Prospective Randomized Comparison of Capsular Management Techniques During Hip Arthroscopy

Area of Science:

• Orthopedic Surgery
• Arthroscopy
• Hip Preservation

Background:

• Capsular management during hip arthroscopy is a debated topic.
• Existing studies are primarily retrospective reviews.

Purpose of the Study:

• To prospectively compare three common capsular management techniques in hip arthroscopy.
• To test the hypothesis that capsular closure leads to superior outcomes.

Main Methods:

• A prospective randomized trial involving 150 patients undergoing hip arthroscopy with labral repair and femoral osteoplasty.
• Patients were randomized into three groups: T-capsulotomy without closure (TC), interportal capsulotomy without closure (IC), and interportal capsulotomy with closure (CC).
• Outcomes including patient-reported scores and need for revision surgery were assessed over 24 months.

Main Results:

• The capsular closure (CC) group showed significantly better modified Harris Hip Score (mHHS) and Hip Outcome Score-Activities of Daily Living (HOS-ADL) at 2-year follow-up compared to the interportal capsulotomy (IC) group.
• The CC group also demonstrated superior mHHS, HOS-ADL, and Hip Outcome Score-Sports-Specific Subscale (HOS-SSS) compared to the T-capsulotomy (TC) group.
• Fewer patients in the CC and IC groups required conversion to hip arthroplasty compared to the TC group (P = .02).

Conclusions:

• Complete capsular closure during hip arthroscopy results in improved patient-reported and surgical outcomes.
• Capsular repair after capsulotomy appears to be a favorable management technique in hip arthroscopy.
• This technique may reduce the need for subsequent hip surgeries.