Hip Arthroscopy in the High-Level Athlete: Does Capsular Closure Make a Difference?

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Athletic Performance

Background:

• Hip arthroscopy is effective for athletes with femoroacetabular impingement and labral tears.
• The impact of complete capsular closure versus nonclosure on return to play remains unclear.

Purpose of the Study:

• To evaluate the effect of complete capsular closure on return to play rates and times in athletes undergoing hip arthroscopy.
• To compare patient-reported outcomes between complete capsular closure and nonclosure groups.

Main Methods:

• A retrospective review of 111 athletes (high school, collegiate, professional) who underwent hip arthroscopy by a single surgeon.
• Athletes were divided into complete capsular closure (CC) and non-capsular closure (NC) groups.
• Return to play metrics and patient-reported outcomes (mHHS, HOS-ADL, HOS-SSS) were assessed at a minimum of 2 years.

Main Results:

• A higher percentage of athletes in the CC group returned to play (90.3%) compared to the NC group (75.5%) (P = .03).
• The CC group had a faster mean return to play (4.7 months) versus the NC group (5.8 months) (P < .001).
• The CC group showed significantly higher patient-reported outcomes, meeting minimal clinically important differences for mHHS and HOS-ADL.

Conclusions:

• Complete capsular closure following hip arthroscopy is associated with a higher rate and faster return to play in high-level athletes.
• This technique also leads to significantly improved patient-reported outcomes at a minimum 2-year follow-up.