Outcomes of Capsular Plication in Athletes Undergoing Hip Arthroscopy with Minimum Two-Year Follow-Up

Background: The hip capsule serves as a static stabilizer. Capsular plication is performed to treat patients with borderline dysplasia and/or ligamentous laxity in an attempt to treat hip microinstability. In athletes, the hip’s stabilizers play an important role due to extreme ranges of motion and high force applied to the joint. Although hip arthroscopy has demonstrated favorable outcomes in athletes, there are no studies to our knowledge that report the outcomes of capsular plication in this active patient population.

Purpose:To report the minimum two-year postoperative outcomes for athletes that underwent capsular plication during hip arthroscopy.

Methods: Since 2008, data were prospectively collected on patients who underwent hip arthroscopy for the treatment of femoroacetabular impingement and/or labral tears. Inclusion criteria were as follows: athlete at the high school, collegiate, or professional levels preoperatively, underwent capsular plication, and preoperatively recorded patient-reported outcome (PRO) scores including modified Harris Hip Score (mHHS), Non-Arthritic Hip Score (NAHS), Hip Outcome Score – Sports Specific Subscale (HOS-SSS), and Visual Analog Scale (VAS). Exclusion criteria were 1, and previous hip conditions. Sports activity and competitive levels were collected at a minimum of two years postoperatively.

Results: Fifty-one hips (49 patients) met the inclusion criteria and 41 hips (39 patients) had minimum two year follow-up (80.4% follow-up). Significant improvements from pre- to two-year post-operative PRO scores were found in mHHS (16.4), NAHS (22), HOS-SSS (33.3), and VAS (-3.4). Thirty-five (85.4%) hip arthroscopy patients returned to sports and 34 (82.9%) maintained their competitive physical abilities.

Conclusions: PROs and VAS in athletes significantly improved at a minimum of two years post-arthroscopic capsular plication. Additionally, most patients returned to sports at similar or higher competitive levels. These results suggest that capsular plication is a favorable treatment option in athletes that should be warranted when indicated.