Orthopaedic journal of sports medicine · 2025
Extensive Capsule-Labrum Adhesion: A Potential Risk Factor for Continuous Symptom and Worse Patient-Reported Outcomes in Patients With Femoroacetabular Impingement Syndrome With Labrum Tear After Arthroscopy.
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Shen Lin-Yi, Sun Yang, Li Wei-Xing, Gao Zhao-Wen, Sun Li, Hu Yi-Wen, Chen Ji-Wu, Li Hong-Yun
Аннотация
BACKGROUND: Capsule-labrum adhesions are a common complication of hip arthroscopy surgery. However, their effects on patient outcomes are poorly understood.
PURPOSE: To examine the effect of capsular adhesions on outcomes in patients undergoing hip arthroscopy for treatment of femoroacetabular impingement with labrum tear.
STUDY DESIGN: Cross-sectional study; Level of evidence, 3.
METHODS: We retrospectively examined 65 adult patients (67 hips) with a diagnosis of femoroacetabular impingement syndrome (FAIS) with labral tear (LT) who underwent hip arthroscopy. All were followed for at least 2 years. Patients were divided into symptomatic and asymptomatic groups. All patients underwent physical examination and magnetic resonance imaging of the hip at the last follow-up. Patients were also divided into 3 groups based on capsule-labrum adhesion length to further explore the association between adhesions and patient-reported outcomes (PROs).
RESULTS: A total of 65 patients (67 hips) were analyzed, with 29 hips allocated to the symptomatic group and 38 to the asymptomatic group. The mean age was 44.39 years, and the mean follow-up time was 56 months. Patient characteristics were mostly similar between the 2 groups (P > .05). The only difference between the 2 groups was sex (P = .027). Symptomatic and asymptomatic patients experienced a high incidence of postoperative adhesions (86.84% vs 96.55%; P = .168). The length of adhesive layers was significantly higher in the symptomatic group (21.66 ± 10.52 mm vs 15.16 ± 9.88 mm; P = .012). With respect to capsule-labrum adhesion length, there was no notable discrepancy in postoperative PROs between patients with a length of <13 mm and those with a length between 13 and 23 mm. However, these groups had significantly higher PROs than the group with a capsule-labrum adhesion length of >23 mm. The length of adhesion was negatively correlated with the degree of external rotation postoperatively (ρ = -0.294, 95% CI -0.504 to -0.051) and the age at the time of surgery (ρ = -0.314; 95% CI -0.515 to -0.080).
CONCLUSION: Postoperative capsule-labrum adhesions were highly prevalent among patients treated with hip arthroscopy under interportal capsulotomy without capsular repair for FAIS with LT. In this cohort, more extensive capsule-labrum adhesions were associated with persistent symptoms and worse PROs.
PURPOSE: To examine the effect of capsular adhesions on outcomes in patients undergoing hip arthroscopy for treatment of femoroacetabular impingement with labrum tear.
STUDY DESIGN: Cross-sectional study; Level of evidence, 3.
METHODS: We retrospectively examined 65 adult patients (67 hips) with a diagnosis of femoroacetabular impingement syndrome (FAIS) with labral tear (LT) who underwent hip arthroscopy. All were followed for at least 2 years. Patients were divided into symptomatic and asymptomatic groups. All patients underwent physical examination and magnetic resonance imaging of the hip at the last follow-up. Patients were also divided into 3 groups based on capsule-labrum adhesion length to further explore the association between adhesions and patient-reported outcomes (PROs).
RESULTS: A total of 65 patients (67 hips) were analyzed, with 29 hips allocated to the symptomatic group and 38 to the asymptomatic group. The mean age was 44.39 years, and the mean follow-up time was 56 months. Patient characteristics were mostly similar between the 2 groups (P > .05). The only difference between the 2 groups was sex (P = .027). Symptomatic and asymptomatic patients experienced a high incidence of postoperative adhesions (86.84% vs 96.55%; P = .168). The length of adhesive layers was significantly higher in the symptomatic group (21.66 ± 10.52 mm vs 15.16 ± 9.88 mm; P = .012). With respect to capsule-labrum adhesion length, there was no notable discrepancy in postoperative PROs between patients with a length of <13 mm and those with a length between 13 and 23 mm. However, these groups had significantly higher PROs than the group with a capsule-labrum adhesion length of >23 mm. The length of adhesion was negatively correlated with the degree of external rotation postoperatively (ρ = -0.294, 95% CI -0.504 to -0.051) and the age at the time of surgery (ρ = -0.314; 95% CI -0.515 to -0.080).
CONCLUSION: Postoperative capsule-labrum adhesions were highly prevalent among patients treated with hip arthroscopy under interportal capsulotomy without capsular repair for FAIS with LT. In this cohort, more extensive capsule-labrum adhesions were associated with persistent symptoms and worse PROs.