Journal article
Does Closure of the Capsule Impact Outcomes in Hip Arthroscopy? A Systematic Review of Comparative Studies
The Iowa orthopaedic journal, Vol.38, pp.93-99
2018
PMCID: PMC6047380
PMID: 30104930
Appears in Diamond Open Access
Abstract
Introduction: Arthroscopic management of the hip capsule has become a topic of debate in recent literature. Few comparative studies exist to help establish clear treatment recommendations.
Methods: Utilizing the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a systematic review of the literature was conducted using PubMed, CINAHL, EMBASE, sportDiscus (EBSCO) and Cochrane Central Register of Controlled Trials databases by two independent investigators. Comparative studies evaluating outcomes after two or more distinct treatment approaches to capsule management were included.
Results: The review yielded 7 articles that met inclusion criteria. Outcomes included in the review include patient reported outcome measures (mHHS, HOS, NASH) in 5 articles, return to sport in 1 article, and formation of postoperative heterotopic ossification (HO) in 1 article. In two articles evaluating the outcomes of revision hip arthroscopy, plication was associated with > 10 point improvements in HOS-ADL and mHHS scores when compared to no plication. The literature is inconclusive regarding routine hip capsule closure in primary arthroscopy, with one study supporting the practice, and one study showing no difference; capsular closure may help accelerate return to sports and improve outcomes while decreasing revisions in cases of borderline dysplasia. Closure does not influence HO rates after surgery.
Conclusion: There is insufficient evidence in the present literature to suggest routine closure of inter-portal capsulotomies after primary hip arthroscopy impacts patient outcomes. Capsular closure or plication should be given strong consideration in revision cases. Complete closure or plication may influence outcomes in patients with borderline dysplasia, for athletes wishing to return to sport, and in cases of extensile capsulotomies, although the data are inconclusive. Prospective, high level studies are indicated to create evidence-based treatment recommendations for capsular management in hip arthroscopy.
Details
- Title: Subtitle
- Does Closure of the Capsule Impact Outcomes in Hip Arthroscopy? A Systematic Review of Comparative Studies
- Creators
- Robert W Westermann - University of Iowa, Department of Orthopaedics, Iowa City, IAMatthew C Bessette - Cleveland Clinic Foundation Sports Health Center. 5555T. Sean Lynch - Columbia University, New York, NYJames Rosneck - Transportation Blvd. Garfield Heights, OH 44125
- Resource Type
- Journal article
- Publication Details
- The Iowa orthopaedic journal, Vol.38, pp.93-99
- Publisher
- Dept. of Orthopaedics, The University of Iowa; United States
- PMID
- 30104930
- PMCID
- PMC6047380
- ISSN
- 1541-5457
- eISSN
- 1555-1377
- Language
- English
- Date published
- 2018
- Academic Unit
- Orthopedics and Rehabilitation; Athletic Training Program
- Record Identifier
- 9984040476602771
Metrics
27 Record Views