Arthroscopic Capsular Management of the Hip: A Comparison of Indications for and Clinical Outcomes of Periportal Versus Interportal Capsulotomy

Ryan P. McGovern, Gabriella Bucci, Beth A. Nickel, Henry B. Ellis, Joel E. Wells, John J. Christoforetti

Research output: Contribution to journalArticlepeer-review

4 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)86-94
Number of pages9
JournalArthroscopy - Journal of Arthroscopic and Related Surgery
Volume37
Issue number1
DOIs
StatePublished - Jan 2021

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine

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