Capsular Repair May Improve Outcomes in Patients Undergoing Hip Arthroscopy for Femoroacetabular Impingement: A Systematic Review of Comparative Outcome Studies
Authors: Owens JS, Jimenez AE, Shapira J, Saks BR, Glein RM, Maldonado DR, Ankem HK, Sabetian PW, Lall AC, Domb BG
DOI: 10.1016/j.arthro.2021.03.063
Background
The role of capsular repair during hip arthroscopy for femoroacetabular impingement (FAI) remains debated, with concerns about whether repairing the capsule improves patient outcomes compared to leaving it unrepaired.
Methods
This systematic review evaluated 16 comparative studies including 2,996 hips undergoing hip arthroscopy for FAI. It compared patient-reported outcomes (PROs) between capsular repair and unrepaired capsulotomy groups.
Key Findings
- Most studies demonstrated that capsular repair leads to superior or at least equivalent PROs compared to leaving the capsule unrepaired.
- No studies favored the unrepaired capsulotomy approach.
- Benefits of capsular repair were especially evident in patients without arthritis.
Conclusions
Repairing the hip capsule during arthroscopy for FAI is associated with improved patient outcomes and may reduce hip pain and dysfunction postoperatively.
What Does This Mean for Providers?
- Consider routine capsular repair during hip arthroscopy for FAI to optimize functional outcomes.
- Pay particular attention to capsular management in patients without osteoarthritis, who may benefit most from repair.
- Recognize that leaving the capsule unrepaired may compromise joint stability and patient-reported outcomes.
- Discuss capsular management strategy during preoperative planning and patient counseling.