EP3.28 A Cross-Sectional Analysis of Hip Arthroscopy Approaches and Capsular Management Among ISHA Members

Abstract Introduction Hip arthroscopy is a minimally invasive surgical procedure used to treat hip pathologies. Methods of accessing the hip joint include t-capsulotomy, interportal capsulotomy, and periportal (also known as puncture) capsulotomy. The purpose of this study is to quantify hip capsular management practices among ISHA members and evaluate operative metrics and outcomes. Methods A survey generator, Qualtrics, was used to generate a 36-question survey. The survey was emailed to ISHA members. The survey was active for 5 weeks, with two reminder emails at weeks 3 and 4. Chi-square and ANOVA were used for statistical analysis. Results The survey had a 25.13% response rate. Capsular management techniques utilized were interportal 40.8%, t-capsulotomy 31.3%, and periportal 20.4% (p < .001). The USA had 19.7% interportal, 17.0% t-capsulotomy, and 2.0% report using periportal (p < .001). Compared to international responses with 21.1% interportal, 14.3% t-capsulotomy, and 18.4% periportal (p < .001). Technique transitions were reported by several surgeons: 68.18% switched to periportal, 22.73% to t-capsulotomy, and 9.09% to interportal (p < .001). Of the 66% of surgeons performing capsular closure, 51.5% utilize interportal, 39.2% t-capsulotomy, and 2.1% periportal (p < .001). Mean hip capsule closure time was 13.02 ± 6.26 minutes. Permanent sutures were utilized 76.3% (p < .001). Mean number of sutures was 3.67 ± 1.34. Among the 34% surgeons not performing capsular closure, 56.0% utilize periportal, 20.0% interportal, and 16.0% t-capsulotomy (p < .001). A total of 24 dislocations following hip arthroscopy were reported by 18 respondents: 11 with t-capsulotomy, 8 with interportal, 3 with periportal, and 2 unsure of technique (p < .001). Discussion This study highlights substantial international and domestic variability in capsular management techniques for hip arthroscopy. Significant differences in hip dislocation rates were observed between the capsular management techniques (p < .001). Future research is needed to identify the optimal hip arthroscopy approach and capsular management.