What did the study look at?
During hip arthroscopy the capsule surrounding the joint is cut to gain access (capsulotomy), and surgeons may differ in whether they close it at the end of the operation. This study aimed to identify surgeons' preferences for capsular management in hip arthroscopy for femoroacetabular impingement syndrome (FAIS) and the factors associated with them. It is a survey of surgeons, not a study of patients.
How was it done?
An anonymous, non-validated survey was distributed through the American Orthopaedic Society for Sports Medicine (AOSSM), the Arthroscopy Association of North America (AANA), the European Society of Sports Traumatology, Knee Surgery and Arthroscopy (ESSKA), the International Society for Hip Arthroscopy (ISHA) and the Turkish Society of Sports Traumatology, Arthroscopy and Knee Surgery (TUSYAD). The questions covered six areas: demographics, capsulotomy preference, traction stitches, capsular closure, postoperative rehabilitation and postoperative complications.
What did it find?
- The survey was completed by 157 surgeons.
- Surgeons who performed half or full T-shaped capsulotomies had 2.4 times higher odds of using traction stitches to hold the capsule (P = .024).
- Surgeons who believed there was sufficient evidence on the importance of capsular closure had 1.9 times higher odds of routinely closing the capsule completely (P = .044).
- Surgeons practising in the United States had 8.1 times higher odds of routinely closing the capsule than international surgeons (P < .001).
- Surgeons who had trained in hip arthroscopy during residency or fellowship had 2.4 times higher odds of closing the capsule completely than those without such exposure (P = .009).
The authors' conclusion
The authors conclude that capsular management preferences in hip arthroscopy are associated with geographic and surgeon-related factors. Surgeons performing T-capsulotomies use traction stitches more often. Those who routinely close the capsule are more likely to believe the practice is supported by sufficient evidence, and surgeons in the United States routinely close the capsule more often than their international colleagues. The authors expect capsular management to remain important for access, instrumentation and postoperative outcomes as hip preservation surgery develops.
Note: this article is based on the published abstract of the paper.
Reference
Kerzner B, Dasari SP, Khan ZA, Hevesi M, Ozbek EA, Fortier LM, Nho SJ, Gürsoy S, Chahla J. (2024). Capsular Management at the Time of Hip Arthroscopy for Femoroacetabular Impingement Syndrome Varies With Geography and Surgeon Subspecialty Training: A Cross-Sectional, Multinational Surgeon Survey. Arthroscopy, 40(11):2695-2703.e1. Licence: CC BY-NC-ND 4.0.
DOI: 10.1016/j.arthro.2024.02.016
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This article summarises a published scientific paper for general information; it does not replace an examination or a personal medical assessment. Please consult your doctor about your symptoms.
