Patients Report Improved Functional Outcomes After Puncture Capsulotomy Technique for Hip Arthroscopy at 5 Years

PURPOSE: To (1) evaluate minimum 5-year functional outcomes, (2) assess secondary surgery rates, and (3) analyze postoperative complications after hip arthroscopy for labral tears due to femoroacetabular impingement using the puncture capsulotomy technique. METHODS: This was a retrospective review of prospectively collected data from May 2014 to May 2019 that included patients aged 18 years or older who underwent hip arthroscopy via puncture capsulotomy for labral tears and concomitant femoroacetabular impingement and completed patient-reported outcome measure surveys for 5 years postoperatively. RESULTS: A total of 109 hips were included in this study (49.5% female sex; mean age ± standard deviation, 37.7 ± 14.1 years), with a mean follow-up time of 61.0 ± 1.58 months (range, 60-67 months) and mean body mass index of 25.5 ± 3.93. When compared with mean enrollment values, the mean modified Harris Hip Score (mHHS), Hip Outcome Score-Activities of Daily Living, Hip Outcome Score-Sports-Specific Subscale, and International Hip Outcome Tool-33 score were all significantly improved (P < .001) at 5-year follow-up (mHHS, 63.1 ± 14.6 preoperatively vs 88.9 ± 14.6 postoperatively; Hip Outcome Score-Activities of Daily Living, 71.1 ± 19.5 vs 92.8 ± 11.1; Hip Outcome Score-Sports-Specific Subscale, 41.8 ± 25.3 vs 81.7 ± 23.8; International Hip Outcome Tool-33 score, 41.9 ± 19.1 vs 84.4 ± 19.6). Furthermore, for the mHHS, 83.8%, 71.4%, and 52.1% of patients achieved the minimal clinically important difference, patient acceptable symptom state, and substantial clinical benefit, respectively. The rate of revision hip arthroscopy was 0%, and the rate of conversion to total hip arthroplasty was 7.83%. CONCLUSIONS: At minimum 5-year follow-up, puncture capsulotomy results in significantly improved functional outcomes, as well as clinically meaningful outcomes. Overall, patients reported minimal rates of complications and conversion to total hip arthroplasty. LEVEL OF EVIDENCE: Level IV, retrospective case series.