Capsular management in the arthroscopic treatment of the femoro-acetabular impingement in athletes: our experience

Paolo Di Benedetto; Andrea Zangari; Francesco Mancuso; Michele Mario Buttironi; Araldo Causero

doi:10.23750/abm.v91i14-S.10988

Capsular management in the arthroscopic treatment of the femoro-acetabular impingement in athletes: our experience

Authors

Paolo Di Benedetto clinic of orthopaedics, University Hospital of Udine
Andrea Zangari Clinic of Orthopedics, Academic Hospital of Udine, Udine, Italy
Francesco Mancuso Clinic of Orthopedics, Academic Hospital of Udine, Udine, Italy
Michele Mario Buttironi Clinic of Orthopedics, Academic Hospital of Udine, Udine, Italy
Araldo Causero Clinic of Orthopedics, Academic Hospital of Udine, Udine, Italy Medical Department, Universitiy of Udine, Italy

DOI: https://doi.org/10.23750/abm.v91i14-S.10988

Keywords:

Hip arthroscopy, capsular suture, capsulotomy, femoral-acetabular impingement, athletes

Abstract

Background and aim of the work

In the last decade arthroscopic treatment of hip diseases has significantly spread and evolved and currently it represents the gold standard for the treatment of femoral-acetabular impingement in athletes. The function of the joint capsule has been better understood, opening a heated debate.

The aim of the present retrospective study is to assess the influence of different capsulotomy techniques and a possible capsular suture role on the patient's functional outcome in a cohort of patients with femoral-acetabular impingement arthroscopically treated.

Methods

36 patients (competitive athletes) treated with hip arthroscopy for femoral-acetabular impingement have been retrospectively enrolled during a period of two years (2016-2018). Patients have been divided into three equivalent groups, 12 without a suitable capsular management (T-Capsulotomy technique), 12 performing a Longitudinal Capsulotomy but without a final suture and 12 treated with a conservative Longitudinal Capsulotomy and a capsular suture. Patient’s post-operative functional outcome has been analysed using the modified Harris Hip Score (mHHS), the Hip Outcome Score-Activity of Daily Living (HOS-ADL) and the Hip Outcome Score-Sport Scale (HOS-SS). Return to sport.

Results

In our series there was no statistically significant difference in functional scores, however longitudinal capsulotomy seems to be associated with a higher percentage of return to sports activity (91,6% vs 75%).

Conclusions

The new longitudinal shape capsulotomy technique and a capsular suture with a single side-to-side stitch at the end of the procedure in athletes can positively influence the patient's functional outcome.

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