EP3.17 Postoperative Capsular Elevation Following Hip Arthroscopy: A Paired MRI Analysis and Patient Reported Outcomes

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ID: 330913
2026
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Abstract
Abstract Purpose The purpose of this study was to evaluate changes in hip capsular height on magnetic resonance imaging (MRI) before and after hip arthroscopy and to report associated patient-reported outcomes. Methods A retrospective case series was performed of patients who underwent hip arthroscopy with both preoperative and postoperative MRI arthrogram available. Demographics including age, sex, body mass index (BMI), and laterality were collected. Capsular height was measured preoperatively and postoperatively on MRI, to determine whether intra-operative capsular elevation resulted in durably altered capsulolabral recess morphology on subsequent imaging. The primary outcome analyzed was postoperative capsular height and change from baseline. Patient-reported outcomes collected included Tegner activity score, Visual Analog Scale for pain at rest and with activity, modified Harris Hip Score (mHHS), Hip Outcome Score-Activities of Daily Living (HOS-ADL), HOS-Sports, subjective surgery outcome, and surgery satisfaction (0-10). Results Fifty hips were included with a mean age of 30.9 ± 10.9 years and mean BMI of 29.1 ± 6.3 kg/m2. There were 37 females (74.0%) with 28 right hips (56.0%). Mean time from preoperative MRI to surgery was 0.6 ± 0.7 years (range, 0.0 – 3.6 years), and from surgery to postoperative MRI was 2.5 ± 1.6 years (range, 0.2 – 6.6 years). Preoperative capsular height was 2.2 ± 3.2 mm and increased to 7.9 ± 5.4 mm postoperatively (p<0.01) (Δ 5.7 ± 6.3 mm). At a mean follow-up of 4.7 ± 1.4 years, Tegner scores improved from 3.2 ± 2.1 preoperatively to 4.6 ± 2.4 postoperatively. Mean VAS scores were 2.4 ± 2.7 at rest and 4.2 ± 2.7 with use. Mean mHHS was 72.0 ± 17.6, HOS-ADL was 81.4 ± 16.5, and HOS-Sports was 71.1 ± 28.2. Mean satisfaction (0-10) was 7.1 ± 2.5, with 83.3% of patients reporting they felt “much better” or “slightly better” after surgery. Additionally, neither postoperative capsular height nor magnitude of postoperative change in capsular height were correlated patient-report outcome scores. Conclusions Hip arthroscopy is associated with a measurable increase in capsular height on postoperative MRI, suggesting capsular elevation following intervention. These findings provide early quantitative imaging evidence demonstrating changes in capsular morphology postoperatively and highlight the need for further studies correlating capsular elevation with long-term clinical outcomes.
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Authors Rana Ahmad, John Kelly, Jacob D. Mikula, Nicholas Rhodes, Aaron John Krych, Mario Hevesi
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Journal Journal of hip preservation surgery
Year 2026
DOI
10.1093/jhps/hnag043.302
URL
https://doi.org/10.1093/jhps/hnag043.302
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