121 patients (57%) were female. Within the study period 19/214 (9%) patients dropped out or were lost to follow-up. By 6 months, 153/195 (78%) patients completed the intervention and elected to avoid surgery, and 42/195 (22%) patients signed up for or underwent surgery. Final iHOT-33 scores were completed by 192/195 participants (98%) with mean improvement from baseline 6-months of 11.7 (95%CI: 9.2-14.1, p<0.001). By 6 months, 103/192 participants (53%) achieved the iHOT-33 MCID of >6.8. Significant improvements also were seen in the iHOT-33 from baseline to 3-months (mean difference [MD]: 7.6, 95%CI: 5.7-9.6), and 3-months to 6-months (MD: 3.7, 95%CI: 1.8-5.6), as well as in the HOS-ADL (0-3mo MD: 2.65, 95%CI: 0.8-4.4) and Pain VAS (0-3mo MD:-7.7, 95%CI: -4.8- -10.5; MD 3-6mo:-3.5, 95%CI: -0.6- -6.3). No adverse advents were reported. Conclusion In this study of patients with FAIS, pelvic-tilt focused physiotherapy was utilized to improve patient function with 78% avoiding surgery. These results suggest the HipFit10 program is a safe and effective non-operative option for patients with FAIS.