Male patient, 32-year old physician, intensive recreational sports (Karate), 4 years after left hip arthroscopy for FAI with persistent pain and restriction of movement (ROM). Despite the evident radiological signs of osteoarthritis (4a, 4b) the patient insisted on a repeat arthroscopy due to the pain and limitations for sports. Considering the young age and the conserved joint space in the load-bearing area, a revision arthroscopy was performed. During the hip arthroscopy the chondrolabral damage was treated in the central compartment. In the peripheral compartment the osteophytes were identified and resected (4c) as well as the cam deformity. A satisfactory correction of the deformity was achieved (4d–4f). Even in this case with a satisfactory anatomic correction and a satisfactory clinical short-term result, the long-term outcome is still unknown with a high risk of progression to osteoarthritis.