FP9.2 Identifying risk factors for adhesion formation in the hip following primary arthroscopy: a case-control study

Abstract ICLB09 - The Revision Playbook: Advanced Execution and Technical Rescues in Failed Preservation, Session Room 6 (BMCC Level 3), October 9, 2026, 10:30 - 12:30 Background Although primary hip arthroscopy has a high rate of successful outcomes, there is some risk of postoperative complications requiring revision arthroscopy. The mechanism of capsulo-labral adhesion formation, a common complication, is not well understood despite the increasing prevalence of lysis of adhesions procedures during revision arthroscopy. This case-control study sought to identify risk factors for adhesion formation in the hip following primary arthroscopy. Methods A single institution retrospective review of patients who underwent revision hip arthroscopy and a group of patients who underwent primary hip arthroscopy only was conducted from 2013-2024. Demographic, preoperative, intraoperative, and postoperative data from primary and revision arthroscopy was collected. Data from hips with intraoperatively confirmed adhesions during revision arthroscopy were compared to primary arthroscopy only group data. Descriptive statistics are reported as mean ± standard deviation for continuous variables and percentages for categorical variables. Between-group comparisons were performed using ANOVA for continuous variables and chi-square tests for categorical variables. Significance was set to p <0.05. Results A total of 210 hips (179 patients) underwent revision arthroscopy. Adhesions were identified and lysed in 158 hips (75.2%) during revision surgery; 52 hips (24.8%) had no adhesions. The primary arthroscopy only group consisted of 132 hips that had not undergone revision arthroscopy. There were no statistically significant differences between the adhesion cohort and primary arthroscopy only cohort demographics: sex (77% female vs. 72% female, p = 0.4), age (30.8 vs. 32.2, p = 0.2), BMI (24.5±4.9 vs. 25.0±5.00, p =0.5), smoking history (20% vs. 18%, p > 0.9). Additionally, there were no significant between-group differences in number of labral anchors used during primary arthroscopy, rates of cam lesions present during primary arthroscopy, rates of labral repair or reconstruction, or rates of concomitant peri-acetabular osteotomy with primary arthroscopy. The adhesion group and primary arthroscopy only group differed significantly in rates of microfracture during primary arthroscopy (37% vs. 19%, p = 0.002) and losartan use postoperatively after primary arthroscopy (20% vs. 33%, p = 0.020). Conclusions Microfracture during hip arthroscopy may be associated with increased risk for adhesion formation, while losartan use postoperatively may be associated with decreased risk.