Hip Capsule Repair for Hip Pain
What You Need to Know Before You Apply
What is the purpose of this trial?
This trial tests whether repairing the hip capsule, a protective tissue around the hip joint, can reduce hip pain and improve movement. It compares patients who undergo hip capsule repair during surgery to those who do not. The goal is to determine if the repair leads to better outcomes for individuals with hip pain unresponsive to other treatments. This trial may suit adults who have experienced persistent hip pain for over three months, despite trying physical therapy or medication. As an unphased trial, it provides a unique opportunity to explore innovative treatment options for those seeking relief from chronic hip pain.
Will I have to stop taking my current medications?
The trial does not specify if you need to stop taking your current medications. However, if you are on immunosuppressant medication, you would not be eligible to participate.
What prior data suggests that this hip capsule repair technique is safe?
Research has shown that hip capsule repair, a procedure often performed during hip arthroscopy, is generally safe for patients. One study found complications to be uncommon, with minor issues occurring in about 4.5% to 7.9% of cases, while major problems were even rarer. Another study indicated that closing the hip capsule after surgery did not negatively affect patient recovery or function. These findings suggest that the procedure is well-tolerated, with a low risk of serious side effects.12345
Why are researchers excited about this trial?
Researchers are excited about hip capsule repair for hip pain because it offers a new approach to addressing joint issues directly at the source. Unlike standard treatments, which might include physical therapy, medication, or less invasive surgical techniques, this method involves a detailed arthroscopic procedure that allows for a comprehensive assessment and repair of the hip's internal structures. By directly treating pathologies in both the central and peripheral compartments and repairing the hip capsule itself, this technique aims to provide more effective and lasting relief from pain. The use of simple interrupted sutures with absorbable material ensures a precise and potentially more natural healing process. This focus on repairing the hip capsule distinguishes it from other treatments, potentially leading to improved outcomes for patients with persistent hip pain.
What evidence suggests that hip capsule repair is effective for hip pain?
Research shows that repairing the hip capsule after arthroscopy, a minimally invasive joint surgery, leads to better patient outcomes. In this trial, participants in the Hip Capsule Repair group will undergo this procedure. Studies have found that patients who receive this repair often experience improved hip function compared to those who do not. A review of multiple studies found that routinely stitching the capsule back together results in fewer complications and a smoother recovery. Additionally, using self-dissolving stitches has been associated with positive patient feedback. Overall, repairing the capsule aids recovery and reduces the need for additional surgeries in patients without arthritis.14678
Who Is on the Research Team?
Aaron Krych, MD
Principal Investigator
Mayo Clinic
Are You a Good Fit for This Trial?
The CREST trial is for adults aged 18 to 50 with hip pain lasting over three months that hasn't improved with non-surgical treatments. Participants must have FAI confirmed by imaging, an intact labrum or one repaired during surgery, and be able to understand and speak English.Inclusion Criteria
Exclusion Criteria
Timeline for a Trial Participant
Screening
Participants are screened for eligibility to participate in the trial
Treatment
Patients undergo arthroscopic hip surgery with or without capsular repair
Follow-up
Participants are monitored for safety and effectiveness after treatment
What Are the Treatments Tested in This Trial?
Interventions
- Hip Capsule Repair
Trial Overview
This study tests if repairing the hip capsule during arthroscopy improves function. It involves 240 patients split into two groups, comparing outcomes like hip motion and satisfaction at six months post-surgery using a blinded approach.
How Is the Trial Designed?
2
Treatment groups
Experimental Treatment
Active Control
Patients in the intervention group (Hip capsule repair) will undergo initial diagnostic arthroscopy of the hip. Two to three standard portals (anterolateral, mid anterior, distal antero-lateral, posterolateral) will be used during the entire procedure to assess and treat the patient. After establishing standard portals, an interportal capsulotomy is completed to allow for complete evaluation of the central compartment of the hip. In the central compartment, significant and obvious pathologies will be addressed accordingly. Following addressing central compartment pathologies, cam impingement type lesions in the peripheral compartment will be treated. Once all pathologies are addressed, the interportal capsulotomy10 will be repaired by using simple interrupted sutures with absorbable suture (Number 1 Vicryl). Three to four simples sutures will be placed and tied using arthroscopic technique.
Patients in the control group (no hip capsule repair) have the same portals utilized and will have the same interportal capsulotomy performed. They will have all central and peripheral compartment pathologies addressed in the same way that the study group does. At the conclusion of the case, the hip capsule will be left open and not repaired.
Find a Clinic Near You
Who Is Running the Clinical Trial?
Mayo Clinic
Lead Sponsor
Citations
Capsular Repair Versus No Repair After Hip Arthroscopy in ...
Capsular repair after hip arthroscopy was associated with superior clinical outcomes when compared with no capsular repair in patients without dysplasia or GLL.
Meta-analysis Routine Capsular Closure Outperforms ...
This study found an increased proportion of well outcomes with decreased rates of moderate (requiring revision hip arthroscopy) and major (requiring early ...
3.
journaloei.scholasticahq.com
journaloei.scholasticahq.com/article/141825-hip-capsule-closure-using-absorbable-sutures-demonstrates-similar-patient-reported-outcomes-and-rates-of-revision-with-potentially-lower-complicationHip Capsule Closure Using Absorbable Sutures ...
The primary findings of our study demonstrated that absorbable suture material for hip capsular closure showed comparable outcomes and revision ...
CREST: Capsular Repair During Hip Arthroscopy
The goal of the CREST is to evaluate functional stability and patient reported outcome scores following capsular repair after arthroscopic hip surgery for FAI.
Capsular Repair May Improve Outcomes in Patients ...
Conclusions: Midterm outcome studies suggest that capsular repair is safe and effective in patients without arthritis who are undergoing hip arthroscopy, and ...
Outcomes and complications of hip arthroscopy for ...
Moreover, hip arthroscopy demonstrates a favorable safety profile, with minor complications occurring in 4.5–7.9 % of cases and major complications in less than ...
Does Capsular Closure Affect Clinical Outcomes in Hip ...
Capsular closure appears to have no detrimental effect on functional outcome scores after hip arthroscopy. We recommend restoration of native anatomy if ...
Interportal and T-Capsulotomy, Suspension, and Closure
We present an effective method for capsular management in hip arthroscopy that consistently allows excellent exposure and working space.
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