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. 2022 Apr 18;13(4):400-407.
doi: 10.5312/wjo.v13.i4.400.

Integrity of the hip capsule measured with magnetic resonance imaging after capsular repair or unrepaired capsulotomy in hip arthroscopy

Niels H Bech  1 , Lode A van Dijk  2 , Sheryl de Waard  1 , Gwendolyn Vuurberg  3 , Inger N Sierevelt  4 , Gino Mmj Kerkhoffs  1 , Daniël Haverkamp  4
Affiliations

Integrity of the hip capsule measured with magnetic resonance imaging after capsular repair or unrepaired capsulotomy in hip arthroscopy

Niels H Bech et al. World J Orthop. .

Abstract

Background: Current literature shows no clear answer on the question how to manage the capsule after hip arthroscopy. Regarding patient reported outcome measures there seems to be no difference between capsular repair or unrepaired capsulotomy.

Aim: To evaluate and compare the integrity of the hip capsule measured on a magnetic resonance imaging (MRI) scan after capsular repair or unrepaired capsulotomy.

Methods: A case series study was performed; a random sample of patients included in a trial comparing capsular repair vs unrepaired capsulotomy had a postoperative MRI scan. The presence of a capsular defect and gap size were independently evaluated on MRI.

Results: A total of 28 patients (29 hips) were included. Patient demographics were comparable between treatment groups. There were 2 capsular defects in the capsular repair group and 7 capsular defects in the unrepaired capsulotomy group (P = 0.13). In the group of patients with a defect, median gap sizes at the acetabular side were 5.9 mm (range: 2.7-9.0) in the repaired and 8.0 mm (range: 4.5-18.0) in the unrepaired group (P = 0.462). At the muscular side gap sizes were 6.6 mm (range: 4.1-9.0) in the repaired group and 11.5 mm (range: 3.0-18.0) in the unrepaired group (P = 0.857). The calculated Odds ratio (OR) for having a capsular defect with an increasing lateral center-edge (CE) angle was 1.12 (P = 0.06). The OR for having a capsular defect is lower in the group of patients that underwent a labral repair with an OR of 0.1 (P = 0.05).

Conclusion: There is no significant difference in capsular defects between capsular repair or unrepaired capsulotomy. Regarding clinical characteristics our case series shows that a larger CE angle increases the likelihood of a capsular defect and the presence of a labral repair decreases the likelihood of a capsular defect.

Keywords: Arthroscopy; Capsule; Hip; Magnetic resonance imaging; Thickness.

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Conflict of interest statement

Conflict-of-interest statement: All authors declare that there is no conflict of interest.

Figures

Figure 1
Figure 1
Example of capsular defect and intact capsule on magnetic resonance imaging-arthrography. A: example of a capsular defect on magnetic resonance imaging (MRI)-arthrography with extracapsular contrast leakage to the adjacent soft-tissue; B: Gap length measurement; solid line: gap length muscular side. Dotted line: Gap length acetabular side; C: Example of an intact capsule on MRI-arthrography (Arrow). There is no contrast leakage to the adjacent soft-tissue.
See this image and copyright information in PMC

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