Purpose
To describe patient outcomes 3 to 5 years after arthroscopic hip capsule reconstruction.
Methods
Between January 2007 and December 2016, patients aged 18 to 50 years who underwent
arthroscopic hip capsular reconstruction using an Iliotibial band allograft by the
senior author and had minimum of 3-year follow-up were identified. Patients were excluded
if they had previous open hip surgery, advanced osteoarthritis (Tönnis grade >2),
significant acetabular dysplasia (lateral center edge angle <20°), avascular necrosis,
or Legg–Calve–Perthes disease. Outcome scores including the Hip Outcome Score (HOS)-Activities
of Daily Living scale, modified Harris Hip Score, HOS-Sports scale, SF-12, and Western
Ontario & McMaster Universities Osteoarthritis Index were compared in addition to
failure rate, revision rate, and patient satisfaction rate with the outcome (range,
1-10). All patients were assessed by the senior author pre- and postoperatively.
Results
Thirty-nine patients met the inclusion criteria. The mean age of the cohort was 32
± 10 years, with 6 male and 33 female patients. The average number of previous hip
arthroscopy surgeries was 2 ± 1. Six patients (15%) converted to total hip arthroplasty
at an average of 2.1 years (range 7 months to 6 years) following capsular reconstruction.
Four patients required revision hip arthroscopy after the arthroscopic capsular reconstruction.
All arthroscopic revisions occurred in female patients with the primary intraoperative
finding of capsulolabral adhesions at the time of revision. At mean follow-up of 4.3
years (range 3-6.8 years), the 29 patients who did not require subsequent surgery
had significant improvements from preoperatively to postoperatively in HOS-Activities
of Daily Living and HOS-Sport with 90% reaching minimal clinically important difference.
All other scores showed significant improvement. Survival for patients not requiring
total hip arthroplasty was 86% at 3 years, with a mean survival of 5.7 years (95%
confidence interval 4.97-6.4).
Conclusions
Arthroscopic hip capsular reconstruction with iliotibial band allograft is a successful
treatment option for patients with symptomatic capsular defects, demonstrating improved
patient-reported outcomes maintained at mean follow-up time of 4 years. This technique
offers restoration of the anatomic structure and function of the capsular ligaments
to improve pain and instability.
Level of Evidence
IV, case series.
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Article info
Publication history
Published online: January 02, 2022
Accepted:
December 21,
2021
Received:
June 16,
2021
Footnotes
The authors report the following potential conflicts of interest or sources of funding: M.J.P. reports grants and personal fees from Smith & Nephew, other from Arthrosurface, other from MJP Innovations, LLC, other from MIS, grants from Ossur, grants and personal fees from Siemens, other from Bledsoe, other from ConMed Linvatec, other from DonJoy, other from Slack, other from Elsevier, other from Vail Valley Surgery Center, other from EffRX, other from Vail MSO Holdings LLC, and other from Synthes GMBH, outside the submitted work. Full ICMJE author disclosure forms are available for this article online, as supplementary material.
Research performed at The Steadman Philippon Research Institute, Vail, Colorado, U.S.A.
Identification
Copyright
© 2021 by the Arthroscopy Association of North America
