EP8.72 Comparing 2-Year Outcomes Between Contemporary and Historical Cohorts Undergoing Surgery for Femoroacetabular Impingement Syndrome: Capsular Repair vs Non-Repair
Abstract
Abstract Purpose Femoroacetabular impingement syndrome (FAIS) is a leading cause of hip pain and functional impairment, especially in young active individuals. While capsular repair during hip arthroscopy has become more routine and studies have associated it with improved outcomes, further research is needed to fully understand the impact of capsular repair on functional outcomes. Therefore, the objective of this study is to compare 2-year outcomes between cohorts undergoing hip arthroscopy for femoroacetabular impingement syndrome (FAIS) with capsular repair (2022-2023) versus without capsular repair (2012-2013). Methods A retrospective analysis was performed on 96 propensity-matched patients who underwent hip arthroscopy by a single surgeon at an urban academic center. Patient-reported outcomes (PROs) including the modified Harris Hip Score (mHHS) and Non-Arthritic Hip Score (NAHS) were collected preoperatively and at 2 years postoperatively. Radiographic measurements including alpha angle and lateral center-edge angle were also assessed. Results Both historical (without capsular repair) and contemporary (capsular repair) cohorts demonstrated similar absolute PRO scores at 2 years, with no significant differences in NAHS (88.4 ± 16.0 vs 81.9 ± 21.3, p = 0.091) or mHHS (87.8 ± 15.0 vs 82.8 ± 19.1, p = 0.165). The historical cohort showed greater improvements in both scores (NAHS: 36.5 ± 14.3 vs 11.5 ± 14.4, p < 0.001; mHHS: 37.4 ± 17.2 vs 8.3 ± 14.6, p < 0.001) due to lower baseline function. The contemporary cohort demonstrated greater radiographic correction of alpha angle on AP and 45° Dunn views (Δ -6.8° ± 9.0° vs Δ -2.5° ± 5.5°, p = 0.007; Δ -5.7° ± 6.9° vs Δ -3.1° ± 5.3°, p = 0.038). Approximately two-thirds of patients in both cohorts achieved the Patient Acceptable Symptom State threshold. Conclusion Despite differences in capsular management, both cohorts achieved comparable 2-year functional outcomes. Smaller improvements in the contemporary cohort reflect higher baseline function rather than diminished surgical efficacy. These findings suggest capsular repair benefits may relate more to long-term durability than short-term outcomes in higher-functioning patients.