Hip Arthroscopists Consistently Use Capsular Closure With Preference for Interportal Capsulotomy

Purpose To examine recent trends of capsular management in hip arthroscopy over a 5‐year period (2018‐2023), both within the United States and internationally utilizing a repeated, international, cross‐sectional survey. Methods A repeated cross‐sectional survey was distributed via Qualtrics to a cohort of surgeons identified through a PubMed search of hip arthroscopy publications. The survey was administered in 2018, 2020, and 2023, with additional distribution through the American Orthopaedic Society for Sports Medicine listserv in later years. The 29‐question survey assessed surgical experience, capsular management techniques, postoperative protocols, and complications. Responses were analyzed for trends over time. Results A total of 74, 78, and 83 surgeons completed the survey in 2018, 2020, and 2023, respectively. Interportal capsulotomy was the most commonly used technique across all time points. Capsular closure was performed in the majority of cases, with 50% of surgeons reporting always performing closure in 2018 and 2020, increasing to 67% in 2023. T‐capsulotomy was the second most utilized technique, with ≥75% of surgeons who used it reporting always performing capsular closure. Of 52 reported postoperative dislocations, 27 (52%) occurred in cases where capsular closure was performed. Conclusions Interportal capsulotomy remains the preferred technique for joint access during hip arthroscopy, with consistent use across the 5‐year study period. Capsular closure was routinely performed regardless of capsulotomy type, and although survey responses suggested a trend toward more consistent closure practices, no statistically significant change in closure frequency was observed. Surgeons performing T‐capsulotomy were more likely to report routine closure than those using interportal capsulotomy. Clinical Relevance Understanding evolving trends in capsular management provides insight into current surgical practices and may inform future guidelines in hip preservation surgery.