Evidence has emerged that femoroacetabular impingement (FAI) may instigate early osteoarthritis of the hip and that symptomatic patients can be successfully treated by addressing the underlying pathomorphology. There is also an increasing body of evidence to support FAI as one major cause of hip and groin pain, decreased mobility and reduced performance in athletes. This study therefore aimed to investigate if professional athletes with FAI can resume to their sports after a surgical dislocation of the hip and continue their professional career up to a mid-term follow-up. We identified fifteen professional athletes (21 hips, all cam-type or mixed-type FAI, mean alpha-angles of 68°) who underwent a surgical hip dislocation for FAI treatment. Surgery was performed by the senior author in all cases. The patients were evaluated by postal survey at a mean of 47 months (range, 9–79) postoperatively. The evaluation inquired about the type and level of sports, subjective ratings, and clinical outcomes (Hip Outcome Score [HOS], SF-12, UCLA activity scale, FAI sports scale [FSS], VAS pain). At follow-up, 14 of the 15 patients (93%) were still professionally sports active. Twelve athletes maintained their levels and two were active in minor leagues. Eleven patients (75%) were satisfied with their hip surgery and their sports ability. Mean activity levels were 7.5 according to the self-developed FSS and 9.7 according to the UCLA scale, respectively. Mean scores of the HOS ADL and Sport subscales were 92.6 and 85.2, respectively. Mean scores of the SF-12 PCS and MCS were 50.7 and 56.1, respectively. Pain levels during sports were rated to be 2.0 according to the VAS. In conclusion, this study highlighted that professional athletes suffering from FAI can successfully return to professional sports after a surgical dislocation of the hip. All athletes except one (93%) could continue their professional career up to the follow-up four years after surgery. Clinical outcomes in terms of subjective ratings and scores were encouraging, nevertheless, longer-term follow-up has to show if results deteriorate with time considering the exhaustive joint use related to a professional sports career.

After THR, trochanteric soft tissue abnormalities may be associated with residual trochanteric pain and limping. However, normal MR appearance of the trochanteric region after THR is not known. The aim was to evaluate MR imagings in asymptomatic and symptomatic patients after THR through a transgluteal approach.

Triplanar MR images of 25 asymptomatic (14 men, mean age 60.4 years, 11 women, mean age 60.2) and 49 symptomatic patients (19 men, mean age 62.7 years, 20 women, mean age 64.3) at least 1 year after THR were analyzed by two blinded radiologists. In 14 symptomatic patients MR imaging was correlated to surgical findings.

Tendon defects were uncommon in asymptomatic and significantly more frequent in symptomatic patients (gluteus minimus 8% vs. 56%, p< 0.001; lateral gluteus medius 16% vs 62%, p< 0.001; posterior gluteus medius 0% vs18%, p< 0.025). Signal changes within tendons were very frequent in both groups except for the posterior gluteus medius tendon which demonstrated this finding more frequently in symptomatic patients (20% vs 59%, p=0.002). Changes in tendon diameter were very frequent in both groups but significantly (p=0.001–009) more frequent in symptomatic patients. Fatty atrophy was evident in the anterior two thirds of the gluteus minimus muscle in both asymptomatic and symptomatic patients. In the posterior superior third of the gluteus minimus muscle differences of fatty degeneration were significant. Fatty atrophy of the gluteus medius muscle was only present in symptomatic patients. Bursal fluid collections were more frequent in asymptomatic (32% vs 62%, p=0.021). MR diagnosis was confirmed in all 14 patients undergoing revision surgery.

Although more frequent in symptomatic patients many MR findings are frequently found in asymptomatic patients. However, defects of the abductor tendons and fatty atrophy of the gluteus medius and the posterior part of the gluteus minimus muscle are rare in asymptomatic patients.