PMID- 33529782 OWN - NLM STAT- MEDLINE DCOM- 20210819 LR - 20210819 IS - 1526-3231 (Electronic) IS - 0749-8063 (Linking) VI - 37 IP - 6 DP - 2021 Jun TI - Complete Capsular Closure Provides Higher Rates of Clinically Significant Outcome Improvement and Higher Survivorship Versus Partial Closure After Hip Arthroscopy at Minimum 5-Year Follow-Up. PG - 1833-1842 LID - S0749-8063(21)00051-7 [pii] LID - 10.1016/j.arthro.2021.01.035 [doi] AB - PURPOSE: To (1) compare the rates of reaching threshold hip-specific outcome scores for achieving the minimal clinically important difference (MCID) and patient acceptable symptomatic state (PASS) in patients who underwent partial versus complete T-capsulotomy repair and (2) identify the failure rates in each group 5 years after undergoing hip arthroscopy for femoroacetabular impingement syndrome (FAIS). METHODS: Data from consecutive patients who underwent hip arthroscopy for FAIS performed by a single fellowship-trained surgeon from January 2011 to March 2013 were collected and analyzed. Baseline data, hip-specific outcomes, and clinical failure rates were recorded at a minimum of 5 years postoperatively. Patients with partial T-capsulotomy repair were matched 1:3 by age, body mass index, and sex to patients with complete T-capsulotomy repair. Threshold scores for achieving the MCID and PASS were calculated and compared between the 2 groups. Additionally, rates of revision and conversion to total hip arthroplasty (THA) were compared between the groups. RESULTS: A total of 379 patients were available for analysis (39 partial and 340 complete repairs), with 100 patients included in the matching process (25 in the partial-repair group and 75 in the complete-repair group). Comparison of radiographic parameters, including the Tonnis grade, alpha angle, and lateral center-edge angle, between the 2 groups showed no statistically significant difference (P > .05 for all). Comparison of postoperative score averages between the partial- and complete-closure groups showed a significant difference in the Hip Outcome Score-Activities of Daily Living Subscale (85.4 +/- 17.7 vs 94.6 +/- 7.8, P < .001), Hip Outcome Score-Sports Subscale (76.6 +/- 26.2 vs 89.3 +/- 16.8, P = .034), modified Harris Hip Score (83.2 +/- 19.7 vs 90.5 +/- 11.2, P = .035), and visual analog scale pain score (24.5 +/- 30.8 vs 13.4 +/- 15.8, P = .035). A total of 65 complete-repair patients (95.6%) achieved the MCID for at least 1 outcome measure versus 18 patients with partial repair (78.3%) (P = .04). A total of 69 complete-repair patients (92%) achieved the PASS for at least 1 outcome measure versus 18 partial-repair patients (72%) (P = .017). Of the 39 partial-repair patients, 35.9% (n = 14) underwent revision or conversion to THA, as compared with 2.9% (n = 10) in the overall cohort. CONCLUSIONS: At a minimum 5-year follow-up, patients with complete capsular closure after hip arthroscopy for FAIS show superior long-term outcomes and achieve higher rates of meaningful clinical success when compared with patients with partial capsular closure. Furthermore, patients with partial capsular repair undergo revision or conversion to THA at high rates. LEVEL OF EVIDENCE: Level III, retrospective comparative study. CI - Copyright (c) 2021 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved. FAU - Beck, Edward C AU - Beck EC AD - Department of Orthopedic Surgery, Wake Forest Baptist Health, Winston-Salem, North Carolina, U.S.A.. Electronic address: Ecbeck@wakehealth.edu. FAU - Nwachukwu, Benedict U AU - Nwachukwu BU AD - Division of Sports Medicine Surgery, Department of Orthopedic Surgery, Hospital for Special Surgery, New York, New York, U.S.A. FAU - Chahla, Jorge AU - Chahla J AD - Division of Sports Medicine Surgery, Department of Orthopedic Surgery, Rush University Medical Center, Chicago, Illinois, U.S.A. FAU - Clapp, Ian M AU - Clapp IM AD - Division of Sports Medicine Surgery, Department of Orthopedic Surgery, Rush University Medical Center, Chicago, Illinois, U.S.A. FAU - Jan, Kyleen AU - Jan K AD - Division of Sports Medicine Surgery, Department of Orthopedic Surgery, Rush University Medical Center, Chicago, Illinois, U.S.A. FAU - Nho, Shane J AU - Nho SJ AD - Division of Sports Medicine Surgery, Department of Orthopedic Surgery, Rush University Medical Center, Chicago, Illinois, U.S.A. LA - eng PT - Journal Article DEP - 20210130 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 CIN - Arthroscopy. 2021 Jun;37(6):1843-1844. PMID: 34090568 MH - Activities of Daily Living MH - *Arthroscopy MH - *Femoracetabular Impingement/surgery MH - Follow-Up Studies MH - Hip Joint/surgery MH - Humans MH - Patient Reported Outcome Measures MH - Retrospective Studies MH - Survivorship MH - Treatment Outcome EDAT- 2021/02/03 06:00 MHDA- 2021/08/20 06:00 CRDT- 2021/02/02 20:10 PHST- 2020/05/20 00:00 [received] PHST- 2021/01/06 00:00 [revised] PHST- 2021/01/12 00:00 [accepted] PHST- 2021/02/03 06:00 [pubmed] PHST- 2021/08/20 06:00 [medline] PHST- 2021/02/02 20:10 [entrez] AID - S0749-8063(21)00051-7 [pii] AID - 10.1016/j.arthro.2021.01.035 [doi] PST - ppublish SO - Arthroscopy. 2021 Jun;37(6):1833-1842. doi: 10.1016/j.arthro.2021.01.035. Epub 2021 Jan 30.