## 4 Discussion
[48] demonstrated that patients who underwent arthroscopic surgery achieved superior functional gains, particularly in hip flexion-related movements, within the first year of treatment. However, the long-term comparison provided by [PERSON] et al. [5] indicated that these advantages diminished over time, suggesting that surgical intervention may primarily serve to accelerate early-stage functional recovery rather than provide additional long-term benefits. Range-of-motion (ROM) restoration was another important factor in evaluating the efficacy of different treatment approaches. The studies reviewed indicate that surgery is particularly effective in improving hip flexion and abduction, as evidenced by [PERSON] et al. [25] and [PERSON] et al. [48]. However, [PERSON] et al. [47] demonstrated that conservative approaches incorporating trunk stabilization exercises also resulted in meaningful gains in hip ROM, particularly in flexion and internal rotation. The absence of significant long-term differences in ROM between surgical and non-surgical groups in the study by [PERSON] et al. [5] suggests that, while surgery may facilitate faster improvements, rehabilitation-focusedinterventions can achieve similar outcomes with sufficient time. This finding supports the notion that non-operative management, when tailored appropriately to individual patients, may serve as an effective first-line approach for restoring mobility in FAIS. Muscle strength is another crucial aspect of rehabilitation, particularly given the role of hip and core musculature in stabilizing the joint and mitigating excessive stress on the femoroacetabular interface. Studies by [PERSON] et al. [47] and [PERSON] et al. [19] demonstrated that progressive strengthening interventions lead to substantial improvements in hip flexor and abductor strength, which directly correlated with enhanced functional outcomes. In contrast, [PERSON] et al. [29] and [PERSON] et al. [48] reported that surgical patients exhibited superior strength gains, particularly in hip extensors and stabilizers, at twelve months. While this suggests that surgery may allow for more rapid muscle adaptation, the finding that core stability improvements were more pronounced in the physiotherapy group in the study by [PERSON] et al. [48] reinforces the importance of targeted rehabilitation strategies. Strength gains associated with physiotherapy are likely due to increased neuromuscular activation and motor control improvements rather than solely muscle hypertrophy, emphasizing the need for well-designed exercise programs tailored to FAIS patients. Quality-of-life outcomes further reinforce the potential of conservative rehabilitation as an effective treatment option. While studies such as those by [PERSON] et al. [29] and [PERSON] et al. [48] reported superior quality-of-life scores for surgical patients at the twelve-month mark, long-term follow-ups demonstrated a narrowing of differences between surgical and non-surgical groups. [PERSON] et al. [47] and [PERSON] et al. [19] showed that structured rehabilitation interventions led to significant and sustained improvements in patient-reported quality of life, particularly when exercise programs were designed to address functional limitations and pain management. The absence of long-term differences in quality-of-life outcomes in the study by [PERSON] et al. [5] suggests that physiotherapy, when appropriately applied, can provide comparable long-term benefits to surgery. This finding is particularly relevant in the context of healthcare resource allocation, as it highlights the potential for high-quality rehabilitation programs to serve as a cost-effective alternative to surgical intervention in select patient populations. Taken together, the findings of this review support the growing body of evidence suggesting that conservative rehabilitation should be considered a primary intervention for FAIS, particularly in cases where surgery is not immediately indicated [48].