Arthroscopy - 2026-04-24 - Journal Article
Hip Arthroscopy With Periportal Capsulotomy for Femoroacetabular Impingement Syndrome Shows Clinically Meaningful Outcomes Improvement at Midterm 5-Year Follow-Up.
Chen KY, Pepic L, Brumm ZG, Petrie KA, Sampson H, Zhang AL
Topics
Key Takeaway
Periportal capsulotomy without capsular closure for hip arthroscopy in FAIS achieved MCID in 94.0%, PASS in 86.7%, and SCB in 80.1% of patients at minimum 5-year follow-up with zero cases of hip instability.
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Summary
This study evaluated 5-year PRO outcomes in 161 patients undergoing primary hip arthroscopy for FAIS using periportal capsulotomy without capsular closure, excluding patients with clinical hypermobility. All PRO measures (mHHS, HOOS subscales, SF-12 PCS, VAS) improved significantly from baseline (all P<.001), with 96.9% achieving at least one CSO threshold. No cases of hip instability, revision arthroscopy, or conversion to THA were recorded.
Key Limitation
Absence of a control group with interportal capsulotomy and capsular closure makes it impossible to attribute outcomes or the zero-instability rate to the capsulotomy technique specifically rather than patient selection or surgeon volume.
Original Abstract
PURPOSE
To analyze minimum 5-year outcomes after arthroscopic treatment of femoroacetabular impingement syndrome (FAIS) utilizing the periportal capsulotomy technique for joint access without capsular closure.
METHODS
A retrospective review of a prospectively collected database of patients undergoing primary hip arthroscopy for FAIS without clinical signs of hypermobility was performed to analyze patients who underwent hip arthroscopy utilizing the periportal capsulotomy technique without capsule closure with minimum 5-year follow-up. Periportal capsulotomy was utilized for joint access, and arthroscopic labral treatment and osteochondroplasty were completed as indicated without capsular closure. Patient demographics, surgical details, and complications were recorded. Pre- and postoperatively, patients completed the modified Harris Hip Score, Hip Disability and Osteoarthritis Outcome Score (HOOS), 12-item Short-Form survey (SF-12 physical and mental components), and visual analog scale (VAS). Achievement of clinically significant outcomes (CSO) including minimal clinically important difference (MCID), patient acceptable symptom state (PASS), and substantial clinical benefit (SCB) was calculated.
RESULTS
One hundred and sixty-six hips from 161 patients (mean age, 34.1 ± 11.2; body mass index, 24.1 ± 3.6; 54% female) were included. There were no major postoperative complications including hip instability, revision arthroscopy, or conversion to total hip arthroplasty. Mean patient-reported outcome scores (PROs) were significantly improved from preoperative scores to 5-year postoperative scores (VAS, HOOS symptoms, pain, activities of daily life, sport, quality of life, and SF-12 physical component, all P < .001). Overall, 96.9% of patients achieved at least one of the CSO thresholds with 94.0% achieving MCID in at least one PROs, 86.7% meeting PASS in at least one PROs, and 80.1% achieving SCB in at least one PROs.
CONCLUSIONS
Patients undergoing arthroscopic FAIS treatment utilizing periportal capsulotomy for hip capsule management show high rates for CSO achievement at midterm 5-year follow-up.
LEVEL OF EVIDENCE
Level IV, retrospective therapeutic case series.