No Difference in 2-Year Outcomes for Non-Hypermobile Femoroacetabular Impingement Syndrome Patients Undergoing Hip Arthroscopy With and Without Closure of Periportal Capsulotomy.

PURPOSE

To assess whether capsular closure during hip arthroscopy with periportal capsulotomy affects 2-year postoperative outcomes for patients with femoroacetabular impingement syndrome (FAIS) without hypermobility.

METHODS

A matched-cohort retrospective analysis of a single institutional database of patients who underwent hip arthroscopy with periportal capsulotomy for management of FAIS between 2014 and 2022 was performed. Study inclusion criteria consisted of patients with FAIS who exhibited no signs of generalized ligamentous laxity (GLL) (Beighton score 0). Patients with evidence of hip osteoarthritis (Tönnis grade >1) and hip dysplasia and those undergoing revision surgery were excluded. Capsular closure was performed via a simple suture configuration through the mid-anterior portal. The capsular closure group (n = 51) was matched 1:1 by age, sex, and body mass index with the nonclosure group. Patient-reported outcome (PRO) surveys, including the Hip Disability and Osteoarthritis Outcome Score, 12-item Short-Form Survey, and visual analog scale for pain, were completed preoperatively and 2 years postoperatively. Mean score change was calculated across all PROs, and unpaired samples t tests were used to compare groups.

RESULTS

The overall matched cohort included 90 patients and 102 hips (age: 30.5 ± 9.5 years; body mass index: 23.3 ± 2.6; 66.7% male), with no differences in demographic or preoperative hip characteristics. Both groups achieved significant score improvements in all PROs at 2 years (P < .001), except 12-item Short-Form Survey Mental Component Summary, which remained unchanged. There was no difference in 2-year postoperative mean score change between the closure and nonclosure groups, and both groups achieved minimal clinically important difference (60.8%-84.3% vs 54.9%-86.3%), patient acceptable symptom state (60.8%-84.3% vs 52.9%-76.5%), and substantial clinical benefit (54.9%-76.5% vs 47.1%-64.7%) thresholds at similar rates across all PROs, with no complications or conversions to total hip arthroplasty, respectively.

CONCLUSIONS

Among patients with FAIS without hypermobility (Beighton score of 0) undergoing periportal capsulotomy during hip arthroscopy, capsular closure showed no differences in 2-year postoperative outcomes compared to nonclosure.

LEVEL OF EVIDENCE

Level III, retrospective matched-cohort study.