PMID- 36661250 OWN - NLM STAT- MEDLINE DCOM- 20230209 LR - 20230213 IS - 1552-3365 (Electronic) IS - 0363-5465 (Linking) VI - 51 IP - 2 DP - 2023 Feb TI - Outcomes for Treatment of Capsulolabral Adhesions With a Capsular Spacer During Revision Hip Arthroscopy. PG - 487-493 LID - 10.1177/03635465221145704 [doi] AB - BACKGROUND: The presence of adhesions is a common source of pain and dysfunction after hip arthroscopic surgery and an indication for revision surgery. The placement of a capsular spacer in the capsulolabral recess after lysis of adhesions has been developed to treat and prevent the recurrence of adhesions. PURPOSE: To evaluate patient-reported outcomes (PROs) and survivorship at a minimum of 2 years after revision hip arthroscopic surgery with capsular spacer placement for capsular adhesions. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: Between January 2013 and June 2018, a total of 95 patients (99 hips) aged >/=18 years underwent revision hip arthroscopic surgery for the treatment of capsular adhesions with the placement of a capsular spacer. Overall, 53 patients (56 hips) met the inclusion criteria and had a minimum 2-year follow-up, forming the cohort of this study. Exclusion criteria included confounding metabolic bone diseases (eg, Legg-Calve-Perthes disease, Marfan syndrome), labral deficiency, or advanced osteoarthritis (Tonnis grade 2 or 3). Preoperative and postoperative outcome scores (modified Harris Hip Score [mHHS], Hip Outcome Score-Activities of Daily Living [HOS-ADL], Hip Outcome Score-Sport-Specific Subscale [HOS-SSS], 12-Item Short Form Health Survey [SF-12], and Western Ontario and McMaster Universities Osteoarthritis Index [WOMAC]) were collected and compared in addition to the revision rate, conversion to total hip arthroplasty, and patient satisfaction. RESULTS: The mean age of the cohort was 32 +/- 11 years, with 32 female hips (57%) and a median number of previous hip arthroscopic procedures of 1 (range, 1-5). The arthroplasty- and revision-free survivorship rate at 2 years was 91%. Overall, 5 patients (6 hips; 11%) underwent revision surgery at a mean of 2.4 +/- 1.4 years after capsular spacer placement, with symptomatic capsular defects being the most common finding. There were 4 patients (7%) who converted to total hip arthroplasty. For hips not requiring subsequent surgery (n = 46), there was a significant improvement in outcome scores except for the SF-12 Mental Component Summary, with rates of achieving the minimal clinically important difference of 70%, 70%, and 65% for the mHHS, HOS-ADL, and HOS-SSS, respectively. CONCLUSION: Capsular spacers, as part of a systematic approach including lysis of adhesions with early and consistent postoperative physical therapy including circumduction exercises, resulted in improved PROs as well as high arthroplasty- and revision-free survivorship (91%) at a minimum 2-year follow-up. Capsular spacers should be considered in revision hip arthroscopic procedures when an adequate labral volume remains but adhesions continue to be a concern. FAU - Ruzbarsky, Joseph J AU - Ruzbarsky JJ AD - Steadman Philippon Research Institute, Vail, Colorado, USA. AD - The Steadman Clinic, Vail, Colorado, USA. FAU - Comfort, Spencer M AU - Comfort SM AD - Steadman Philippon Research Institute, Vail, Colorado, USA. FAU - Martin, Maitland D AU - Martin MD AD - Steadman Philippon Research Institute, Vail, Colorado, USA. FAU - Briggs, Karen K AU - Briggs KK AD - Steadman Philippon Research Institute, Vail, Colorado, USA. FAU - Philippon, Marc J AU - Philippon MJ AD - Steadman Philippon Research Institute, Vail, Colorado, USA. AD - The Steadman Clinic, Vail, Colorado, USA. LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20230120 PL - United States TA - Am J Sports Med JT - The American journal of sports medicine JID - 7609541 SB - IM MH - Humans MH - Female MH - Adolescent MH - Adult MH - Young Adult MH - Hip Joint/surgery MH - Treatment Outcome MH - Arthroscopy/methods MH - Follow-Up Studies MH - Activities of Daily Living MH - *Arthroplasty, Replacement, Hip/methods MH - *Osteoarthritis/surgery MH - Patient Reported Outcome Measures MH - *Femoracetabular Impingement/surgery MH - Retrospective Studies OTO - NOTNLM OT - adhesions OT - capsular spacer OT - functional outcomes OT - hip arthroscopic surgery EDAT- 2023/01/21 06:00 MHDA- 2023/02/10 06:00 CRDT- 2023/01/20 07:22 PHST- 2023/01/21 06:00 [pubmed] PHST- 2023/02/10 06:00 [medline] PHST- 2023/01/20 07:22 [entrez] AID - 10.1177/03635465221145704 [doi] PST - ppublish SO - Am J Sports Med. 2023 Feb;51(2):487-493. doi: 10.1177/03635465221145704. Epub 2023 Jan 20.