PMID- 25530511
OWN - NLM
STAT- MEDLINE
DCOM- 20151117
LR  - 20191210
IS  - 1526-3231 (Electronic)
IS  - 0749-8063 (Linking)
VI  - 31
IP  - 4
DP  - 2015 Apr
TI  - Influence of capsular repair versus unrepaired capsulotomy on 2-year clinical 
      outcomes after arthroscopic hip preservation surgery.
PG  - 643-50
LID - S0749-8063(14)00863-9 [pii]
LID - 10.1016/j.arthro.2014.10.014 [doi]
AB  - PURPOSE: The primary objective of this study was to determine whether capsular 
      management technique influences clinical outcomes at a minimum of 2 years after 
      arthroscopic hip preservation surgery. METHODS: A retrospective review of 
      prospectively collected data was conducted to determine the relative influence of 
      2 capsular management strategies on clinical outcomes: unrepaired capsulotomy 
      (group A) and capsular repair (group B). Four hundred three patients who had 
      undergone arthroscopic hip preservation surgery met the inclusion criteria and 
      had 2-year outcome data available. All patients completed 4 patient-reported 
      outcome (PRO) questionnaires preoperatively and at a minimum of 2 years' 
      follow-up. These included the Hip Outcome Score-Activities of Daily Living 
      (HOS-ADL) and Hip Outcome Score-Sport-Specific Subscale (HOS-SSS) subsets, 
      Non-Arthritic Hip Score (NAHS), and modified Harris Hip Score (mHHS). RESULTS: 
      Group A included 235 patients and group B, 168. The mean age of all patients at 
      final follow-up was 36.9 years. Patients in group A were significantly older 
      (42.3 years v 29.4 years, P < .0001) and had a significantly higher body mass 
      index (26.8 kg/m(2)v 22.9 kg/m(2), P < .0001) compared with group B. In addition, 
      female patients were more likely than male patients to undergo capsular repair 
      (136 female patients v 32 male patients, P < .0001). Patients in group A also 
      showed greater chondral damage by acetabular labrum articular disruption 
      classification (P = .0081) and reduced preoperative PROs (HOS-ADL of 60.5 v 66.0, 
      P = .087; HOS-SSS of 37.0 v 46.4, P = .0002; NAHS of 54.6 v 62.2, P < .0001; mHHS 
      of 58.7 v 64.4, P = .0009; and visual analog scale score of 6.3 v 5.84, P = 
      .028). All PROs showed statistically significant improvements for both groups at 
      a minimum follow-up of 2 years (HOS-ADL, 60.5 to 82.2 in group A and 66 to 86.1 
      in group B; HOS-SSS, 36.9 to 67.3 and 46.4 to 71.2, respectively; NAHS, 54.6 to 
      79 and 62.2 to 82.8, respectively; visual analog scale score, 6.3 to 3.1 and 5.8 
      to 2.9, respectively; and mHHS, 58.7 to 81 and 64.4 to 83.8, respectively; 
      P < .0001 for all differences). Furthermore, group B showed greater overall 
      improvements than group A for the HOS-ADL (P = .03) and NAHS (P = .03) on 
      uncorrected univariate analysis, but significance was lost once we controlled for 
      confounding variables. CONCLUSIONS: Arthroscopic capsular repair, used in 
      conjunction with arthroscopic hip preservation surgery, appears to be safe and 
      did not negatively influence clinical outcomes in this study. When confounding 
      variables were controlled for, the use of capsular repair did not show clinically 
      relevant superiority over the use of unrepaired capsulotomy. LEVEL OF EVIDENCE: 
      Level IV, therapeutic case series.
CI  - Copyright (c) 2015 Arthroscopy Association of North America. Published by Elsevier 
      Inc. All rights reserved.
FAU - Domb, Benjamin G
AU  - Domb BG
AD  - Hinsdale Orthopaedics, Hinsdale, and Loyola University Chicago, Chicago, 
      Illinois, U.S.A.
FAU - Stake, Christine E
AU  - Stake CE
AD  - Hinsdale Orthopaedics, Hinsdale, and Loyola University Chicago, Chicago, 
      Illinois, U.S.A.
FAU - Finley, Zachary J
AU  - Finley ZJ
AD  - Hinsdale Orthopaedics, Hinsdale, and Loyola University Chicago, Chicago, 
      Illinois, U.S.A.
FAU - Chen, Tian
AU  - Chen T
AD  - Hinsdale Orthopaedics, Hinsdale, and Loyola University Chicago, Chicago, 
      Illinois, U.S.A.
FAU - Giordano, Brian D
AU  - Giordano BD
AD  - Hinsdale Orthopaedics, Hinsdale, and Loyola University Chicago, Chicago, 
      Illinois, U.S.A.. Electronic address: Brian_Giordano@urmc.rochester.edu.
LA  - eng
PT  - Evaluation Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20141216
PL  - United States
TA  - Arthroscopy
JT  - Arthroscopy : the journal of arthroscopic & related surgery : official 
      publication of the Arthroscopy Association of North America and the International 
      Arthroscopy Association
JID - 8506498
SB  - IM
MH  - Activities of Daily Living
MH  - Adult
MH  - Aged
MH  - Arthroscopy/*methods/rehabilitation
MH  - Body Mass Index
MH  - Female
MH  - Hip Joint/*surgery
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Retrospective Studies
MH  - Surveys and Questionnaires
MH  - Treatment Outcome
MH  - Wound Healing
MH  - Young Adult
EDAT- 2014/12/23 06:00
MHDA- 2015/11/18 06:00
CRDT- 2014/12/23 06:00
PHST- 2014/02/19 00:00 [received]
PHST- 2014/10/15 00:00 [revised]
PHST- 2014/10/24 00:00 [accepted]
PHST- 2014/12/23 06:00 [entrez]
PHST- 2014/12/23 06:00 [pubmed]
PHST- 2015/11/18 06:00 [medline]
AID - S0749-8063(14)00863-9 [pii]
AID - 10.1016/j.arthro.2014.10.014 [doi]
PST - ppublish
SO  - Arthroscopy. 2015 Apr;31(4):643-50. doi: 10.1016/j.arthro.2014.10.014. Epub 2014 
      Dec 16.