No Differences in Clinical Outcomes Between Hip Arthroscopy With Versus Without Capsular Closure in Patients With Cam- or Mixed-Type Femoroacetabular Impingement: A Randomized Controlled Trial

Abstract

Purpose

To compare two-year clinical outcomes of primary hip arthroscopy with versus without capsular closure after interportal capsulotomy in patients with cam- or mixed- type femoroacetabular impingement (FAI).

Methods

Patients with cam- or mixed-type FAI undergoing primary hip arthroscopy with interportal capsulotomy were prospectively enrolled in this randomised controlled trial (RCT) and allocated into either capsular closure or no capsular closure groups. Patients were blinded to group allocation. Clinical outcomes were assessed preoperatively and at 2 years follow-up using the International Hip Outcome Tool (iHOT-12), modified Harris Hip Score (mHHS), and six subsections of the Copenhagen Hip and Groin Outcome Score (HAGOS). Complications and reoperations were noted.

Results

Eighty-four patients (100 hips) were enrolled, 49 hips in the capsular closure group and 51 in the no capsular closure group, with no significant differences in age (28.5±7.5 vs 30.4±8.4, p=0.261), BMI (23.5±3.0 vs 23.4±1.9, p=0.665), and sex distribution (F: 10.2% vs 13.7%, p=0.760). Four patients were lost to follow-up (2.0% vs 5.9%, p=0.618) and 6 had reoperations (6.1% vs 5.9%, p=1.000), which left 45 hips per group for clinical assessment. There were no significant differences between groups in the net change of iHOT-12 (28.3±19.6 vs 32.5±22.7, p=0.388), mHHS (7.6±13.1 vs 7.5±10.2, p=0.954), and subsections of HAGOS (p>0.05). Complication rates were also similar between groups (p>0.05).

Conclusion

The present RCT compared primary hip arthroscopy with versus without capsular closure after interportal capsulotomy in a male-dominated, non-dysplastic, non-arthritic cohort with cam- or mixed- type FAI, and found no significant differences in patient-reported clinical outcomes, complication rates, or reoperation rates.

Level of Evidence

Level I, Randomised Controlled Trial