Effect of Capsular Closure on Outcomes of Hip Arthroscopy for Femoracetabular Impingement: A Systematic Review and Meta-analysis

Liang Liu; Yan Zhang; Qi Gui; Feng Zhao; Xue-Zhen Shen; Xing-Huo Zhang; Xiao-Peng Cong; Ya-Kui Zhang

doi:10.1111/os.12717

Effect of Capsular Closure on Outcomes of Hip Arthroscopy for Femoracetabular Impingement: A Systematic Review and Meta-analysis

Orthop Surg. 2020 Aug;12(4):1153-1163. doi: 10.1111/os.12717. Epub 2020 Jun 10.

Authors

Liang Liu¹, Yan Zhang², Qi Gui¹, Feng Zhao¹, Xue-Zhen Shen¹, Xing-Huo Zhang³, Xiao-Peng Cong¹, Ya-Kui Zhang³

Affiliations

¹ Department of Sports Medicine, Beijing LUHE Hospital Capital Medical University, Beijing, China.
² Department of Education, Beijing LUHE Hospital Capital Medical University, Beijing, China.
³ Department of Orthopedic Center, Beijing LUHE Hospital Capital Medical University, Beijing, China.

Abstract

Objective: To evaluate the effect of hip arthroscopy with or without capsular closure in femoracetabular impingement (FAI) by meta-analysis.

Methods: Pertinent studies were identified by searching Pubmed, EMBASE databases with the last search update on 16 February 2020. Studies that reported hip arthroscopy for FAI were collected. Meta-analysis was performed by the use of Review Manager 5.3 software. The odds ratios (OR) and mean differences (MD) were used to compare dichotomous and continuous variables. Additionally, the I² was used to assess heterogeneity among studies, and the fixed-effects model or the random-effects model was selected for the quantitative analysis. Outcomes were evaluated by forest plots. For statistical analysis, P < 0.05 was considered significant.

Results: There was no significant difference among the preoperative mHHS (MD = -2.66，95% CI [-7.25, 1.92], I² = 80%, P = 0.25), preoperative (MD = -4.94, 95% CI [-11.56, 1.67], I² = 50%, P = 0.14) and postoperative HOS-SSS (MD = -1.00, 95% CI [-6.98, 4.98], I² = 66%, P = 0.74), patient satisfaction (MD = 0.03, 95% CI [-0.25, 0.31], I² = 19%, P = 0.84; OR = 0.94, 95% CI [0.59, 1.50], I² = 0%, P = 0.78), complications (OR = 1.23, 95%CI [0.56, 2.67], I² = 0%, P = 0.61), revisions (OR = 1.77, 95% CI [0.87, 3.60], I² = 36%, P = 0.11), and surgery time (SMD = -0.38, 95% CI [-1.16, 0.40], I² = 92%, P = 0.34) between the capsule closure group and the non-closure group. For the comparison of postoperative mHHS (MD = -2.66, 95% CI [-7.25, 1.92], I² = 80%, P = 0.25) and HOS-ADL (MD = -4.20, 95% CI [-5.75, -2.65], I² = 24%, P < 0.00001), the score of the non-closure group was significantly better than that of the closure group.

Conclusions: Remain capsule unclosed after hip arthroscopy for FAI may, to some extent, has a better postoperative functional score than the non-closure treatment.

Keywords: Capsular closure; FAI; Hip arthroscopy; Meta-analysis; Outcomes.

Publication types

Meta-Analysis
Systematic Review

MeSH terms

Activities of Daily Living
Arthroscopy / methods*
Disability Evaluation
Femoracetabular Impingement / surgery*
Humans
Joint Capsule / surgery*
Patient Satisfaction