Return to Baseball After Hip Surgery Shows Success for Player

UNITED STATES (NORFOLK, VIRGINIA), 13 OCTOBER 2026 —

*Corresponding author: Carter Berry, Department of Orthopedics, Eastern Virginia Medical School, Norfolk, Virginia, United States carterberry434@gmail.com How to cite this article: Berry C, Crawford E, Kaler A, Cuthbert AS, Edge C, Protzuk O, et al .

doi: 10.25259/JOO-D-26-01073 Because of the focus on throwing in baseball, a high volume of research has been dedicated to upper extremity injuries; however, research has suggested that approximately 30% of all injuries in professional baseball involve the lower extremity. Within that cohort, players with hip injuries spent the most time on the disabled list.

This study aims to summarize the existing evidence regarding the return to sport after hip arthroscopy for femoroacetabular impingement in baseball players across all levels of play to provide a more comprehensive understanding of the effect of intra-articular hip pathology on baseball players returning to sport.

Current literature was reviewed, and Medline, PubMed Central, Embase, and Web of Science were searched from their inception until July 2024 using terms such as “hip arthroscopy”, “baseball”, “Major League Baseball,” and “FAI,”. Abstracts were screened for articles that included baseball players who underwent arthroscopic hip surgery and reported return to sport data. 665 individual records were screened and 11 met inclusion criteria. The median rate of return to baseball amongst studies was 88.4%.

Levels of competition included recreational, high school (varsity), club, NCAA, minor leagues, and MLB. 45% (5/11) of studies defined “return to sport” as “playing in at least 1 game”. The average time to return to baseball was 7.9 months. Baseball players from all levels of play were reliably able to return to sport following hip arthroscopy. Future projects should focus on standardizing definitions of returning to sport and capturing data on athletes of all levels.

Of the four major sports in the United States (football, basketball, hockey, and baseball), baseball has the longest regular season across all levels of competition. Baseball teams play nearly twice as many games as basketball and hockey, and nearly five times as many games as football in both high school and college; these numbers are even more exaggerated at the professional level. Consequently, players have a shorter off-season period for rehab, training, and recovery.

The effects of this are evident in Major League Baseball (MLB). An average of 439 players per year are placed on the disabled list due to injury. 1 Yet effects of these injuries reach beyond the professional level: players at all levels may have scholarships, draft status, and future contracts jeopardized. Moreover, individuals are not the only entity affected. Injury to players can also drastically affect a team’s ability to compete and, consequently, their revenue.

Due to the prominence of throwing in baseball, significant research has been dedicated to upper extremity injuries. Yet, throwing movements require large amounts of energy generated through the lower extremities and transferred up the kinetic chain to the arm. Significant rotational forces are generated across the hip, which, in the setting of abnormal hip joint morphology as seen in femoroacetabular impingement (FAI), can lead to dysfunction, injury, and decompensation in athlete performance.

2 , 3 Current research has suggested that around 30% of all injuries in professional baseball and 27% of collegiate injuries involve the lower extremity. 4 - 8 Lower extremity injuries can be debilitating enough to account for 14% of all placements on the MLB injured list (IL). 9 Within this subset, data obtained between 2011 and 2014 suggest that up to 17% of all MLB players suffer specifically from hip and groin injuries.

10 Radiographic findings of FAI have been identified in up to 66% of high-level athletes, and even 76.6% in baseball players specifically, making this a highly prevalent issue. Hip injuries have been found to result in the longest recovery time and highest average days on the IL.

4 , 11 , 12 Current studies report a wide range of return to sport (RTS) outcomes following hip arthroscopy for FAI in baseball players, ranging from 57% to 95% 13 , and few studies seek to understand the effects of RTS at various levels of competition. To our knowledge, a review of current literature is lacking on this topic.

Therefore, the aim of this study is to provide a comprehensive summary of the existing evidence regarding return to sport after hip arthroscopy for FAI in baseball players at the high school, college, and professional level. The results of this study will aid physicians and therapists when counseling players and coaches on hip arthroscopy expectations and recovery.

A comprehensive review of current literature was conducted through database searches of Medline, PubMed Central, Embase, and Web of Science. We conducted a Boolean search using a combination of terms such as “hip arthroscopy, “baseball,”, “Major League Baseball,” “MLB,” “return to baseball,” “return to sport,” “femoroacetabular impingement,” “FAI,” “pincer deformity,” “Cam deformity”, and “labral tear.” We included studies that reported RTS after hip arthroscopy in baseball players at all levels.

Our inclusion criteria further included original studies and those published in English. We excluded case reports, articles that did not report on baseball athletes, articles that used identical cohorts, and return to sport in baseball players with injuries unrelated to the treatment of FAI with hip arthroscopy (such as spinal or upper extremity orthopedic injuries). We did not exclude studies based on publication year or level of evidence.

Abstracts were screened in Covidence by multiple independent researchers for eligibility criteria. Conflicts were resolved, and full-text articles were reviewed.

The following data were extracted from each study: number of patients, number of hips operated on, procedure performed during hip arthroscopy, hip outcome scoring system, level of evidence, return to sport or return to play (with the authors’ specific definition of “return to sport”), level of competition, and percentage of successful return to sport or play.

The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were used during the review process, as seen in Figure 1 .

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