The type of capsulotomy did not affect clinical outcomes after arthroscopy to treat femoroacetabular impingement syndrome (FAIS) when the capsulotomy included repair, a new study finds.
Capsulotomy Type Doesn’t Affect FAIS Outcomes
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Secondary#arthroscope#capsulotomy#fais
“Capsule management has emerged as an important topic in the field of hip arthroscopy. The two most popular techniques are interportal capsulotomy and T-type capsulotomy, but few studies have compared outcomes between these two techniques,” the researchers wrote.
In their study, “Achievement of Meaningful Clinical Outcomes Is Unaffected by Capsulotomy Type During Arthroscopic Treatment of Femoroacetabular Impingement Syndrome: Results From the Multicenter Arthroscopic Study of the Hip (MASH) Study Group,” published on February 09, 2021 in The American Journal of Sports Medicine, they compared two-year patient-reported outcomes between patients who underwent interportal versus T-type capsulotomy during arthroscopic labral repair for femoroacetabular impingement syndrome.
Data from nine surgeons at nine centers between January 2104 and February 2018 were included in the study. The researchers recorded baseline demographic data, preoperative patient-reported outcomes, and minimum two-year postoperative patient-reported outcomes including Hip Outcome Score-Activities of Daily Living (HOS-ADL, HOS-Sports Subscale (HOS-SS), modified Harris Hip Score, and International Hip Outcome Tool-12 (iHOT-12).
The final analysis included 658 of 1,483 eligible patients with a mean ±SD age of 32.6 ±11.6 years and BMI of 24.0 ± 3.7. Of these, 329 patients were treated via interportal capsulotomy, and 329 patients were treated via T-type capsulotomy. More than half of the patients were female.
The researchers found capsulotomy type was not a predictor of 2-year postoperative patient-reported outcomes on multivariate linear regression analysis when adjusted for covariates. Chi-square analysis showed no statistical difference in achievement of MCID, PASS, and SCB between the interportal and T-type groups for HOS-ADL (80.3%, 75.8%, 52.7% and 77.1%, 71.7%, 53.6% respectively; p > .01 for all), HOS-SS (83.6%, 72.5%, 51.5% and 81.7%, 68.4%, 49.2%, respectively; p > .01 for all, and iHOT-12 (87.5%, 72.0%, 50.5% and 80.0%, 64.7%, 45.6%, respectively; p > .01 for all).
“Arthroscopic management of FAIS resulted in significant clinical improvement that was independent of capsulotomy type when the capsulotomy included repair,” they wrote.
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This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?
Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.
We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.
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