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

Jeffrey D Hassebrock1, Justin L Makovicka1, Anikar Chhabra1

  • 1Department of Orthopedics, Mayo Clinic Arizona, Phoenix, Arizona, USA.

The American Journal of Sports Medicine
|July 16, 2020
PubMed
Summary

Complete capsular closure after hip arthroscopy improves return to play rates and speed for athletes. This technique also leads to better patient-reported outcomes, enhancing recovery and performance.

Keywords:
athletescapsular closurecapsulotomyhip arthroscopyreturn to play

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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.