FP4.11 A randomized controlled trial comparing capsular closure versus no capsular closure in hip arthroscopy for patients with cam- or mixed-type femoroacetabular impingement

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Abstract Purpose: The aim of this study was to compare the 2-year clinical outcomes of primary hip arthroscopy with capsular closure versus without capsular closure after interportal capsulotomy in patients with cam- or mixed-type femoroacetabular impingement (FAI). Methods: Patients with cam- or mixed-type FAI undergoing primary hip arthroscopy with interportal capsulotomy were included in this randomized controlled trial (RCT). They were randomly assigned to either a capsular closure group or a no capsular closure group. Patients were blinded to group allocation. Clinical outcomes were assessed preoperatively and at 2-year follow-up using the 12-item International Hip Outcome Tool (iHOT-12), modified Harris Hip Score (mHHS), and 6 subsections of the Copenhagen Hip and Groin Outcome Score (HAGOS). Any complications and reoperations were documented. Results: Eighty-four patients (100 hips) were included in the study, with 49 hips in the capsular closure group and 51 hips in the no capsular closure group. There were no significant differences in age (28.5 ±7.5 vs 30.4 ±8.4, P= 0.261), body mass index (23.5 ±3.0 vs 23.4 ±1.9, P= 0.665), and sex distribution (female: 10.2% vs 13.7%, P= 0.760) between the groups. Four patients were lost to follow-up (2.0% vs 5.9%, P= 0.618) and 6 underwent reoperations (6.1% vs 5.9%, P= 1.000), resulting in 45 hips per group for clinical assessment. There were no significant differences between groups in the net change of iHOT-12 (28.3 ±19.6 vs 32.5 ±22.7, P= 0.388), mHHS (7.6 ±13.1 vs 7.5 ±10.2, P= 0.954), and subsections of HAGOS (P > 0.05). Complication rates were also similar between groups (P > 0.05). Conclusion: The present RCT compared primary hip arthroscopy with capsular closure versus without capsular closure after interportal capsulotomy in a male-dominated, nondysplastic, nonarthritic cohort with cam- or mixed-type FAI and found no significant differences in patient-reported clinical outcomes, complication rates, or reoperation rates.

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