The next talk will be given by Benjamin Dome on the long-term survivorship and outcomes of patients undergoing capsular repair and primary hip arthroscopy for femoral asthma or impingement syndrome. Thanks very much, Shane, and thanks to the OSSM for the invitation. My disclosures are listed with the AOS. By way of background, the procedure for capsular repair and plication was introduced in our setting in 2008, initially for patients at higher risk of instability. It subsequently became routine for patients of a variety of shapes, sizes, activity levels, and genders. And we have previously published the short and midterm outcomes. The technique was first published in 2013 in the Journal of Arthroscopy. And in this technique, we described the use of the interportal capsulotomy with sutures across it. This enabled us to perform a closure or, in cases of instability, a capsular shift with imbrication by virtue of the placement and obliquity of the sutures. The purpose of this study was to report the 10-year survivorship and patient-reported outcomes following primary hip arthroscopy with capsular repair for FAI and to evaluate the impact of capsular repair in those patients who were at highest risk for conversion to total hip arthroplasty. We looked at cases that were done between 2008 and 2011, excluding previous hip surgery, workers' compensation, tonus grade greater than 1, and hip dysplasia. Looked at the patient-reported outcomes, survivorship, MCID, and PASS, and also performed a propensity-matched subanalysis amongst those at highest risk for conversion to THA, which were those 40 years old or greater, and those with cartilage grade 2 or more. We were able to achieve greater than 80% follow-up at minimum 10 years, which is a tribute to the many personnel who have been involved in that follow-up. A preponderance of this cohort was female because during these study years, the capsular repair was used primarily for those at higher risk for instability, which were preferentially female. And the average age was 30. 88% had tonus zero, and 83% underwent a labral repair. A minority underwent other procedures, such as selective debridement or reconstruction. At 10-year follow-up, we had 91% survivorship in this cohort, and of those 99% who underwent THR, the average time to THR was 72 months, or six years. The patients experienced significant improvement in all patient-reported outcomes and achieved high rates of MCID and PAS. Specifically for the Harris HIP score, those rates were 82% and nearly 90%, respectively. In the propensity-matched subanalysis, we did a one-to-three match, 29 HIPs with a capsular repair and 81 without. Both groups experienced significant improvements in all PROs, but the capsular repair group had significantly higher survivorship. The strengths of the study, then, were 10-year follow-up, prospectively collected data, greater than 80% follow-up rate, and the use of a propensity-matched subanalysis. Limitations include the variety of labral treatments involved, the retrospective nature of the analysis, and the uncertainty of generalizability from a single-center, single-surgeon study. In conclusion, primary HIP arthroscopy with capsular repair achieved a high rate of survivorship at 10 years of 91%. Significant improvements in all patient-reported outcomes and high rates of clinical benefit with a 90% rate of achieving PAS. And amongst those patients at highest risk for conversion to arthroplasty, greater survivorship was seen with capsular repair. Thank you.

long-term survivorship

capsular repair

patient-reported outcomes

total hip arthroplasty

retrospective analysis