Interportal and T‐Capsulotomy Yield Similar Short‐Term Outcomes After Hip Arthroscopy With Capsular Repair

PURPOSE: To compare clinical outcomes following hip arthroscopy for femoroacetabular impingement syndrome using either limited interportal (IP) or T-capsulotomy (TC) technique, with routine capsular closure. METHODS: This retrospective cohort study included patients ≤50 years old who underwent primary hip arthroscopy for femoroacetabular impingement syndrome between May 2021 and January 2024 with a minimum of 12-month follow-up. Patients were treated with either IP or TC, and all underwent standardized capsular repair. Patient-reported outcomes (PROs) were collected preoperatively and at final follow-up. Cohort-specific minimum clinically important difference thresholds were calculated for each PROs and compared between groups. Improvements in scores were compared with established thresholds for the patient acceptable symptomatic state (PASS). Statistical significance was set at P < .05. RESULTS: A total of 116 patients met the inclusion criteria (54 IP, 62 TC; mean age 34.5 ± 8.8 years; 55% female). Mean follow-up was 15.5 ± 5.4 months. Both groups showed significant improvements in all PROs. Although mean improvements were not statistically different, the interportal group showed consistently higher average postoperative scores. Cohort-specific minimum clinically important difference thresholds were achieved at similar rates in both groups, whereas exploratory analyses using previously published PASS thresholds showed higher PASS achievement in the interportal group for International Hip Outcomes Tool (76% vs 54%) and Patient Reported Outcome Measurement Information System Physical Function (58% vs 46%). No revisions or Clavien-Dindo grade ≥2 complications occurred in either group. CONCLUSIONS: Both IP and TC techniques led to significant improvements in PROs following hip arthroscopy with capsular repair, with similar rates of cohort-specific minimum clinically important difference achievement and no differences in revision surgery or major complications. Exploratory analyses showed higher PASS rates for International Hip Outcomes Tool and Patient Reported Outcome Measurement Information System Physical Function in the IP group, suggesting that a more limited capsulotomy may confer functional advantages. LEVEL OF EVIDENCE: Level III, retrospective comparative case series.