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CAM-type femoroacetabular impingement continues to be an underrecognized cause of hip pain in elite athletes. Properties inherent to baseball such as throwing mechanics and hitting may enhance the risk of developing a cam deformity. Our goal is to gain an appreciation of the radiographic prevalence of cam deformities in elite baseball players. Prospective evaluation and radiographs of 80 elite baseball players were obtained during the 2016 preseason entrance examination. A sports medicine fellowship-trained orthopedic surgeon with experience treating hip disorders used standard radiographic measurements to assess for the radiographic presence of cam impingement. Radiographs with an alpha angle >55° on modified Dunn views were defined as cam positive. Of the 122 elite baseball players included in our analysis, 80 completed radiographic evaluation. Only 7.3% (9/122) of players reported hip pain and 1.6% (4/244) had a positive anterior impingement test. The prevalence of cam deformities in right and left hips were 54/80 (67.5%) and 40/80 (50.0%), respectively. The mean alpha angle for cam-positive right and left hips were 64.7 ± 6.9° and 64.9 ± 5.8°, respectively. Outfielders had the highest risk of right-sided cam morphology (Relative Risk (RR) = 1.6). Right hip cam deformities were significantly higher in right-handed pitchers compared with left-handed pitchers (P = 0.02); however, there was no significant difference in left hip cam deformities between left- and right-handed pitchers (P = 0.307). Our data suggest that elite baseball players have a significantly higher prevalence of radiographic cam impingement than the general population.

Water polo places significant stress on the hip joint requiring repetitive hip flexion and rotation to elevate the body out of water for passing, shooting and blocking. Femoroacetabular impingement (FAI) is common in water polo athletes; however, no study to date has investigated the results of hip arthroscopy in this patient population. The purpose of this study was to determine return to play rates and satisfaction following hip arthroscopy for FAI in a cohort of elite level water polo players. A retrospective review of our surgical database was performed. Collegiate water polo players with clinical and radiographic FAI who underwent hip arthroscopy were identified. Pre- and post-operative modified Harris hip scores (mHHSs) were obtained. Patient surveys were administered to determine return to play rates, level of return to play, timing of return and patient satisfaction. A Wilcoxon ranked sum test was performed to compare pre- and post-operative outcome scores. Ten patients met inclusion criteria. Average age was 19.5 years old (SD ±1.08). All patients were male Division 1 collegiate water polo players. Median mHHS improved from 66.0 (SD ±7.9) pre-operatively to 89.5 (SD ±3.2) at average 1.6 years (range: 0.4–3.6 years) post-operatively. Patient survey responses demonstrated a 100% return to water polo and 100% return to the same level of play (NCAA Division 1) at mean 5.75 months (SD ±1.8). All patients (10/10) reported being satisfied with their surgical result. Our study results, suggest that return to sport rates and patient satisfaction are high in water polo players who undergo hip arthroscopy for FAI.

Multiple self-reported allergies have been reported as a prognostic factor for outcome the following orthopedic procedures. This relationship has not yet been evaluated in a hip arthroscopy population. The purpose of this study is to identify associations between allergies and post-operative outcome scores in patients undergoing hip arthroscopy for femoroacetabular impingement (FAI). A retrospective review of surgically treated FAI patients at our institution was performed. Patient-reported allergies and 6-month and 1-year modified Harris Hip Scores (mHHS) were recorded. Bivariate analysis was performed evaluating association between allergies and post-operative mHHS. Multivariate regression was used to identify independent factors associated with post-operative mHHS while controlling for age, sex, BMI, psychiatric comorbidity, symptom duration, labral repair versus debridement, capsular management, chondral lesions and use of adjunct platelet rich plasma (PRP). Seventy patients were analysed. Average age was 30.7 years old (SD 8.96). A 52.9% were females. Twenty-six patients (37.1%) had reported allergies. At 6 months, bivariate analysis demonstrated no significant association between allergies and postop mHHS. This was true comparing patients with 0 versus 1 versus 2 versus 3 versus 5 allergies as separate groups (medians from 83.1 to 91.0, P = 0.60) as well as when combining patients with >2 allergies into one group (0 versus 1 versus 2–5 allergies) (medians 84.7, 83.1, 86.0, respectively, P = 0.328). At 1 year, this lack of association was more pronounced (0 versus 1 versus 2 versus 3 versus 5: medians from 87.0 to 93.5, P = 0.9265 and 0 versus 1 versus 2–5: medians 93.5, 91.7, 89.0, respectively, P = 0.6450). Linear regression demonstrated preop mHHS and age were significantly associated with 1-year mHHS (logit mHHS rate = 0.026 ± 0.008 per unit, P = 0.0014 for preop mHHS and logit mHHS rate=−0.061 ± 0.018 per year, P = 0.0010 for age). After controlling for age and preop mHHS, allergies were not associated with postop mHHS. Allergies demonstrated no association with post-operative outcome following surgical treatment of FAI.