Arthroscopy: The Journal of Arthroscopic & Related Surgery
Systematic ReviewCapsular Repair May Improve Outcomes in Patients Undergoing Hip Arthroscopy for Femoroacetabular Impingement: A Systematic Review of Comparative Outcome Studies
Section snippets
Study Identification and Search Strategy
This study used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist to find the articles by using PubMed and Embase. Two orthopedic surgeon reviewers (AEJ, BRS) performed the search and data extraction through August 1, 2020, and came to a consensus about the eligibility of relevant studies. Differences regarding study inclusion were settled by discussion. Reference lists from relevant articles were retrieved to identify additional studies. The following
Study Identification
After our initial search in PubMed and Embase with the selected keywords, we identified 1,452 studies (Fig 1). After removing review articles, duplicates, technique reports, case reports, and opinion articles, we obtained 972 total articles. We then evaluated abstracts and removed studies that were irrelevant based on our inclusion criteria. We identified 66 articles for full-text review. An additional 50 studies were excluded leaving 16 studies (Fig 1).
Study Quality
There were 11 Level III studies, 3 Level
Discussion
The main finding of this review was that capsular repair is safe and effective in patients without arthritis who are undergoing hip arthroscopy, and it may result in superior patient-reported outcomes compared to unrepaired capsulotomy. The results of this systematic review aligned with previous studies. Of the 10 comparative outcome studies that evaluated PROs between capsular repair and unrepaired capsulotomies, 8 found more favorable results in the capsular repair groups. There was
Conclusions
Midterm outcome studies suggest that capsular repair is safe and effective in patients without arthritis who are undergoing hip arthroscopy and may result in superior patient-reported outcomes compared with unrepaired capsulotomy. Studies consistently demonstrated similar or superior outcomes in the capsular repair cohorts compared to groups with unrepaired capsulotomy, and no studies reported superior results with unrepaired capsulotomies.
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Cited by (0)
The authors report that they have no conflicts of interest in the authorship and publication of this article. Full ICMJE author disclosure forms are available for this article online, as supplementary material.
Dr. Domb reports grants and other from American Orthopedic Foundation, during the conduct of the study; personal fees from Amplitude, grants, personal fees and non-financial support from Arthrex, personal fees and non-financial support from DJO Global, grants, personal fees and non-financial support from Medacta, grants, personal fees, non-financial support and other from Stryker, grants from Breg, personal fees from Orthomerica, grants and non-financial support from Medwest Associates, grants from ATI Physical Therapy, personal fees and non-financial support from St. Alexius Medical Center, grants from Ossur, non-financial support from Zimmer Biomet, outside the submitted work; In addition, Dr. Domb has a patent 8920497-Method and instrumentation for acetabular labrum reconstruction with royalties paid to Arthrex, a patent 8708941-Adjustable multi-component hip orthosis with royalties paid to Orthomerica and DJO Global, and a patent 9737292-Knotless suture anchors and methods of tissue repair with royalties paid to Arthrex and Dr. Domb is a board member of American Hip Institute Research Foundation, AANA Learning Center Committee, the Journal of Hip Preservation Surgery, the Journal of Arthroscopy; has had ownership interests in the American Hip Institute, Hinsdale Orthopedic Associates, Hinsdale Orthopedic Imaging, SCD#3, North Shore Surgical Suites, and Munster Specialty Surgery Center. Dr. Lall reports grants, personal fees and non-financial support from Arthrex, non-financial support from Iroko, non-financial support from Medwest, non-financial support from Smith & Nephew, grants and non-financial support from Stryker, non-financial support from Vericel, non-financial support from Zimmer Biomet, personal fees from Graymont Medical, outside the submitted work; and Dr. Lall is the Co-Medical Director of Hip Preservation at St. Alexius Medical Center, the Clinical Instructor at the University of Illinois College of Medicine, and member of the AANA Learning Center Committee. Dr. Maldonado reports non-financial support from Arthrex, non-financial support from Stryker, non-financial support from Smith & Nephew, non-financial support from Ossur, outside the submitted work; and Dr. Maldonado is an editorial board member of the Journal of Arthroscopy. Dr. Saks reports grants from Arthrex, personal fees from DJO Global, outside the submitted work. Dr. Shapira reports non-financial support from Arthrex, non-financial support from Stryker, non-financial support from Smith & Nephew, non-financial support from Ossur, outside the submitted work.