FP13.8 Adhesive Capsulitis of the Hip: Clinical Characteristics, Treatment Outcomes, and Recovery Timeline

Abstract ICLB13 - Outside the Joint: Mastering Extra-Articular Pain and Hip-Spine Basics, Session Room 6 (BMCC Level 3), October 9, 2026, 14:00 - 16:00 Introduction Adhesive capsulitis of the hip (ACH), or “frozen hip,” is an uncommon and underrecognized cause of painful stiffness in non-arthritic hips. Existing literature consists primarily of small series, while recovery timelines and the proportion of patients successfully treated with and without surgery remain poorly defined. The purpose of this study was to characterize the clinical profile, imaging findings, treatment outcomes, and recovery timelines of patients with ACH. Methods An IRB–approved retrospective cohort study was performed at a tertiary hip-focused sports medicine practice between 2010 and 2025. ACH was diagnosed clinically after exclusion of alternative etiologies, including radiographic osteoarthritis. Demographics, comorbidities, symptom characteristics, range of motion (ROM), radiographic parameters, and magnetic resonance imaging (MRI) findings were recorded. All patients underwent standardized nonoperative management emphasizing capsular stretching and supervised physical therapy. Primary outcomes included clinical resolution, need for surgery, time to resolution, and changes in ROM. Results Forty-nine patients were included (mean age 40.9 ± 9.1 years; 83.7% female). Symptom onset was atraumatic in 79.6%, and 34.7% had an autoimmune or endocrine comorbidity; 14.3% had a history of frozen shoulder. At initial clinical presentations, when compared with the contralateral hip, affected hips demonstrated marked reductions in external rotation (22.1° vs 53.3°), internal rotation (16.6° vs 24.1°), flexion (119.0° vs 127.8°), and FABER height (18.6 cm vs 11.1 cm). MRI, obtained in 71.4%, demonstrated mean inferior capsular thickness of 3.4 ± 1.1 mm and labral tears in 85.7%. Forty patients (81.6%) achieved clinical resolution with nonoperative management at a mean of 8.3 ± 8.3 months. Nine patients (18.4%) underwent surgery after a mean of 11.1 ± 8.8 months; resolution occurred 6.8 ± 2.3 months postoperatively, with total time to resolution of 18.0 ± 10.9 months. Post-treatment improvements in the affected hip included increases of 17.8° in external rotation decrease in FABER height of −5.5 ± 3.4 cm. Conclusion ACH predominantly affects middle-aged women and is characterized by substantial ROM deficits. The majority of patients achieve durable resolution with nonoperative management within one year, while a minority require surgery but typically recover by approximately 18 months from presentation. These findings provide objective benchmarks for diagnosis, prognosis, and patient counseling in frozen hip.