The Demographic Characteristics of High-Level and Recreational Athletes Undergoing Hip Arthroscopy for Femoroacetabular Impingement: A Sports-Specific Analysis


      The purpose of this study was to determine differences in age, gender, and the need for bilateral surgery between high-level athletes grouped by sports with similar mechanical demands on the hip and recreational athletes undergoing hip arthroscopy for femoroacetabular impingement (FAI).


      By use of a hip-preservation center registry, a retrospective review of patients undergoing hip arthroscopy for FAI between March 2010 and April 2012 was performed. Athletes were categorized as high level (high school, collegiate, or professional) or recreational. We performed a subgroup analysis for high-level athletes, looking at differences among contact, cutting, impingement, overhead/asymmetric, endurance, and flexibility sports.


      The study included 288 high-level athletes and 334 recreational athletes. Being a high-level athlete was associated with a younger age (mean age, 20.2 years v 33.0 years; odds ratio, 0.69; P < .001) and male gender (61.5% v 53.6%; odds ratio, 1.75; P = .03). The percentage of high-level athletes undergoing bilateral surgery was higher than that of recreational athletes (28.4% v 15.9%); however, this association was found to be confounded by age on multivariate analysis. The most common sports for high-level athletes were soccer, hockey, and football. Athletes participating in cutting sports were significantly younger than athletes participating flexibility, contact, or impingement sports.


      When compared with recreational athletes undergoing arthroscopic treatment for FAI, high-level athletes are more likely to be younger, to be male, and to undergo bilateral surgery. When high-level athletes are grouped by the mechanical demands placed on the hip by their sport, athletes participating in cutting sports are more likely to be younger than those in the other groups.

      Level of Evidence

      Level IV, case series.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Arthroscopy
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Alradwan H.
        • Philippon M.J.
        • Farrokhyar F.
        • et al.
        Return to preinjury activity levels after surgical management of femoroacetabular impingement in athletes.
        Arthroscopy. 2012; 28: 1567-1576
        • Byrd J.W.T.
        • Jones K.S.
        Arthroscopic management of femoroacetabular impingement in athletes.
        Am J Sports Med. 2011; 39: 7S-13S
        • Nho S.J.
        • Magennis E.M.
        • Singh C.K.
        • Kelly B.T.
        Outcomes after the arthroscopic treatment of femoroacetabular impingement in a mixed group of high-level athletes.
        Am J Sports Med. 2011; 39: 14S-19S
        • Philippon M.
        • Schenker M.
        • Briggs K.
        • Kuppersmith D.
        Femoroacetabular impingement in 45 professional athletes: Associated pathologies and return to sport following arthroscopic decompression.
        Knee Surg Sports Traumatol Arthrosc. 2007; 15: 908-914
        • Singh P.J.
        • O'Donnell J.M.
        The outcome of hip arthroscopy in Australian Football League players. A review of 27 hips.
        Arthroscopy. 2010; 26: 743-749
        • Malviya A.
        • Paliobeis C.P.
        • Villar R.N.
        Do professional athletes perform better than recreational athletes after arthroscopy for femoroacetabular impingement?.
        Clin Orthop Relat Res. 2013; 471: 2477-2483
        • Agricola R.
        • Bessems J.H.J.M.
        • Ginai A.Z.
        • et al.
        The development of cam-type deformity in adolescent and young male soccer players.
        Am J Sports Med. 2012; 40: 1099-1106
        • Gerhardt M.B.
        • Romero A.A.
        • Silvers H.J.
        • Harris D.J.
        • Watanabe D.
        • Mandelbaum B.
        The prevalence of radiographic hip abnormalities in elite soccer players.
        Am J Sports Med. 2012; 40: 584-588
        • Kapron A.L.
        • Anderson A.E.
        • Aoki S.K.
        • et al.
        Radiographic prevalence of femoroacetabular impingement in collegiate football players. AAOS Exhibit Selection.
        J Bone Joint Surg Am. 2011; 93: e111(1-10)
        • Siebenrock K.A.
        • Ferner F.
        • Noble P.C.
        • Santore R.F.
        • Werlen S.
        • Mamisch T.C.
        The cam-type deformity of the proximal femur arises in childhood in response to vigorous sporting activity.
        Clin Orthop Relat Res. 2011; 469: 3229-3240
        • Silvis M.L.
        • Mosher T.J.
        • Smetana B.S.
        • et al.
        High prevalence of pelvic and hip magnetic resonance imaging findings in asymptomatic collegiate and professional hockey players.
        Am J Sports Med. 2011; 39: 715-721
        • Allen D.
        • Beaulé P.E.
        • Ramadan O.
        • Doucette S.
        Prevalence of associated deformities and hip pain in patients with cam-type femoroacetabular impingement.
        J Bone Joint Surg Br. 2009; 91: 589-594
        • Hack K.
        • DiPrimio G.
        • Rakhra K.
        • Beaulé P.E.
        Prevalence of cam-type femoroacetabular impingement morphology in asymptomatic volunteers.
        J Bone Joint Surg Am. 2010; 92: 2436-2444
        • Laborie L.B.
        • Lehmann T.G.
        • Engesæter I.Ø.
        • Eastwood D.M.
        • Engesæter L.B.
        • Rosendahl K.
        Prevalence of radiographic findings thought to be associated with femoroacetabular impingement in a population-based cohort of 2081 healthy young adults.
        Radiology. 2011; 260: 494-502
        • Leunig M.
        • Jüni P.
        • Werlen S.
        • et al.
        Prevalence of cam and pincer-type deformities on hip MRI in an asymptomatic young Swiss female population: A cross-sectional study.
        Osteoarthritis Cartilage. 2013; 21: 544-550
        • Klingenstein G.G.
        • Martin R.R.
        • Kivlan B.
        • Kelly B.T.
        Hip injuries in the overhead athlete.
        Clin Orthop Relat Res. 2012; 470: 1579-1585
        • Gosvig K.K.
        • Jacobsen S.
        • Sonne-Holm S.
        • Palm H.
        • Troelsen A.
        Prevalence of malformations of the hip joint and their relationship to sex, groin pain, and risk of osteoarthritis.
        J Bone Joint Surg Am. 2010; 92: 1162-1169
        • Nogier A.
        • Bonin N.
        • May O.
        • et al.
        Descriptive epidemiology of mechanical hip pathology in adults under 50 years of age. Prospective series of 292 cases: Clinical and radiological aspects and physiopathological review.
        Orthop Trauma Surg Res. 2010; 96: S53-S58
        • Reichenbach S.
        • Jüni P.
        • Werlen S.
        • et al.
        Prevalence of cam-type deformity on hip magnetic resonance imaging in young males. A cross-sectional study.
        Arthritis Care Res (Hoboken). 2010; 62: 1319-1327
        • Kienle K.P.
        • Keck J.
        • Werlen S.
        • Kim Y.J.
        • Siebenrock K.A.
        • Mamisch T.C.
        Femoral morphology and epiphyseal growth plate changes of the hip during maturation: MR assessments in a 1-year follow-up on a cross-sectional asymptomatic cohort in the age range of 9-17 years.
        Skeletal Radiol. 2012; 41: 1381-1390
        • Siebenrock K.A.
        • Wahab K.H.A.
        • Werlen S.
        • Kalhor M.
        • Leunig M.
        • Ganz R.
        Abnormal extension of the femoral head as a cause of cam impingement.
        Clin Orthop Relat Res. 2004; 418: 54-60
        • Mair S.D.
        • Uhl T.L.
        • Robbe R.G.
        • Brindle K.A.
        Physeal changes and range-of-motion differences in the dominant shoulders of skeletally immature baseball players.
        J Shoulder Elbow Surg. 2004; 13: 487-491
        • DiFiori J.P.
        • Caine D.J.
        • Malina M.R.
        Wrist pain, distal radial physeal injury, and ulnar variance in the young gymnast.
        Am J Sports Med. 2006; 34: 840-849
        • Fleisig G.S.
        • Andrews J.R.
        • Cutter G.R.
        • et al.
        Risk of serious injury for young baseball pitchers: A 10-year prospective study.
        Am J Sports Med. 2011; 39: 253-257
        • Lyman S.
        • Fleisig G.S.
        • Andrews J.R.
        • Osinski E.D.
        Effect of pitch type, pitch count, and pitching mechanics on risk of elbow and shoulder pain in youth baseball pitchers.
        Am J Sports Med. 2002; 30: 463-468
        • Krych A.J.
        • Thompson M.
        • Larson C.M.
        • Byrd J.W.T.
        • Kelly B.T.
        Is posterior hip instability associated with cam and pincer deformity?.
        Clin Orthop Relat Res. 2012; 470: 3390-3397
        • Hamilton D.
        • Aronsen P.
        • Løken J.H.
        • et al.
        Dance training intensity at 11-14 years is associated with femoral torsion in classical ballet dancers.
        Br J Sports Med. 2006; 40: 299-303
      1. Hammoud S, Brown HC, Kelly BT, Padgett DE. Hip arthroscopy in the professional dancer. Presented at the American Academy of Orthopaedic Surgeons 2011 Annual Meeting, San Diego, CA, February 15-19, 2011.

        • Steinberg N.
        • Hershkovitz I.
        • Peleg S.
        • et al.
        Range of joint movement in female dancers and nondancers aged 8 to 16 years.
        Am J Sports Med. 2006; 34: 814-823
        • Bedi A.
        • Galano G.
        • Walsh C.
        • Kelly B.T.
        Capsular management during hip arthroscopy: From femoroacetabular impingement to instability.
        Arthroscopy. 2011; 27: 1720-1731