Interportal and T-capsulotomy gave comparable results at two years in hip arthroscopy

Design

Propensity-score-matched retrospective cohort, level 3 evidence

Population

52 interportal and 206 T-capsulotomy hip arthroscopy patients with at least 2 years follow-up

Primary outcome

Patient-reported outcomes, MCID, PASS, SCB and reoperation-free survival

Effect

MCID 93.5% vs 92.8%; SCB 78.4% vs 77.5%; reoperation-free survival 98% vs 98% (P = .81)

A propensity-score-matched cohort compared interportal capsulotomy (52 patients) with T-capsulotomy (206 patients, matched 1:4 by age, sex and BMI) in hip arthroscopy from late 2020 to late 2022, with at least two years of follow-up. Mean age was 32.7 years and 85.3% were women. All patients had capsular closure.

There were no differences in postoperative patient-reported outcomes (all p of 0.10 or more). Achievement of the minimal clinically important difference was 93.5% with interportal and 92.8% with T-type capsulotomy, and substantial clinical benefit 78.4% against 77.5%. Reoperation-free survivorship was 98% in both groups. Pain interference fell more in the interportal group (-15.8 against -11.8, p = 0.03), but the groups differed at baseline and no other outcome differed.

The interportal group was small and the study retrospective, level 3 evidence. It suggests that when capsular closure is done, the smaller incision is a reasonable choice for surgeons who do not need the extra exposure of a T-capsulotomy.

• Patient-reported outcomes were similar at 2 years with either technique.
• MCID was reached in about 93% of both groups.
• Reoperation-free survival was 98% in both groups.
• Both groups had capsular closure, so this does not apply to unrepaired capsules.
• Choose by the exposure you need; this study does not favour either.

Why it matters

It lowers the pressure to make larger capsular incisions routine on the assumption that they do better.

Don't overread it

The interportal group had 52 patients and all had closure, so the study cannot compare techniques without repair.

The statistics, in plain English

No significant difference in a modest matched cohort does not prove equivalence, but the percentages are close in every measure. The one significant finding, pain interference, could reflect higher baseline pain in the interportal group (63.1 against 61.0) and is one of many comparisons.

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