Return to Sport in Professional Athletes With Borderline Hip Dysplasia After Hip Arthroscopy for Femoroacetabular Impingement

BACKGROUND: Hip arthroscopy for femoroacetabular impingement (FAI) in professional athletes is associated with significant improvements in postoperative pain and function and a return-to-sport (RTS) rate >80%. However, RTS rate after hip arthroscopy for FAI in professional athletes with borderline dysplasia is unknown. PURPOSE: To assess RTS rates exclusively in professional athletes with borderline dysplasia after hip arthroscopy for treatment of FAI. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: A total of 40 professional and Olympic athletes (42 hips) with borderline dysplasia (lateral center edge angle LCEA 18°-25°) underwent hip arthroscopy for FAI between 2005 and 2022. RTS was defined as competing in a single professional game at an equal level after surgery. Data were retrospectively obtained for each athlete from publicly available sport-specific data sources. RESULTS: = .008) were associated with a lower likelihood of return to professional sport. No statistically significant association was found between femoral version, LCEA, alpha angle, the presence of Outerbridge grade 3 or 4 defect, or minimum joint space and RTS. CONCLUSION: In the primary setting, professional athletes with borderline hip dysplasia who underwent hip arthroscopy for FAI demonstrated a 79% RTS rate. The mean time to return was 7.5 months, with older age and a history of prior hip arthroscopy predictive of a lower likelihood of RTS (25% RTS among revision cases). Hip arthroscopy for FAI in professional athletes with borderline dysplasia was effective for returning the majority of these athletes to their preoperative level, especially in the primary setting.