 Popular youth sports, such as baseball, gymnastics, and soccer, often require complex and repetitive movements involving turning, twisting, and squatting. These movements can lead to conditions such as femoral-acetabular impingement, which is characterized by painful rubbing of the femoral head against the acetabulum. Surgery is a common treatment, but success is not guaranteed. Understanding the factors that lead to repeat operations could help surgeons make more informed treatment decisions, ultimately reducing the need for secondary surgeries and improving patient outcomes. A recent study published in the American Journal of Sports Medicine evaluated whether certain anatomical characteristics of the hip bones could help predict surgical success. Researchers examined pre-operative standing antroposterior pelvis radiographs collected from adolescent patients who eventually underwent surgery to correct femoral-acetabular impingement. Specifically, they measured the femoral-epiphyseal-acetabular roof, or FEAR index, the alpha angle, the lateral center edge angle, or LCEA, the tonus angle, and sharps angle. These measurements and patient-reported outcomes were then compared between patients for whom surgery was considered successful in alleviating impingement and those needing secondary surgery within two years after the primary operation. Among the 81 evaluated patients, 11 underwent re-operation within this two-year timeframe. Many of the pre-operatively measured parameters were found to be significant predictors of surgical success. Patients were considered at increased risk of re-operation if they had a FEAR index value greater than negative 8.7 degrees, an LCEA less than 22 degrees, a tonus angle greater than 6 degrees, and sharps angle greater than 44 degrees. These values are often associated with a relatively shallow acetabulum and hip dysplasia. Patients who did not require a second operation also demonstrated significant improvements in all patient-reported outcome categories during the follow-up period. These findings are based on a relatively small dataset collected by three surgeons working in a single clinical center, which may reduce their generalizability to other patient populations. They nevertheless demonstrate that radiographic imagery could be an important tool in identifying adolescent femoroacetabular impingement patients at increased risk of re-operation after surgery and in developing more effective treatment strategies.