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Background: Acetabular labral reconstruction has demonstrated good results for labral lesions not amenable to labral repair. Purpose: To determine the predictors of outcomes at a minimum 2 years after labral reconstruction. Study Design: Case series; Level of evidence, 4. Methods: Patients included in the study underwent labral reconstruction with a minimum 2-year follow-up. The primary outcome variable was the Hip Outcome Score–Activities of Daily Living (HOS-ADL). Secondary outcome measures included the 12-item Short Form Health Survey physical component summary (SF-12 PCS) and patient satisfaction with surgical outcomes. Preoperative and intraoperative variables assessed included demographics, prior surgery, chronicity of symptoms, radiographic measurements, preoperative outcome scores, and findings at arthroscopic surgery. Predictors were assessed using logistic regression with restricted cubic splines. Bivariate statistics assessed risk factors for reoperation including revision arthroscopic surgery and total hip arthroplasty (THA). Results: Three hundred seventeen of 368 labral reconstructions were available for follow-up (86.1%). Of these, 42 were converted to THA (13.2%) and 35 required revision arthroscopic surgery after labral reconstruction (11.0%). Factors associated with THA included older age, ≥2 previous surgeries, ≤2 mm of joint space, and lateral center edge angle (LCEA) 2 mm ( P = .004), and no prior surgery ( P = .039). Predictors of improvement for the SF-12 PCS included higher preoperative SF-12 PCS scores ( P < .001), subacute chronicity (3 months to 1 year) of symptoms ( P = .013), and joint space >2 mm ( P = .046). Joint space >2 mm ( P < .001) and higher preoperative SF-12 scores (PCS: P = .034; mental component summary: P = .039) predicted higher satisfaction. Conclusion: At a minimum 2 years’ follow-up, patients who did not undergo conversion to THA (13.2%) or require revision (11.0%), reported significant improvement in outcome scores and high satisfaction with outcomes. Predictors of revision or THA included ≥2 previous surgeries, low LCEA, female sex for revision, and narrowed joint space for THA. Higher preoperative outcome scores were the most significant predictors of improvement after labral reconstruction. Lower preoperative scores, joint space narrowing, and history of surgery were predictive of an inferior result and decreased postoperative satisfaction.

The purpose of this study was to report the proportion of venous thromboembolic events (VTE) in patients undergoing primary hip arthroscopy for femoroacetabular impingement (FAI) and present a critical overview of the literature to aid in better result interpretation. MedLine, Scopus and Web of Science databases were searched from January 2000 to March 2017. Four thousand-five-hundred and seventy-seven hip cases were included in the meta-analysis of 38 studies. The mean age of patients was 36 ± 1.8 years and the mean follow-up time was 20.6 months. The meta-analysed rate of deep vein thrombosis (DVT) in patients undergoing primary hip arthroscopy for FAI syndrome was 1.18%; 95%CI [0.8–1.74%]; The meta-analysed rate of pulmonary embolism (PE) in patients undergoing primary hip arthroscopy for FAI syndrome was 0.59%; 95%CI [0.38–0.92%]. Quality assessment was performed using the Methodological Index for Non-Randomized Studies (MINORS) criteria the Quality in Prognostic Studies (QUIPS) tool. Sensitivity analysis was conducted to assess for publication bias and its influence on the results. The corrected for publication bias proportion of DVT was 2.02%; 95%CI [1.36–2.99%]. The DVT rate was double following the correction of bias while additional types of bias were detected. Attention must be paid when considering the outcomes of observational studies to make clinical decisions. Insufficient evidence exists to support whether anti-VTE chemoprophylaxis should be administered to patients undergoing primary hip arthroscopy for FAI. Due to the life-threatening character of this complication, the results should serve as starting point to design clinical trials and establish guidelines. Until then, the application of preventive measures against VTE should be decided on a case-by-case basis.

Background: Hip arthroscopy has been shown to be effective for management of symptomatic femoroacetabular impingement (FAI) in professional athletes; however, it is unclear how hip arthroscopy affects career length and performance when professional baseball players return to play. Purpose: To determine the career length, performance, and return-to-play rates of professional baseball players after undergoing arthroscopy for symptomatic FAI. Study Design: Case series; Level of evidence, 4. Methods: Forty-four professional baseball players (51 hips) underwent hip arthroscopy for FAI between 2000 and 2015 by a single surgeon. Data were retrieved for each player from MLB.com , MiLB.com , Baseballreference.com , and individual team websites. Age, surgical procedure, and intraoperative findings were also used in analysis. Return to play was defined as playing in a preseason or regular season major or minor league game after arthroscopy. Career length was measured as total years played before and after arthroscopy. Performance measures included earned run average for pitchers, batting average for position players, and games played for all players. Results: Of the 44 players, there were 21 pitchers and 23 position players. Ninety-five percent (n = 42) were able to return to professional baseball after hip arthroscopy. The mean career length for all players was 9.5 years. The mean career length after return to play was 3.6 seasons (range, 1-14 seasons). Pitchers had a mean career length of 8.7 years (3.3 after surgery), and position players averaged a career length of 10 years (3.9 after surgery). There were no differences in performance measures between preinjury and postoperative values. Conclusion: Professional baseball players undergoing hip arthroscopy for FAI returned to sport and had similar performance as they did before injury. The average career length was 9.5 years. In our study cohort, more pitchers than position players underwent hip arthroscopy. Hip arthroscopy appears to be an effective surgical intervention, allowing for return to play after complete recovery.

Background: Arthroscopic hip surgery has been shown to be effective in returning professional athletes back to play at a high level of performance in different sports. Limited information exists regarding professional soccer players and their return to play. Purpose: To determine the rate and time to return to sport for professional soccer players after hip arthroscopic surgery for the treatment of femoroacetabular impingement (FAI) and to identify possible risk factors associated with a delay in returning to play. Study Design: Case series; Level of evidence, 4. Methods: Professional soccer players who underwent hip arthroscopic surgery for FAI by a single surgeon between 2005 and 2015 were evaluated. Data retrieved from www.mlssoccer.com , www.fifa.com , www.transfermarkt.co.uk , and www.wikipedia.org included information on each player’s professional career, participation on the national team, length of professional career before surgery, number of appearances (games) before surgery, time between surgery and first appearance in a professional game, and number of appearances after surgery. Other data were obtained from the patient’s medical records. Results: Twenty-four professional soccer players (26 hips) were included. The mean age at surgery was 25.0 ± 4.0 years (range, 19-32 years). A total of 96% of patients were able to return to play at the professional level. The mean time between surgery and the first professional game played was 9.2 months (range, 1.9-24.0 months). On average, players played in 70 games after surgery (range, 0-224). National team players were able to return to play significantly earlier than the rest of the players (median, 5.7 months vs 11.6 months, respectively; P = .018). Severe chondral damage and microfracture did not interfere with return to play. Conclusion: The arthroscopic management of FAI in symptomatic professional soccer players allowed 96% of them to return to play. Players with national team experience were able to return to play earlier than those without it. Severe chondral damage and microfracture did not interfere with return to play.

Studies have demonstrated hip arthroscopy to be an effective treatment for femoroacetabular impingement (FAI) with associated labral tears. The purposes of this study were to report 10-year outcomes and hip survival following hip arthroscopy for FAI and to compare labral debridement with labral repair.Prospectively collected data on patients followed for a minimum of 10 years after hip arthroscopy for FAI with either labral debridement or labral repair performed by a single surgeon were retrospectively analyzed. The primary patient-reported outcome measure was the Hip Outcome Score (HOS) Activities of Daily Living (ADL) subscale. Mann-Whitney U tests were used to compare outcomes between groups, and Wilcoxon signed-rank tests were used to compare preoperative with postoperative scores. Survival analysis was performed using a multivariate Cox proportional hazards model.Seventy-nine patients who underwent labral repair and 75 who underwent debridement were included in the study, and 94% (145) were followed for ≥10 years. Fifty patients (34%) underwent total hip arthroplasty (THA) within 10 years following the arthroscopy. Older patients, hips with2 mm of joint space preoperatively, and patients requiring acetabular microfracture had significantly higher prevalences of THA. The multivariate Cox proportional hazards model showed that increased age (hazard ratio [HR] for 31 years to 51 years = 3.06, 95% confidence interval [CI] = 1.69 to 5.56, p0.001), a joint space of ≤2 mm (HR = 4.26, 95% CI = 1.98 to 9.21, p0.001), and acetabular microfracture (HR = 2.86, 95% CI = 1.07 to 7.62, p = 0.036) were independently associated with an increased hazard rate for THA. When the analysis was adjusted for these factors, there was no significant difference in the HR between treatment groups (HR = 1.10, 95% CI = 0.59 to 2.05, p = 0.762). There was also no significant difference in postoperative outcome scores between groups. The debridement group demonstrated a significant increase, between the preoperative and postoperative evaluations, in the HOS-ADL score (from 71 to 96; p0.001), HOS-Sport score (from 42 to 89; p0.001), modified Harris hip score (mHHS) (from 62 to 90; p0.001), and Short Form-12 physical component summary (SF-12 PCS) score (from 43 to 56; p0.001). The repair group also demonstrated a significant increase in the HOS-ADL score (from 71 to 96; p0.001), HOS-Sport score (from 47 to 87; p0.001), mHHS score (from 65 to 85; p0.001), and SF-12 PCS score (from 41 to 56; p0.001). The median patient satisfaction score was 10 (very satisfied) in both groups.Hip arthroscopy for FAI with labral debridement or repair resulted in significant improvements in the patient-reported outcomes and satisfaction of patients who did not eventually require THA. Higher rates of conversion to THA were seen in older patients, patients treated with acetabular microfracture, and hips with ≤2 mm of joint space preoperatively, regardless of labral treatment.Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

Anterior hip pain can be difficult to diagnose due to the many pathologies and overlapping pain patterns that exist in the hip region. Clinical findings of pain at the anterior inferior iliac spine with passive hip flexion, proximal quadriceps pain and weakness, and painful impingement tests of the hip may be indicative of subspine hip impingement. This report describes the diagnosis and treatment of anterior hip pain, including subspine impingement and femoroacetabular impingement in an elite weightlifter. This case also describes how with the correct diagnosis and treatment, the athlete returned to play to her previous level of sport 11 months after a complex hip injury.

Background: The incidence of hip arthroscopic surgery is increasing in the young athlete. This has also led to increased numbers of revision hip arthroscopic surgery. Hypothesis/Purpose: The purpose of this study was to describe the outcomes after revision hip arthroscopic surgery in patients ≤18 years of age in comparison to a matched cohort of patients undergoing primary hip arthroscopic surgery. Our hypothesis was that patients undergoing revision hip arthroscopic surgery would demonstrate similar outcomes to those patients undergoing primary hip arthroscopic surgery. Study Design: Cohort study; Level of evidence, 3. Methods: Patients were included in the study if they underwent revision hip arthroscopic surgery by a single surgeon and did not undergo prior open hip surgery. Each patient in the revision hip arthroscopic surgery cohort was matched with 2 patients undergoing primary hip arthroscopic surgery from the same institution. Cohorts were matched by age, sex, and year of surgery. Preoperatively and at a minimum follow-up of 2 years, outcome scores were collected. The primary outcome measure was the Hip Outcome Score for activities of daily living scale (HOS-ADL), a self-reported validated outcome instrument, in addition to the HOS for sports scale (HOS-Sport), modified Harris Hip Score (mHHS), and 12-Item Short Form Health Survey Physical Component Summary (SF-12 PCS). Results: Forty-two patients were included in the revision group and were matched with 84 patients in the primary group. The mean age in both groups was 16 years (range, 14-18 years). All female patients in the study were ≥14 years of age, and all male patients were ≥16 years of age. In patients undergoing revision, 13 underwent 1 prior surgical procedure, 22 underwent 2 prior surgical procedures, and 7 underwent ≥3 prior surgical procedures. The mean time from last surgery to revision was 18.7 months (range, 4.7-74 months). Eleven patients (26%) had prior femoroacetabular impingement treated, which required osteoplasty or rim trimming at revision. Subsequent hip arthroscopic surgery was reported in 3 of 84 (4%) patients in the primary group and 6 of 42 (14%) patients in the revision group ( P = .162). The mean follow-up in the revision group was 43 ± 17 months, and scores significantly improved (HOS-ADL: 59.6 to 77.6; HOS-Sport: 37.6 to 64.8; mHHS: 55.3 to 74.3; SF-12 PCS: 41.0 to 50.4; P < .05). The mean follow-up in the primary group was 45 ± 18 months, and all scores significantly improved (HOS-ADL: 65.8 to 87.4; HOS-Sport: 46.3 to 79.9; mHHS: 57.5 to 84.2; SF-12 PCS: 39.0 to 51.8; P < .05). At follow-up, there were no significant differences between the primary and revision groups for the HOS-ADL values ( P = .051) and SF-12 PCS values ( P = .846). Patients in the primary group had significantly higher HOS-Sport values ( P = .008), mHHS values ( P = .008), and patient satisfaction ( P = .008). Patients who underwent 1 prior hip arthroscopic procedure had a higher mean postoperative mHHS value (79.5 vs 72, respectively), HOS-ADL value (91.2 vs 73.4, respectively), and HOS-Sport value (76 vs 60, respectively) ( P < .05) compared with those who underwent more than 1 prior procedure. Median patient satisfaction was 9.0 (range, 2-10) in the primary group and 8.0 (range, 2-10) in the revision group. Conclusion: In conclusion, young patients who required revision hip arthroscopic surgery showed significant improvement in patient-reported outcome scores; however, final outcome scores in the revision group for sport activity, general health, and satisfaction were lower than those in the primary group. Patients who underwent 1 revision surgical procedure had higher outcome scores than patients who underwent more than 1 revision surgical procedure.

Background: As the number of hip arthroscopic surgeries being performed increases, so too does the prevalence of revision hip arthroscopic surgery. Hypothesis/Purpose: The purpose of this study was to compare outcomes in patients requiring revision hip arthroscopic surgery to patients undergoing primary hip arthroscopic surgery. The hypothesis was that patients undergoing revisions would demonstrate similar outcomes to those undergoing primary hip arthroscopic surgery. Study Design: Cohort study; Level of evidence, 2. Methods: Included in the study were patients undergoing revision hip arthroscopic surgery who did not have a history of prior open hip surgery. Each patient in the revision cohort was matched with 2 patients undergoing primary hip arthroscopic surgery. Preoperatively and at a minimum follow-up of 2 years, outcome scores were collected, including the Hip Outcome Score–Activities of Daily Living subscale (HOS-ADL), which was the primary outcome variable; modified Harris hip score (mHHS); Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC); Hip Outcome Score–Sports subscale (HOS-Sports); and the 12-Item Short Form Health Survey (SF12). At follow-up, scores from the Tegner activity scale and patient self-reported satisfaction with surgical outcome were also collected. Results: A total of 246 patients in the revision cohort were matched with 492 patients in the primary cohort. In the revision cohort, 183 patients had 1 prior surgery, 45 had 2 surgeries, and 18 had ≥3 prior surgeries. Subsequent hip arthroscopic surgery was reported in 39 of 492 (8%) patients in the primary cohort and 5 of 246 (2%) patients in the revision cohort ( P = .001). Subsequent surgery was reported in 50 of 492 (10%) patients in the primary cohort and 15 of 246 (6%) patients in the revision cohort ( P = .07). Both groups saw significant improvement in outcome scores from preoperation to follow-up. The HOS-ADL was lower in the revision cohort preoperatively (65 vs 70) and postoperatively (79 vs 87) ( P = .001). This was also seen in the HOS-Sports, WOMAC, and SF12 physical component scores. Patients who had 1 prior hip arthroscopic procedure had higher postoperative mHHS (81 vs 75) compared with patients with >1 hip arthroscopic procedure; however, there was no difference in postoperative mHHS between the single-revision cohort and the primary cohort. In the revision group, patients whose HOS-ADL improved ≥10 points had greater joint space. Patients with greater improvement were more likely to have had a previous labral tear that was not repaired and to require capsular plication at revision. Conclusion: Patients who underwent revision hip arthroscopic surgery had significant improvement in outcome scores but did have lower scores compared with patients with primary hip arthroscopies. Patients with ≥2 revisions had lower outcomes. Improvement in the revision cohort was seen in patients with increased joint space, no prior labral repair, and capsular plication at revision.

Objectives: Hip arthroscopy is a highly effective treatment for symptomatic femoroacetabular impingement (FAI). High level, professional athletes have been able to return to their professional sport following arthroscopic hip surgery intervention. To date, there is a paucity of literature related to professional baseball player’s ability to return to sport following hip injury as a result of FAI. The purpose of this study was to determine the rate of return to play and length of career in professional baseball players following hip arthroscopy for FAI. We hypothesized that professional baseball players were able to return to the same level of pre-surgical competition following FAI arthroscopic hip surgery for a sustained period of time. Methods: 44 professional baseball players (51 hips) underwent hip arthroscopy for FAI between 2000 and 2015 by a single surgeon. Return to play was defined as a player competing in a pre-season or regular season minor or major league baseball game following surgery. Data was obtained for each player from MLB.com, MiLB.com, Baseballreference.com and individual team websites. Results: The average age of players at the time of arthroscopy was 26.6 years (18 to 38 years;StDev=4.8). No players had bilateral arthroscopy on the same day. Of the 44 players, 24 were pitchers and 27 were position players (12 infielders, 10 outfielders, 5 catchers). In hitters, 74% (20/27) of the procedures involved the front side hip of their batting stance. In pitchers, 71% (17/24) of procedures involved the lead leg of their pitching stance. Average career length prior to hip surgery was 6.2 years (range 1-20 years;stdev=5.1). Following hip arthroscopy, 96% (49/51) returned to professional baseball after each hip arthroscopy. Those who returned played for an average of 3.6 seasons (range 1 to 14 seasons;stdev=2.9) after hip arthroscopy. The average career length of players in this cohort was 10 seasons (range 1 to 21;stdev=5). There was no difference in the years played after arthroscopy by position (pitchers average =3.3(stdev=2.5) years and position players average = 3.9 (stdev=3.2) years) (p=0.48). Conclusion: Professional baseball players who underwent hip arthroscopy were able to return to the same high level of competition after surgery. Pitchers were more likely than position players to undergo surgical intervention with hip arthroscopy. Irrespective of player position, hip arthroscopy seems to be a surgical intervention that can allow for treatment of FAI pathology in a minimally invasive manner, while allowing for return to professional competition following full recovery. As hip arthroscopy continues to evolve, future interventions may improve post-operative return to play in baseball—lengthening playing career and level of play. At this time, hip arthroscopy is an effective surgical intervention that allows players to return to their professional level of baseball play.

Background: Previous studies have shown hip arthroscopy to be a highly effective treatment for symptomatic femoroacetabular impingement (FAI) in a wide range of athletes; however, the rate of return to play and length of career after hip arthroscopy in professional football players are unknown. Purpose: To determine how many athletes returned to professional football and the number of seasons they played after surgery. Study Design: Case series; Level of evidence, 4. Methods: Fifty-one professional football players (60 hips) underwent hip arthroscopy for FAI between 2000 and 2014 by a single surgeon. Return to play was defined as competing in a preseason or regular season professional football game after surgery. Data were retrospectively obtained for each player from NFL.com , ESPN.com , individual team websites, and/or CFL.ca . Results: We found that 87% (52/60) of the arthroscopic procedures allowed professional football players to return to play in a preseason or regular season game. Athletes who returned played an average of 38 games during 3.2 seasons after arthroscopy, with an average total career length of 7.4 seasons. Ninety-two percent (48/52) of players who returned had a minimum total career length of 3 years. When participants were analyzed by position, linemen were less likely to return after hip arthroscopy compared with other players (odds ratio 5.6; 95% CI, 1.1-35; P = .04). All quarterbacks and tight ends returned to play after surgery. No significant difference in return to play rate was found between athletes who underwent microfracture and those who did not (25% vs 38%, P = .698). Conclusion: Hip arthroscopy for treatment of FAI and associated pathologic abnormalities in professional football players resulted in a high rate of return to play. The study’s findings demonstrate that 87% of the arthroscopic procedures allowed professional football players to return to play, linemen were less likely to return compared with other positions, and the presence of microfracture did not significantly affect the return to play rate. These findings support hip arthroscopy as an effective procedure to treat FAI and related pathologic abnormalities in the professional football player, and this information is important for proper counseling of athletes with FAI.

Purpose To determine the prevalence of chronic trochanteric bursitis (TB) in patient being treated for femoroacetabular impingement (FAI) and determine the effectiveness of arthroscopic bursectomy and iliotibial band lengthening (AB-ITB-L) at the time of hip arthroscopy for FAI. Methods Patients diagnosed with primary FAI and chronic TB were included in the study. Patients were included if they underwent hip arthroscopy with labral repair, femoral and/or acetabular osteoplasty, and AB-ITB-L. Patients were matched by age and gender to patients without chronic TB. Results The prevalence of chronic TB with FAI was 7% (90/1,278). Females were 5.3 times more likely to have TB compared with males (95% confidence interval: 3.2-8.7). Patients more than 30 years of age were 2.5 times more likely to have TB (95% confidence interval: 1.48-4.4). Of the 90 patients diagnosed with TB, 72 (54 female, 18 male) with an average age of 36.7 years underwent AB-ITB-L at the time of their index hip arthroscopy for FAI. All 72 patients had associated intra-articular pathology consisting of a combined cam and pincer pathology. The TB (average follow-up = 42 ± 9.9 months) and non-TB group (average follow-up = 42 ± 9.1 months) both had significant improvement from preoperative to postoperative scores for Hip Outcome Score Activities Daily Living, Hip Outcome Score Sport, Modified Harris Hip Score, Western Ontario and McMaster Universities Arthritis Index, Short Form (SF)-12 Physical Component score, and SF-12 Mental Component Score. There was no significant difference between the 2 groups in postoperative patient reported outcome scores. Conclusions The occurrence of chronic TB in the FAI population, which did not adequately respond to nonoperative management, for a single surgeon high volume hip arthroscopy practice was 7%, and was more commonly seen in women older than 30 years. Patients who undergo concomitant AB-ITB-L for chronic TB report excellent pain relief, and have equivalent results and outcome scores that are not inferior when compared with patients with primary FAI without chronic TB. Level of Evidence Level III, retrospective matched case control study.

Background Youth sport injuries are on the rise. These injuries at an early age may prevent young people from continuing with sports or eventually limit their ability to participate in physical activity. Objective The purpose of this study was to determine the prevalence of acetabular labral tears in athletes 19 years of age or younger who compete in a club sport. Design Screening Program. Setting Youth sports. Patients (or Participants) 101 (93 males, 8 females) skiers (20) and hockey players (81) with no symptoms around the hip, no history of hip injury or surgery, and parental consent. Average age was 15 (range 11 to 19) years. Interventions (or Assessment of Risk Factors) Participants completed an initial questionnaire and had a clinical exam (hip range of motion, impingement test, hip dial test, FABER distance test). All participants had 3T MRI of dominant hip. Main Outcome Measurements Positive exam findings and labral tear on MRI. Results Labral tears were identified in 70 hips. Average alpha angle was 59 degrees. 89% of the participants 16 years of age or older had labral tears and 56% of the participants 16 years of younger had labral tears. Participants 16 years of older were 7 times more likely to have a labral tear [95% CI: 1.9 to 28] than participants under the age of 16. Participants who had participated in their sport 9 years or greater were 4.9 times more likely to have a labral tear [95% CI: 1.5 to 16.1] compared to participants who had participated less than 9 years. Conclusions This study also showed a high prevalence of labral tears in the asymptomatic young athlete. Patients who were older and participated in their sport longer had increased risk of a labral tear. Limiting certain at risk movements when the young athlete is growing has potential for prevention.

Background It has been reported that relative to other sports participants, ice hockey players suffer from cam femoroacetabular impingement (FAI) in higher numbers. Alpha angles have been reported to increase with the likelihood of symptomatic FAI. It is unclear how alpha angle and other factors related to FAI change over early childhood years. Objective Track youth hockey players over 5 years and determine if factors associated with FAI increased as they aged and increased skating time. Design Screening. Setting Youth club. Patients (or Participants) 16 asymptomatic youth ice hockey players. All players started in the peewee(ages 10 to 12) division and moved up in divisions over the 3 years. Interventions (or Assessment of Risk Factors) Clinical hip examination consisting of the FABER test, impingement testing, and measurement of hip internal rotation. An MRI was taken and the hip alpha angle was measured and labral tears were documented. Main Outcome Measurements Alpha angle and labral tear on MRI Results These youth hockey players played an average of 42 weeks/year Players had significantly increased alpha angle by year 3 of screening. The average alpha angle at year 1 was 56(range 45 to 63), year 2 was 59 (range 52 to 68), year 3 was 75 (range 64 to 88), year 4 was 75 and year 5 was 78. By year 5, 14/16 had asymptomatic labral tears. There were no significant changes in internal rotation over the 5 years. There was a trend toward decreased internal rotation in goalies. Conclusions Young ice hockey players show increasing alpha angles and development of asymptomatic labral tears. Stresses inherent to ice hockey likely enhance the development of a bony overgrowth on the femoral neck contributing to cam FAI.