Early results of hip arthroscopy techniques using peripheral compartment first with periportal capsulotomy <i>versus</i> central compartment first with T-capsulotomy access

Abstract Central compartment (CC) first hip arthroscopy is the traditional method for accessing the hip arthroscopically. However, hip instability and iatrogenic damage have been associated with this hip arthroscopy approach. Recently, peripheral compartment (PC) first with limited periportal capsulotomies has been shown to be a safe and effective method while maintaining capsular integrity. The purpose of this study was to assess whether there is a difference in early patient outcomes and surgical components between the CC first approach with capsulotomy and capsule repair versus the PC first approach with periportal access for the arthroscopic treatment of femoroacetabular impingement and labral pathology. We retrospectively reviewed 45 patients who underwent CC first approach (control group) and 57 patients who underwent PC first approach (study group). Significant improvement in average subjective hip value and modified Harris Hip Score values were seen in the study group 3 months postoperatively (94.28 ± 5.28, 69.56 ± 6.29) compared to the control group (88.24 ± 9.58, P = .001; 65.96 ± 4.81, P = .002) respectively, but pain scores were not significantly different at 3 months postoperatively. Average traction and surgical times were significantly lower in the study group (38.26 ± 6.15 min, 106.02 min ± 24.42) versus the control group (48.16 ± 10.52 min, P &amp;lt; .001; 134.89 min ± 29.13, P &amp;lt; .001), respectively. The PC first approach is associated with significant improvements in surgical time, traction time, and early patient reported outcome scores when compared to the CC first approach, although follow up time was limited to 3 months.