Hip arthroscopy with comprehensive capsular closure following longitudinal outside-in capsulotomy showed improved clinical outcomes in symptomatic borderline hip dysplasia: A retrospective study with minimum 2-year follow-up

IF 3.7 Q1 ORTHOPEDICS

Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine Pub Date : 2026-12-01 Epub Date: 2026-10-20 DOI:10.1016/j.jisako.2026.101226

Shiyu Sha MM, Yi Liu MD, Haoling Li MM, Linyi Shen MM, Weixing Li MM, Wenguang Liu MD, Hongyun Li PhD, Qingfeng Yin MD

{"title":"Hip arthroscopy with comprehensive capsular closure following longitudinal outside-in capsulotomy showed improved clinical outcomes in symptomatic borderline hip dysplasia: A retrospective study with minimum 2-year follow-up","authors":"Shiyu Sha MM, Yi Liu MD, Haoling Li MM, Linyi Shen MM, Weixing Li MM, Wenguang Liu MD, Hongyun Li PhD, Qingfeng Yin MD","doi":"10.1016/j.jisako.2026.101226","DOIUrl":null,"url":null,"abstract":"<div><h3>Purpose</h3><div>To introduce the comprehensive capsular closure technique following longitudinal outside-in capsulotomy (LOIC) and to evaluate its clinical outcomes in patients with symptomatic borderline hip dysplasia (BHD) at a minimum 2-year follow-up period.</div></div><div><h3>Methods</h3><div>This retrospective study included patients (aged 18–60 years) with symptomatic BHD who underwent primary hip arthroscopy for labral tears using LOIC and the comprehensive capsular closure technique between January 2020 and June 2023. The comprehensive capsular closure technique includes proximal capsular augmentation with the indirect head of the rectus femoris, anatomical repair of the zona orbicularis, and mid-capsular plication. Outcomes were assessed using the 12-item International Hip Outcome Tool (iHOT-12), visual analog scale (VAS) for pain, and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Achievement rates for the minimal clinically important difference (MCID) and patient acceptable symptom status (PASS) were analyzed.</div></div><div><h3>Results</h3><div>Thirty-six patients (36 hips) were included with a mean age of 37.5 ± 11.0 years and a mean follow-up of 3.7 ± 1.0 years. Intraoperatively, femoral head cartilage degeneration was observed in 63.9% of cases, and ligamentum teres tears in 77.8%. The median thickness of the middle part of the anterior capsule was 5 mm measured under arthroscopy. Improvements in iHOT-12 (45.2 ± 7.8 vs 79.5 ± 7.0), VAS (3.7 ± 1.0 vs 1.4 ± 0.8) and WOMAC (18.3 ± 8.4 vs 9.1 ± 3.7) were observed from preoperative to final follow-up (all <em>p</em> < 0.001). MCID achievement rates were 100% for iHOT-12, 91.7% for VAS, and 72.2% for WOMAC. PASS achievement rates were 88.9% for iHOT-12, 80.6% for VAS, and 58.3% for WOMAC. No severe complications occurred.</div></div><div><h3>Conclusions</h3><div>Hip arthroscopy with comprehensive capsular closure following LOIC may represent a safe and effective technique for treating symptomatic BHD patients, with favorable clinical outcomes expected in the short- to mid-term follow-up.</div></div><div><h3>Level of evidence</h3><div>Level IV, retrospective case series.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"21 ","pages":"Article 101226"},"PeriodicalIF":3.7000,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2059775426001628","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2026/10/20 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"ORTHOPEDICS","Score":null,"Total":0}

引用次数: 0

Abstract

Purpose

To introduce the comprehensive capsular closure technique following longitudinal outside-in capsulotomy (LOIC) and to evaluate its clinical outcomes in patients with symptomatic borderline hip dysplasia (BHD) at a minimum 2-year follow-up period.

Methods

This retrospective study included patients (aged 18–60 years) with symptomatic BHD who underwent primary hip arthroscopy for labral tears using LOIC and the comprehensive capsular closure technique between January 2020 and June 2023. The comprehensive capsular closure technique includes proximal capsular augmentation with the indirect head of the rectus femoris, anatomical repair of the zona orbicularis, and mid-capsular plication. Outcomes were assessed using the 12-item International Hip Outcome Tool (iHOT-12), visual analog scale (VAS) for pain, and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Achievement rates for the minimal clinically important difference (MCID) and patient acceptable symptom status (PASS) were analyzed.

Results

Thirty-six patients (36 hips) were included with a mean age of 37.5 ± 11.0 years and a mean follow-up of 3.7 ± 1.0 years. Intraoperatively, femoral head cartilage degeneration was observed in 63.9% of cases, and ligamentum teres tears in 77.8%. The median thickness of the middle part of the anterior capsule was 5 mm measured under arthroscopy. Improvements in iHOT-12 (45.2 ± 7.8 vs 79.5 ± 7.0), VAS (3.7 ± 1.0 vs 1.4 ± 0.8) and WOMAC (18.3 ± 8.4 vs 9.1 ± 3.7) were observed from preoperative to final follow-up (all p < 0.001). MCID achievement rates were 100% for iHOT-12, 91.7% for VAS, and 72.2% for WOMAC. PASS achievement rates were 88.9% for iHOT-12, 80.6% for VAS, and 58.3% for WOMAC. No severe complications occurred.

Conclusions

Hip arthroscopy with comprehensive capsular closure following LOIC may represent a safe and effective technique for treating symptomatic BHD patients, with favorable clinical outcomes expected in the short- to mid-term follow-up.

Level of evidence

Level IV, retrospective case series.

查看原文本刊更多论文

在纵向向外向内切开包膜后进行全面包膜关闭的髋关节镜检查显示，对有症状的边缘性髋关节发育不良患者的临床疗效有所改善：一项至少2年随访的回顾性研究。

目的：介绍纵向外-内囊切开术（LOIC）后的综合囊膜闭合技术，并在至少2年的随访期中评估其对有症状的边缘性髋关节发育不良（BHD）患者的临床疗效。方法：本回顾性研究纳入了2020年1月至2023年6月期间使用LOIC和综合囊膜关闭技术进行初级髋关节镜检查的有症状BHD患者（年龄18-60岁）。全面的包膜闭合技术包括股骨直肌间接头近端包膜增强术、轮匝带解剖修复术和中端包膜应用术。使用12项国际髋关节结局工具（iHOT-12）、疼痛视觉模拟量表（VAS）和西安大略和麦克马斯特大学骨关节炎指数（WOMAC）评估结果。分析最小临床重要差异（MCID）和患者可接受症状状态（PASS）的完成率。结果：纳入36例患者（36髋），平均年龄37.5±11.0岁，平均随访3.7±1.0年。术中63.9%的患者出现股骨头软骨退变，77.8%的患者出现股骨头韧带撕裂。关节镜下测量前囊中部的中位厚度为5mm。iHOT-12评分（45.2±7.8 vs 79.5±7.0）、VAS评分（3.7±1.0 vs 1.4±0.8）和WOMAC评分（18.3±8.4 vs 9.1±3.7）从术前到最终随访均有改善（均p < 0.001）。MCID完成率iHOT-12为100%，VAS为91.7%，WOMAC为72.2%。iHOT-12的合格率为88.9%，VAS为80.6%，WOMAC为58.3%。无严重并发症发生。结论：LOIC术后全面闭合髋关节镜可能是一种安全有效的治疗有症状BHD患者的技术，在中短期随访中有望获得良好的临床结果。证据级别：四级，回顾性病例系列。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊