The gold standard of hip replacement surgery is the ability of the implant to restore the athlete to premorbid levels of performance. Clearly this is a Herculean task as the effects of age and degeneration come into play. The ability to perform at a high level is affected by factors outside the surgical implant technology and largely influenced by patient factors. However, high-performance athletes probably have much lower personal barriers to such a return. The progress of this group is rather impressive but falls short of the highest expectations.