Safety of a Novel Capsular Closure Device in Hip Arthroscopy for Femoroacetabular Impingement

Abstract

Abstract Introduction: The utilization of hip arthroscopy for the management of femoroacetabular impingement has increased. Capsular closure has been shown to maintain biomechanical stability postoperatively compared to unrepaired capsules. The novel Cap-Fix device (Smith and Nephew, Watford, UK) was developed to aid in capsular closure both by improving the placement of suture and decreasing the number of steps required for capsulotomy. This study aimed to evaluate the safety of the Cap-Fix device for use in capsulotomy and capsular repair following hip arthroscopy. Materials and Methods: A retrospective review of 30 patients undergoing hip arthroscopy for the treatment of femoroacetabular impingement (FAI) with capsular repair using the Cap-Fix 45° or 70° Suture Passer was performed. The Hip Disability and Osteoarthritis Outcome Score for Joint Replacement (HOOS JR) and Patient-Reported Outcomes Measurement Information System-Physical Function (PROMIS-PF) measures were used to evaluate patient-reported outcomes at the baseline and the follow-up intervals. Outcomes of interest included complications and patient-reported outcomes at 2-week, 6-week, and 3-month follow-up. Results: All patients completed 2- and 6-week follow-up, and 28 (93.3%) completed 3-month follow-up. Two patients experienced complications; one with pain requiring glucocorticoid injection at 6 weeks postoperatively, and another with a 12-mm capsular defect found on 3-month postoperative magnetic resonance imaging requiring repeat arthroscopic debridement, revision labral repair, and capsular plication. By 3 months postoperatively, statistically significant improvement in HOOS JR but not PROMIS-PF scores was seen. Conclusion: The Cap-Fix device appears to be safe for use in capsulotomy and subsequent capsular repair during hip arthroscopy for FAI.