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Puncture Capsulotomy Technique for Hip Arthroscopy: Midterm Functional Outcomes.

Christopher T Eberlin1, Michael P Kucharik1, Paul F Abraham2

  • 1Sports Medicine Center, Department of Orthopaedic Surgery, Massachusetts General Hospital, Mass General Brigham, Boston, Massachusetts, USA.

Orthopaedic Journal of Sports Medicine
|February 6, 2023
PubMed
Summary

Puncture capsulotomy in hip arthroscopy significantly improves patient outcomes for labral tears and femoroacetabular impingement. This technique preserves capsular integrity, leading to better functional results and minimal complications at two years.

Keywords:
femoroacetabular impingementhip arthroscopylabral tearoutcomespuncture capsulotomy

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Area of Science:

  • Orthopedic Surgery
  • Sports Medicine
  • Arthroscopy

Background:

  • Traditional hip arthroscopy techniques like interportal and T-capsulotomy can compromise capsular stability.
  • Puncture capsulotomy offers an alternative by preserving the iliofemoral capsular ligament's integrity.

Purpose of the Study:

  • To evaluate the minimum 2-year functional outcomes of arthroscopic treatment for acetabular labral tears and femoroacetabular impingement using puncture capsulotomy.
  • To assess the efficacy and safety of the puncture capsulotomy technique in hip arthroscopy.

Main Methods:

  • Retrospective review of prospectively collected data from patients undergoing hip arthroscopy with puncture capsulotomy.
  • Inclusion criteria: age ≥18 years, minimum 2-year follow-up with patient-reported outcome measures (PROMs).
  • Data collected included International Hip Outcome Tool (iHOT-33), Hip Outcome Score (HOS-ADL, HOS-SS), modified Harris Hip Score (mHHS), and visual analog scale (VAS) pain scores.

Main Results:

  • Significant improvements observed in all PROMs (iHOT-33, HOS-ADL, mHHS, HOS-SS) and VAS pain scores (P < .001).
  • High percentages of hips achieved clinically meaningful outcomes at 2-year follow-up (e.g., 81.0% for iHOT-33 minimally important difference).
  • No incidences of infection, avascular necrosis, dislocation, or femoral neck fracture were reported.

Conclusions:

  • Puncture capsulotomy is a safe and effective technique for treating acetabular labral tears and femoroacetabular impingement.
  • The technique leads to significant functional improvements and high rates of patient-reported meaningful outcomes.
  • Preservation of capsular integrity via puncture capsulotomy contributes to favorable long-term results with a low complication profile.