Competitive Athletes Who Underwent Hip Arthroscopy With Capsular Repair Showed Greater Improvement in Patient-Reported Outcome Scores Compared With Those Who Did Not Undergo Repair

Competitive Athletes Who Underwent Hip Arthroscopy With Capsular Repair Showed Greater Improvement in Patient-Reported Outcome Scores Compared With Those Who Did Not Undergo Repair

Authors: Jimenez AE, Lee MS, Owens JS, Paraschos OA, Maldonado DR, Domb BG

Journal: Arthroscopy, November 2022

DOI: 10.1016/j.arthro.2022.04.010

Background

Capsular management during hip arthroscopy remains a debated topic, particularly in high-demand populations such as competitive athletes. This study examines the impact of capsular repair versus no repair on outcomes in athletes undergoing surgery for femoroacetabular impingement syndrome (FAIS).

Methods

• Competitive athletes undergoing primary hip arthroscopy for FAIS (2012–2018) were retrospectively reviewed.
• Patients were divided based on whether a capsular repair was performed.
• A propensity-matched analysis controlled for confounders.
• Outcomes included NAHS, HOS-SSS, VAS, and return-to-sport (RTS) at ≥2-year follow-up.

Key Findings

• Athletes who had capsular repair showed significantly greater improvements in all PROMs, particularly in HOS-SSS and VAS.
• Higher rates of achieving MCID were observed in the repair group.
• No significant difference in RTS rates, but those who underwent repair trended toward higher functional recovery.

Conclusions

Capsular repair during hip arthroscopy is associated with improved subjective outcomes in competitive athletes and increases the probability of reaching clinically meaningful improvement thresholds.

What Does This Mean for Providers?

For high-performance athletes, capsular repair may lead to more favorable functional outcomes and better pain relief. Providers should consider routine capsular repair during hip arthroscopy in this population, particularly in cases without preexisting instability.