TY - JOUR
T1 - Arthroscopic Capsular Management of the Hip
T2 - A Comparison of Indications for and Clinical Outcomes of Periportal Versus Interportal Capsulotomy
AU - McGovern, Ryan P.
AU - Bucci, Gabriella
AU - Nickel, Beth A.
AU - Ellis, Henry B.
AU - Wells, Joel E.
AU - Christoforetti, John J.
N1 - Publisher Copyright:
© 2020 Arthroscopy Association of North America
PY - 2021/1
Y1 - 2021/1
N2 - Purpose: To compare the clinical outcomes of periportal capsulotomy versus interportal capsulotomy with closure using a standard clinical algorithm at a minimum of 2 years after hip arthroscopy. Methods: A retrospective cohort study of patients treated from July 2015 to October 2017 was conducted to determine the effects of 2 capsular management approaches on clinical outcomes. When patient pathology limited adequate exposure via periportal capsulotomy, an interportal capsulotomy was performed. The capsular management approaches were correlated with the following patient-reported outcomes (PROs) at 2 years: Hip Outcome Score (HOS), 12-item International Hip Outcome Tool, visual analog scale for pain, and patient satisfaction. Preoperative comparisons between the 2 groups were analyzed using t tests or the Fisher exact test, depending on the category of data. Two-tailed independent t tests were performed to evaluate whether preoperative and follow-up outcome scores were significantly different between patients treated with a periportal capsulotomy and those treated with an interportal capsulotomy. Results: Overall, patients in both groups experienced significant improvements in all PROs on postoperative comparisons at 2-year follow-up (P <.001). The mean changes in the PROs were as follows: HOS–Activities of Daily Living, 24.7 in the periportal group and 23.5 in the interportal group (P =.484); HOS–Sport-Specific Subscale, 30.2 and 31.3, respectively (P =.895); 12-item International Hip Outcome Tool score, 41.9 and 40.2, respectively (P =.564); and visual analog scale pain score, –40.9 mm and –34.5 mm, respectively (P =.791). Additionally, no statistically significant difference in patient satisfaction at 2-year follow-up was found between patients who underwent interportal capsulotomy and those who underwent periportal capsulotomy (P =.604). Conclusions: At 2-year follow-up, patients who underwent a periportal capsulotomy reported statistically and clinically significant improvements in PROs and satisfaction with the surgical intervention. This study confirms that the use of a simple clinical algorithm for selection of periportal capsulotomy or interportal capsulotomy with closure results in acceptable management decisions as defined by 2-year PROs. Level of Evidence: Level III, retrospective cohort study.
AB - Purpose: To compare the clinical outcomes of periportal capsulotomy versus interportal capsulotomy with closure using a standard clinical algorithm at a minimum of 2 years after hip arthroscopy. Methods: A retrospective cohort study of patients treated from July 2015 to October 2017 was conducted to determine the effects of 2 capsular management approaches on clinical outcomes. When patient pathology limited adequate exposure via periportal capsulotomy, an interportal capsulotomy was performed. The capsular management approaches were correlated with the following patient-reported outcomes (PROs) at 2 years: Hip Outcome Score (HOS), 12-item International Hip Outcome Tool, visual analog scale for pain, and patient satisfaction. Preoperative comparisons between the 2 groups were analyzed using t tests or the Fisher exact test, depending on the category of data. Two-tailed independent t tests were performed to evaluate whether preoperative and follow-up outcome scores were significantly different between patients treated with a periportal capsulotomy and those treated with an interportal capsulotomy. Results: Overall, patients in both groups experienced significant improvements in all PROs on postoperative comparisons at 2-year follow-up (P <.001). The mean changes in the PROs were as follows: HOS–Activities of Daily Living, 24.7 in the periportal group and 23.5 in the interportal group (P =.484); HOS–Sport-Specific Subscale, 30.2 and 31.3, respectively (P =.895); 12-item International Hip Outcome Tool score, 41.9 and 40.2, respectively (P =.564); and visual analog scale pain score, –40.9 mm and –34.5 mm, respectively (P =.791). Additionally, no statistically significant difference in patient satisfaction at 2-year follow-up was found between patients who underwent interportal capsulotomy and those who underwent periportal capsulotomy (P =.604). Conclusions: At 2-year follow-up, patients who underwent a periportal capsulotomy reported statistically and clinically significant improvements in PROs and satisfaction with the surgical intervention. This study confirms that the use of a simple clinical algorithm for selection of periportal capsulotomy or interportal capsulotomy with closure results in acceptable management decisions as defined by 2-year PROs. Level of Evidence: Level III, retrospective cohort study.
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U2 - 10.1016/j.arthro.2020.08.004
DO - 10.1016/j.arthro.2020.08.004
M3 - Article
C2 - 32798668
AN - SCOPUS:85097103976
SN - 0749-8063
VL - 37
SP - 86
EP - 94
JO - Arthroscopy - Journal of Arthroscopic and Related Surgery
JF - Arthroscopy - Journal of Arthroscopic and Related Surgery
IS - 1
ER -