Review Question - QID 217335

A 43-year-old male presents to your clinic with complaints of left hip pain. He explains he was a former gymnast and has had intermittent hip pain for years. He now works as a truck driver and the pain is worse with prolonged periods of driving. On exam, pain is worst with flexion, adduction and internal rotation of the hip. Radiographs demonstrate an asphericity of the femoral head/neck junction with an alpha angle of 65º. MRI demonstrates a labral tear with femoral head subchondral cystic changes and edema. Physical therapy was prescribed by his PCP without much benefit. You discuss surgical options including hip arthroscopy with femoral osteoplasty and labral repair. Which one of following is a poor prognostic indicator for the success of hip arthroscopy in this patient population?