- 2026-02
- Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association 42(2)
Study Design
- Type
- Meta-Analysis
- Population
- patients undergoing hip arthroscopy with interportal capsulotomy for femoroacetabular impingement
- Methods
- systematic review and meta-analysis of randomized controlled trials comparing outcomes of interportal capsulotomy with and without hip capsule repair
- Duration
- 2-year follow-up
Purpose
To evaluate whether capsule repair after hip arthroscopy with interportal capsulotomy influences 2-year postoperative clinical outcomes.Methods
A systematic review and meta-analysis of randomized controlled trials comparing outcomes of interportal capsulotomy with and without hip capsule repair in femoroacetabular impingement patients was conducted. The outcomes included modified Harris Hip Score, Hip Outcome Score-Activities of Daily Living, Hip Outcome Score-Sport Specific Subscale, Numerical Rating Scale pain score, Copenhagen Hip and Groin Outcome Score, 12-item International Hip Outcome Tool, Veterans RAND 12-Item Health Survey, and revision rate. Studies with significant differences in preoperative scores between the repair and no repair groups were excluded from the meta-analysis.Results
After the removal of duplicates, 966 studies remained. 56 studies met inclusion criteria. Three randomized controlled trials comprising 256 hips met criteria and were included finally after exclusion. Among these, 127 hips underwent capsule repair and 129 did not. The meta-analysis showed that the outcome measures including modified Harris Hip Score (mean difference = 0.98; 95 confidence interval [-2.77, 4.74]; I2 = 0%; P = .61) and revision rate (mean difference = 0.98; 95% confidence interval [-2.77, 4.74]; I2 = 0%; P = .61) did not significantly differ between the groups. One study reported the proportion of patients that met minimal clinically important difference and patient acceptable symptom state for modified Harris Hip Score. One study reported the proportion of patients met patient acceptable symptom state for Hip Outcome Score-Activities of Daily Living and 12-Item International Hip Outcome Tool.Conclusions
When interportal capsulotomy was applied in hip arthroscopy, capsular repair did not show consistent superiority over nonrepair in femoroacetabular impingement patients at 2-year follow-up. No significant differences were observed in the modified Harris Hip Score and revision rates. Routine capsular closure cannot be universally recommended for interportal capsulotomy.Level of evidence
Level II, systematic review and meta-analysis of Level I and II studies.