Hip Arthroscopy for Labral Tears and FAI is Associated with a High Rate of Return to Play for Professional American Football Athletes, A Literature Review

Femoroacetabular impingement (FAI) with labral tear is an increasingly recognized source of hip pain and lost playing time in elite athletes, yet data pertaining to professional American football athletes remains scarce. Prognostic recommendations are largely limited to single-institution cohort studies. To date, no large-scale literature review of surgical treatment of FAI in elite American football athletes has been performed. This review article reports the prevalence, return to play, performance outcomes, and career longevity following hip arthroscopy in professional American football athletes across all orthopedic literature between 2004–2024. We hypothesize high rates of return to sport (> 85%) to the same competition level and no differences in career longevity or postoperative performance.

In the last 20 years, 8 studies have reported outcomes following hip arthroscopy in NFL athletes; no outcomes have been reported since the 2017 season. Return to play ranged from 79–93% and time to return ranged between 6.0–7.4 months. Offensive lineman returned at the lowest rate among all position groups. There were no differences in postoperative performance or career length compared to age-matched controls.

There is high rate of return to professional American football after hip arthroscopy for labral tear and/or FAI with no differences in performance or career longevity compared to control groups. Offensive lineman undergoing hip arthroscopy return to same-level competition at a lower rate compared to other football positions.