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
Benjamin T. Johnson, Allan K. Metz, Zoe D. Trutner, Charles L. Holliday, Keaton Andra, Collin D. R. Hunter, Stephen K. AokiPurpose
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 χ 2 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.