2021 ISAKOS Biennial Congress Paper
Midterm Outcomes After Arthroscopic Hip Capsular Reconstruction Using Iliotibial Band Allograft
Joseph J. Ruzbarsky, MD, Aspen, CO UNITED STATES
Max Seiter, MD, Breckenridge, CO UNITED STATES
Rui Soares, BS, Vail, CO UNITED STATES
Lauren Pierpoint, PhD, Vail, CO UNITED STATES
Karen K. Briggs, MPH, MBS, Vail, CO UNITED STATES
Marc J. Philippon, MD, Vail, CO UNITED STATES
Steadman Philippon Research Institute, Vail, CO, UNITED STATES
FDA Status Not Applicable
Summary
Capsular reconstruction with ITB allograft shows acceptable success at midterm follow-up.
Abstract
Purpose
The purpose of this study was to describe patient outcomes 3-5 years after arthroscopic hip capsule reconstruction.
Methods
Patients were included in this study if they underwent an arthroscopic hip capsular reconstruction using an ITB allograft by the senior surgeon from 2007 to 2016, and =18 years of age at the time of surgery with minimum 3-5 year follow up. Patients were excluded if they had previous were less than 18 or greater than 50 years at the time of surgery, advanced osteoarthritis (Tonnis grade 3), significant acetabular dysplasia (LCEA < 20 degrees), history of open hip surgery, avascular necrosis, Legg-Calve-Perthes disease or refused to participate. Clinical outcomes including the Hip Outcome Score (HOS)-(Activity of Daily Living (ADL) and Sport), modified Harris Hip Score (mHHS), SF-12, Western Ontario & McMaster Universities Osteoarthritis Index (WOMAC), and Vail Hip Score (VHS) were collected, in addition to failure rate (conversion to total hip arthroplasty (THA), or revision hip arthroscopy), and patient satisfaction (1-10).
Results
Thirty-nine patients met the inclusion criteria. Average age of the cohort was 32 ± 10 years, with 6 males and 33 females. Six patients (15%) converted to total hip arthroplasty at an average of 2.1 years (range 7 months – 6 years) following capsular reconstruction. There were 5 females and 1 male with an average age of 33 years at time of arthroscopy. Five of the patients had 3 prior hip arthroscopies and 1 patient had 5 previous. Four female patients (10%) required revision hip arthroscopy for adhesions. In patients who did not undergo subsequent surgery, mean follow-up time was 4 ± 0.7 years (range 3 to 5.5 years). All outcome scores showed significant improvement. MCID was met for HOS-ADL in 90% of patients, for HOS Sport in 90% of patients and for mHHS in 86% of patients.
Conclusion
Capsular reconstruction with ITB allograft shows acceptable success at midterm follow-up. Most patients had numerous previous surgery; however, 75% did not require additional surgery and 90% had meaningful improvements in outcome scores. Failure was associated with a higher number of previous surgeries.