FP9.3 Integrative Intraoperative Traction Mechanics with Clinical Outcomes in Arthroscopic Hip Capsular Reconstruction

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ID: 330928
2026
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Abstract
Abstract ICLB09 - The Revision Playbook: Advanced Execution and Technical Rescues in Failed Preservation, Session Room 6 (BMCC Level 3), October 9, 2026, 10:30 - 12:30 Background Capsular deficiency is an increasingly recognized cause of persistent pain and instability following hip arthroscopy. Arthroscopic capsular reconstruction has emerged as a salvage procedure for patients with unrepairable capsular defects; however, the relationship between intraoperative axial traction examination findings and postoperative clinical outcomes remains unclear. Hypothesis/Purpose To evaluate clinical outcomes following arthroscopic hip capsular reconstruction and determine whether intraoperative distraction mechanics, alongside demographic, radiographic, and surgical factors, are associated with baseline function and postoperative improvement. Greater distraction across the traction profile was expected to reflect increased capsular laxity and correlate with patient-reported outcomes. Study Design Level III Methods Patients who underwent arthroscopic hip capsular reconstruction between 2019 and 2023 with available intraoperative traction examination data and minimum 2-year follow-up were included. Demographic, radiographic, and intraoperative variables were collected. Joint distraction was measured fluoroscopically at incremental axial traction loads (25, 50, 75, and 100 lbF). Patient-reported outcomes included pain scores, perceived function, and PROMIS Physical Function (PF). Responders were defined as achieving the distribution-based minimal clinically important difference (MCID) for PROMIS PF. Spearman correlation and comparative analyses were performed. Results Seventy-eight patients (mean age 33.2 ± 10.2 years; 87.2% female) met inclusion criteria. At a mean follow-up of 3.48 years, 11.5% required subsequent surgery and were excluded from patient reported outcome analyses. Among the remaining cohort, significant improvements were observed in pain with activity (p = 0.042), function scores (p = 0.023), and PROMIS PF (p < 0.001). Greater distraction at 75 lbF was associated with improvement in pain at rest (ρ = −0.38, p = 0.001) and pain with activity (ρ = −0.27, p = 0.03), whereas distraction at other loads was not associated with outcomes. Sixty-three percent achieved MCID for PROMIS PF, with no differences between responders and nonresponders. Conclusion Arthroscopic capsular reconstruction is a salvage procedure that improves outcomes in patients with capsular deficiency. However, patients reaching MCID is less predictable compared to primary arthroscopy, reinforcing the importance of careful capsular preservation and repair during index surgery.
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Authors Ashley L Matter, Brian Prigmore, Benjamin T Johnson, Keira M Sheehan, Leah Henry, Steve Aoki
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Journal Journal of hip preservation surgery
Year 2026
DOI
10.1093/jhps/hnag043.067
URL
https://doi.org/10.1093/jhps/hnag043.067
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