Does Capsular Closure Influence Clinical Outcomes in Hip Arthroscopy for Femoroacetabular Impingement and Labral Tear

Zachary Sharfman 1 Lior Laver 1 Ran Atzmon 2 Eyal Amar 1 Ehud Rath 1
1Orthopedic Surgery, Tel Aviv Sourasky Medical Center, Affiliated with the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
2Orthopedic Surgery, Assaf Harofeh Medical Center, Tzrifin, Israel

Background: No consensus regarding capsular closure in hip arthroscopy has been reached.

Purpose: To assess clinical outcomes in patients who underwent hip arthroscopy surgery for Femorolacetabular Impingement (FAI) with and without capsular closure.

Methods: Patients who underwent arthroscopic hip surgery for FAI or labral tear were reviewed. In 50 consecutive patients the capsule was not closed and in 50 consecutive patients the capsule was closed. Demographic data, intraoperative findings, as well as preoperative and postoperative modified Harris Hip Score (MHHS) and Hip Outcome Score (HOS) were evaluated.

Results: A total of 47 patients with mean age 41.6 years and 44 patients with mean age 42.2 years were included in the non-closure and capsular closure groups, respectively. Age was not significantly different between groups (p=.855). The mean follow up time was 59.7 months and 40.1 months in the non-closure and closure groups, respectively (p<.001). The mean surgery time was 126.6 minutes in the non-closure group and 117.4 minutes in the closure group. The mean preoperative, postoperative, and mean improvement in HOS scores did not significantly differ between the non-closure and closure groups (65.5 vs. 64.7 p=.873, 84.9 vs. 83.4 p=.748, 19.4 vs. 18.7 p=.53, respectively). However, preoperative MHHS scores and MHHS improvement were significantly different. The non-closure group reported mean preoperative MHHS scores of 67.6 compared to 56.8 in the closure group (p=.011). Mean improvement in MHHS scores was 17.9 in the non-closure group and 27.9 in the closure group (p=.027). Postoperative MHHS scores did not significantly differ (85.5 and 84.7 respectively p=85.9). Overall satisfaction rating in the non-closure group was 86% and the closure group reported a mean satisfaction of 88% (p=.782).

Conclusion: In patients who underwent arthroscopic hip surgery for FAI or labral tear, capsular closure did not significantly alter overall satisfaction or the final clinical outcome scores.