Capsular Repair, Labral Repair, and Femoroplasty With Postless Traction Are Increasingly Performed for the Arthroscopic Treatment of Femoroacetabular Impingement Syndrome

Purpose: To provide an updated assessment of hip arthroscopy use by using an institutional database that is specific to the treatment of femoroacetabular impingement syndrome (FAIS). Methods: All patients undergoing hip arthroscopy for the treatment of FAIS were retrospectively identified between the years 2014 and 2022 via Current Procedural Terminology coding in a multi-institutional, single health system database. A longitudinal analysis was performed to identify trends in the use of arthroscopic techniques including capsular and labral treatment, osteoplasty, and traction set-up. Results: During the study, 789 arthroscopic hip procedures in 733 patients were analyzed (56 staged bilateral). Between 2016 and 2022, the number of hip arthroscopies performed each year increased by 1,490% (R-2 = 0.87, P = .001). Capsular repair (R-2 = 0.92, P < .001), labral repair (R-2 = 0.75, P = .002), and femoroplasty (R-2 = 0.70, P = .004) were performed in an increasing proportion of cases over our study period whereas labral debridement (R-2 = -0.84, P < .001) became less used. Postless traction systems were employed in 84% (663/789) of hip arthroscopies overall, were used in at least 70% of hip arthroscopies each year, and did not undergo any significant changes in use (R-2 = 0.02, P = .73). Conclusions: Capsular repair, labral repair, and femoroplasty were increasingly performed for the arthroscopic treatment of FAIS whereas the use of labral debridement decreased significantly over our study period. Postless traction systems were used in the majority of cases each year. Clinical Relevance: As comparative literature continues to define the safety and efficacy of hip arthroscopy, understanding how novel techniques or procedures are incorporated in clinical practice is important.