EP1.5 Periportal Versus Interportal Capsulotomy in Male Hip Arthroscopy Patients with FAI: A comparative analysis of Patient Reported Outcomes

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ID: 331068
2026
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Abstract
Abstract Background The periportal capsulotomy minimizes violation of the iliofemoral ligament (ILFL) during hip arthroscopy for the treatment of femoroacetabular impingement syndrome (FAIS). However, it remains unclear whether this technique results in meaningful clinical differences in males, a patient population less likely to experience post arthroscopy hip instability secondary to capsular insufficiency. Purpose/Hypothesis To compare patient reported outcomes (PROs) between periportal and interportal capsulotomies in male patients undergoing FAIS hip arthroscopy. We hypothesized that the periportal approach would result in improved clinical outcomes due to preservation of the native ILFL. Study Design: Cohort study, level III Methods Male patients who underwent a primary hip arthroscopy with complete capsular closure for symptomatic FAIS between 2020-2023 were retrospectively identified from a single surgeon’s database. Demographic and surgical data were collected. Patients were contacted at a minimum of 2 years post-operatively to complete PRO questionnaires, including Visual Analogue Scale (VAS) for pain, Single Assessment Numeric Evaluation (SANE), and Patient Reported Outcomes Measurement Information System-Physical Function (PROMIS-PF) scores. Categorical variables were compared using chi-square and Fisher exact tests, and continuous variables were compared using two-tailed independent T-tests, Mann-Whitney U tests, or Welch’s t-test following Shapiro-Wilk test for normality and an F-test for equality of variances. Results In total, 88 male patients (44 interportal, 44 periportal) were included. There were no significant differences in baseline demographic or radiographic parameters between groups. Mean follow-up was longer in the interportal group compared to the periportal group (3.6 ± 0.7 years vs 2.5 ± 0.5 years; p < 0.001). There were no statistically significant differences between groups in improvements in SANE scores (22.8 ± 15.2 vs 18.8 ± 17.4; p = 0.252) or PROMIS-PF scores (11.2 ± 9.2 vs 11.4 ± 9.7; p = 0.948). Pain scores were also similar between groups, including VAS at rest (2.0 ± 2.7 vs 1.9 ± 2.8; p = 0.825) and with ADLs (2.6 ± 2.7 vs 2.9 ± 3.6; p = 0.683). Rates of achieving minimal clinically important difference (MCID) were similar for VAS-Rest (71% vs 68%; p = 0.815), VAS-ADL (79% vs 73%; p = 0.620), SANE (88% vs 80%; p = 0.359), and PROMIS-PF (80% vs 79%; p = 0.902). Two-year revision rates were not significantly different between groups (4.5% periportal vs 6.8% interportal; p = 1.000). Conclusions Among male patients undergoing primary hip arthroscopy with capsular closure for FAIS, periportal and interportal capsulotomy techniques demonstrated comparable patient-reported outcomes, MCID achievement, and revision rates at short- to mid-term follow-up. Preservation of the ILFL with a periportal approach did not confer a measurable clinical advantage in this cohort.
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Authors Ashley L Matter, Benjamin T Johnson, Elisabeth Reinisch, Keira M Sheehan, Leah Henry, Steve Aoki
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Journal Journal of hip preservation surgery
Year 2026
DOI
10.1093/jhps/hnag043.189
URL
https://doi.org/10.1093/jhps/hnag043.189
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