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FP6.7 Capsulolabral Adhesion Formation After Hip Arthroscopy is Associated with Increased Femoral Anteversion: A Case-Control Study
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FP6.7 Capsulolabral Adhesion Formation After Hip Arthroscopy is Associated with Increased Femoral Anteversion: A Case-Control Study

Steven Leary, Alex Demers, Steele McCulley, Richard Van Tienderen, Courtney Seffker, Jonathan Dawkins and Robert Westermann
Journal of hip preservation surgery, Vol.12(Supplement_2), pp.ii11-ii11
12/01/2025
DOI: 10.1093/jhps/hnaf069.032
PMCID: PMC12720804
url
https://doi.org/10.1093/jhps/hnaf069.032View
Published (Version of record) Open Access

Abstract

Background Capsulolabral adhesions commonly cause pain and biomechanical dysfunction following hip arthroscopy for femoral acetabular impingement (FAI) often necessitating revision for lysis of adhesions. Few studies have examined the pathophysiology and risk factors associated with adhesion formation. One proposed mechanism is that increased femoral anteversion leads to abutment of the anterior capsule on the labral repair and femoral neck. Purpose The primary aim of this study was to determine whether patients who required revision arthroscopy for lysis of adhesions had increased preoperative femoral anteversion compared to patients who did not require revision arthroscopy. Methods We performed a retrospective review to identify 25 patients requiring revision arthroscopy for lysis of adhesions following primary hip arthroscopy for FAI. Patient charts were queried for age, sex, and indication for revision. Patients were age- and sex-matched to 25 patients from our institution’s prospective hip arthroscopy database who did not require revision by 2 years postoperatively. Preoperative Interntational Hip Outcome Tool (iHOT) scores were recorded for each group and 1-year scores were recorded for controls. Femoral version was measured using preoperative computed tomography (CT) pelvis with rotational alignment sequences. Student’s t-test (α ≤ 0.05) was used for quantitative variables and chi-square for qualitative. Results In the adhesions cohort, we identified 19 females (76%) with a mean age of 22.52 ± 6.02 years. There was no difference in age (22.52 ± 6.02 years, p=1.0) or sex (19 female, 76%, p=1.0) for matched controls. There was also no difference in baseline iHOT scores (p=0.893) between the adhesions (32.03 ± 10.92) and control (32.60 ± 16.56) groups. The adhesions group had significantly higher preoperative femoral anteversion compared to matched controls (18.64 ± 9.46° vs 13.24 ± 6.65°; p=0.0238). Mean 1-year iHOT scores in the control cohort was 77.91 ± 24.79. Conclusion Patients requiring revision arthroscopy for lysis of adhesions had higher preoperative femoral anteversion compared to age- and sex-matched controls who did not undergo revision. Increased femoral anteversion may be a risk factor for adhesion development following primary hip arthroscopy. Further investigation for adhesion prevention (early circumduction, losartan, and continuous passive motion) in this population may be warranted.
 Adhesion

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