Periportal Capsulotomy Shows Promising Short-Term Outcomes Compared With an Interportal Capsulotomy for the Treatment of Femoroacetabular Impingement Syndrome in Borderline and Dysplastic Female Patients.

PURPOSE: To compare patient-reported outcomes (PROs) and revision rates between borderline and dysplastic women who underwent an interportal capsulotomy approach versus a capsular sparing periportal capsulotomy approach for the treatment of femoroacetabular impingement syndrome.

METHODS

Female patients with a lateral center edge angle ≤25° who underwent a primary hip arthroscopy with complete capsular closure for the treatment of femoroacetabular impingement syndrome from a single surgeon's database between 2020 and 2022 were retrospectively reviewed. Patients were excluded if they were ≤17 years of age, had a Tönnis grade ≥2, and required a revision hip procedure 2 years after their initial hip arthroscopy but before their PRO collection date. Patients were contacted at a minimum of 2 years postoperatively to complete PRO questionnaires including Visual Analog Scale for pain, single assessment numeric evaluation, and PRO information system-physical function scores. Categorical variables were compared using χ2 and Fisher exact tests, whereas continuous variables were compared using 2-tailed independent t tests, Mann-Whitney U tests, or Welch's t tests. Minimal clinically important differences were also calculated for the various PROs.

RESULTS

Sixty-two patients (62 hips) were included (31 interportal, 31 periportal). No significant demographic or radiographic differences between capsulotomy groups were appreciated (P > .05). Time to follow-up was longer in the interportal group compared with the periportal group (3.9 ± 0.8 years vs 2.6 ± 0.6 years; P < .001). Mean improvements in PRO scores were greater in periportal patients compared with interportal patients with regard to single assessment numeric evaluation (34.7 ± 20.1 vs 15.4 ± 19.1; P = .001) and PRO information system-physical function (15.9 ± 9.4 vs 10.3 ± 9.3; P = .045) scores. Single assessment numeric evaluation minimal clinically important difference achievement rates were also higher for periportal patients (93% vs 71%; P = .032). Revision rate was lower in the periportal group, although not statistically significant (6.5% vs 23%; P = .15).

CONCLUSIONS

The periportal capsulotomy shows promising improvements in short-term PROs compared with an interportal approach in female patients with hip dysplasia undergoing primary hip arthroscopy for femoroacetabular impingement syndrome.

LEVEL OF EVIDENCE: Level III, retrospective comparative study.