ePoster #738 - ISHA Annual Scientific Meeting 2016

Outcomes Of Capsular Plication In Athletes Undergoing Hip Arthroscopy With Minimum Two Year Follow-Up

Itay Perets, MD, Westmont, IL UNITED STATES
Lyall Ashberg, MD, Westmont, IL UNITED STATES
Edwin Chaharbakhshi, BS, Hinsdale, IL UNITED STATES
John P. Walsh, MA, Westmont, IL UNITED STATES
Mary R. Close, BS, Westmont, IL UNITED STATES
Benjamin G. Domb, MD, Chicago, IL UNITED STATES

American Hip Institute, Westmont, IL, UNITED STATES

FDA Status Not Applicable

Summary: To our knowledge, this is the first study in the literature that reports on capsular plication indicated in competitive athletes; we reported favorable outcomes in regards to three PROs, VAS, and satisfaction at a minimum of two years postoperatively, indicating that capsular plication is a favorable treatment option for athletes.

Background: The hip capsule plays a functional role in stability by serving as a static stabilizer. Capsular plication is performed to treat patients with borderline dysplasia and/or ligamentous laxity in an attempt to treat hip microinstability. In athletes, the hip’s stabilizers play a more crucial role due to the extreme ranges of motion and high force applied to the joint during activity. Although hip arthroscopy has demonstrated favorable outcomes in athletes, there are no studies to our knowledge that report on the outcomes of capsular plication in this active patient population. Purpose: To report the minimum two year postoperative outcomes for athletes that underwent capsular plication during hip arthroscopy. Methods: Since 2008, data were prospectively collected on patients who underwent hip arthroscopy for the treatment of femoroacetabular impingement and/or labral tears. Inclusion criteria were as follows: athlete at the high school, collegiate, or professional levels preoperatively, underwent capsular plication, and preoperatively recorded patient-reported outcome (PRO) scores including modified Harris Hip Score (mHHS), Non-Arthritic Athletic Hip Score (NAHS), Hip Outcome Score – Sports Specific Subscale (HOS-SSS), and Visual Analog Scale (VAS). Exclusion criteria were as follows: < 16 years old, preoperative Tönnis grade > 1, and previous hip conditions. Sports activity and competitive levels were collected at a minimum of two years postoperatively. Results: 51 hips (49 patients) met the inclusion criteria, and 41 hips (39 patients) had minimum two year follow-up (80.4% follow-up). Mean mHHS increased from 67.1 preoperatively to 83.5 (p < 0.0001). Mean NAHS increased from 66.8 to 88.8 (p < 0.0001). Mean HOS-SSS improved from 46.8 to 80.1 (p < 0.0001). Mean VAS decreased from 5.1 to 1.7 (p < 0.0001). 35 (85.4%) hip arthroscopies allowed the patients to return to sports at follow-up. 34 (82.9%) hip arthroscopies allowed the patients to maintain their competitive physical abilities at follow-up. Conclusions: PROs and VAS in athletes significantly improved at a minimum of two years post-arthroscopic capsular plication. Additionally, most patients returned to sports at similar or higher competitive levels. These results suggest that capsular plication is a favorable treatment option in athletes that should be warranted when indicated.