ROUTINE CAPSULAR REPAIR FOLLOWING ARTHROSCOPY FOR FEMOROACETABULAR IMPINGEMENT DID NOT RESULT IN SUPERIOR OUTCOMES WITH TEN-YEAR REVIEW

Capsular repair has become a routine component of the arthroscopic technique for many surgeons treating patients for FAI. While the protective function of the capsule in the context of optimising hip function has been demonstrated in biomechanical and cadaveric studies, the decision to perform routine repair is still very debatable. In particular, evidence of long term outcomes of routine repair is limited. Cases undergoing primary hip arthroscopy for femoroacetabular impingement between January 2009 and October 2014 (n=1205) were considered for inclusion. Exclusion criteria included missing X-Rays (n= 120), Tonnis>1 (n=158), dysplasia (n=87), and those lost to follow up at 10 years (n=188). Cases were matched by sex and age (± 2 years) in a 1:1 ratio to cases undergoing hip arthroscopy without capsular repair. Survival (avoidance of Total Hip Replacement [THR]) were compared using Kaplan-Meier analysis. Revision rates were compared using a Chi Squared Analysis. Achievement of the Patient Acceptable Symptom State (PASS) as determined by an anchor question was compared using Chi Squared analysis. 229 Repair cases were matched to 229 cases with No Repair. The average age of both groups was 30 ± 9 years. 79.9% of both groups had a Tonnis grade of 0. The average alpha angle for the No Repair group was 64 ± 18 and 62 ± 19 in the Repair Group (p=0.054), while the LCEA for the No Repair Group was 34 ± 6 and 35 ± 7 in the Repair Group (p=0.122). There were 12 (5.2%) THR conversions in the No Repair Group and 9 (3.9%) in the Repair Group and as such there was no difference in survival between groups (p=0.518). 23 cases (10%) in the No Repair group and 37 (16.2%) cases in the Repair group required a reoperation (p=0.054). 85% of the No Repair and 82% Repair Group achieved PASS (p=0.414). Routine capsular repair following arthroscopy for FAI did not result in superior outcomes with long -term follow up. Similar survival, reoperation rates & patient acceptable symptoms states were observed.