the opportunity to present our research. Disclosures can be found on the website and the app. So for the past decade, hip arthroscopy has gained popularity at a higher rate than almost any other surgery within the field of orthopedics. It has become a successful way of treating ephemerocetabular impingement. And capsulotomy has been used to improve visualization and also ease of access. Despite how common hip arthroscopy has become, there are different ways that people approach the capsule. And the purpose of our study was to gain an understanding of the current trends in capsule management used by these hip arthroscopists. So there are differing opinions in regards to the type, size, and location of a capsulotomy. The interportal capsulotomy allows for better visualization of the central compartment, whereas the T-capsulotomy allows for better visualization and access of the peripheral compartment. Repair of these capsulotomies has been shown to restore translational and rotational biomechanical stability of the hip joint. There are recent publications that have supported the benefit of capsular repair. However, it is not universally performed by all hip arthroscopists. In a study by Frank and colleagues, they showed that complete repair of the capsule demonstrated superior sport-specific outcomes when compared to those who only underwent a partial repair with T-capsulotomies. And in another study, Larson and colleagues demonstrated that in revision hip arthroscopic surgery, that capsular replication or repair was an independent predictor of better outcomes. We used the online survey tool Qualtrics and it was sent out via email. There were 29 questions in addition to five optional clinical vignettes that focused on the management of specific hip-related injuries. It took about five minutes to complete. The questions included capsular management, basic demographic information, and also post-operative management and complications. We asked about training and experience in addition to location and type of practice. In regards to the questions on surgical preference, we used a multiple-choice format and also included an optional text box for explanation. In addition, we asked about recent changes in management and also post-operative protocols. These were the optional clinical vignettes that we provided. The answer choices included type of capsulotomy and if they chose to repair it or not. 65 hip arthroscopists responded to our survey. 70% of them are from the United States and 30% were from nine other countries. Surgeon volume and experience ranged between 15 and 1,500 cases per year and also 1 to 32 years of experience. Of all the individuals that responded, 78% were fellowship trained in hip arthroscopy. We found that for interportal capsulotomy, it was always utilized 78% of the time. 8%, it was sometimes utilized and only in cases of labor repair, 3% of surgeons used it. 10% reported never using it at all. 12% of those surveyed always used T-capsulotomy. 28% sometimes did and 18% only did with a CAM lesion. 42% responded saying that they did not utilize this technique at all. For those that did interportal capsulotomy, 53% always closed the capsule. 24% did it most of the time, 13% occasionally did it and 9% never did. And for the T-capsulotomy, 79% always closed the capsule, 14% occasionally did, 3.5% did most of the time and 3.5% never did. And overall, there were 14 surgeons that reported a recent change in management of which 62% reported that they've begun to close the capsule more or using a more robust repair. There are 13 post-operative dislocations among 12 of the surgeons. The capsule is not repaired in a third of these cases and of all the dislocations, only one of these was published, suggesting that these dislocations are going under-reported in the literature. This is a summary of the findings from the clinical vignettes of which 99% of participants responded to. Although interportal capsulotomy was used the most for all of the scenarios, there was a variety of treatment options between the different cases. In conclusion, there are a wide variety of surgical approaches to the capsule and hip arthroscopy. Interportal capsulotomy appears to be the most utilized technique with capsule repair occurring in the majority of cases. This reflects the improved outcomes seen in the recently published literature. However, there are still a fair number of surgeons that choose to forego capsule repair or choose to not use it at all. Thank you.

hip arthroscopy

capsule management

hip impingement

capsulotomy

post-operative dislocations