Achieving Successful Outcomes of Hip Arthroscopy in the Setting of Generalized Ligamentous Laxity With Labral Preservation and Appropriate Capsular Management: A Propensity Matched Controlled Study
Authors: Maldonado DR, Chen JW, Yelton MJ, Rosinsky PJ, Shapira J, Brayboy C, Lall AC, Domb BG
DOI: 10.1177/0363546520914604
Background
Generalized ligamentous laxity (GLL) poses unique challenges in hip arthroscopy due to increased capsular redundancy and joint instability. However, proper surgical technique may mitigate these concerns. This study evaluated outcomes in patients with GLL undergoing hip arthroscopy for FAI and labral tears.
Methods
A matched cohort analysis was performed comparing patients with and without GLL. All underwent hip arthroscopy, with standardized protocols emphasizing labral preservation and customized capsular management (e.g., plication or repair). Patients were followed for a minimum of 2 years.
Key Findings
- Both cohorts experienced significant postoperative improvements in hip function and pain.
- The GLL group had no increased risk of complications or inferior outcomes, despite requiring more extensive capsular procedures.
- Labral preservation and individualized capsular management were critical to achieving these results.
Conclusions
With proper surgical planning, patients with GLL can achieve outcomes comparable to those without laxity. Capsular management and labral preservation are especially important in this population.
What Does This Mean for Providers?
GLL should not be considered a contraindication for hip arthroscopy. When planning surgery for patients with ligamentous laxity, attention to capsular closure or plication is essential. Tailoring the approach to address soft tissue stability allows providers to offer effective, durable treatment for FAI and labral pathology in this population.