{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T05:00:32Z","timestamp":1791954032818,"version":"4.3.4"},"reference-count":105,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,10,17]],"date-time":"2025-10-17T00:00:00Z","timestamp":1760659200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,10,17]],"date-time":"2025-10-17T00:00:00Z","timestamp":1760659200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["esskajournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To compare three capsular management strategies in hip arthroscopy (capsule preservation [CP], capsule repair [CR] and capsule unrepaired [CU]) for femoroacetabular impingement syndrome (FAIS). We hypothesized that CP and CR would provide superior outcomes compared with CU.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic search of PubMed, Embase, CENTRAL and Epistemonikos was conducted up to 31 May 2025. Outcomes of CP, CR and CU were compared using a frequentist multilevel random\u2010effects meta\u2010analysis with restricted maximum likelihood estimation and Hartung\u2013Knapp adjustment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Ultimately, 47 primary studies met the inclusion criteria and were included in the meta\u2010analysis. A total of 7366 hips (7276 patients) were included across the 47 studies. These were distributed into three capsular management groups: (I) CP: 1352 hips, (II) CR: 5043 hips and (III) CU: 971 hips. CR showed the greatest improvement in modified Harris Hip Score with a mean change of 24.00 (95% confidence interval [CI]: 20.86\u201327.14), while CP achieved the highest MCID rate at 12 months post\u2010operatively with a mean of 9.30 (95% CI: 7.47\u201311.14). No other consistent statistically significant differences were observed between groups across post\u2010operative scores, change scores or complication rates. CP and CR both demonstrated superior outcomes compared to CU in selected functional parameters. All three strategies showed comparable results in pain reduction, revision rate, conversion to total hip arthroplasty and overall complication incidence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>CR and CP yield superior outcomes compared to leaving the CU. Surgeons should close or preserve the capsule, while future trials will clarify the optimal strategy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level II, systematic review and meta\u2010analysis of predominantly Level III studies, with additional contributions from Levels I and II studies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ksa.70094","type":"journal-article","created":{"date-parts":[[2025,10,17]],"date-time":"2025-10-17T07:57:58Z","timestamp":1760687878000},"page":"284-308","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Capsular management strategies in hip arthroscopy for femoroacetabular impingement syndrome: A multilevel meta\u2010analysis"],"prefix":"10.1002","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4669-8187","authenticated-orcid":false,"given":"Nikolai","family":"Ramadanov","sequence":"first","affiliation":[{"name":"Center of Orthopaedics and Traumatology, Brandenburg Medical School University Hospital Brandenburg an der Havel Brandenburg an der Havel Germany"},{"name":"Faculty of Health Science Brandenburg, Brandenburg Medical School Theodor Fontane Brandenburg an der Havel Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maximilian","family":"Voss","sequence":"additional","affiliation":[{"name":"Center of Orthopaedics and Traumatology, Brandenburg Medical School University Hospital Brandenburg an der Havel Brandenburg an der Havel Germany"},{"name":"Faculty of Health Science Brandenburg, Brandenburg Medical School Theodor Fontane Brandenburg an der Havel Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maximilian","family":"Heinz","sequence":"additional","affiliation":[{"name":"Center of Orthopaedics and Traumatology, Brandenburg Medical School University Hospital Brandenburg an der Havel Brandenburg an der Havel Germany"},{"name":"Faculty of Health Science Brandenburg, Brandenburg Medical School Theodor Fontane Brandenburg an der Havel Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Hable","sequence":"additional","affiliation":[{"name":"Faculty of Applied Computer Science, Deggendorf Institute of Technology Deggendorf Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Prill","sequence":"additional","affiliation":[{"name":"Center of Orthopaedics and Traumatology, Brandenburg Medical School University Hospital Brandenburg an der Havel Brandenburg an der Havel Germany"},{"name":"Faculty of Health Science Brandenburg, Brandenburg Medical School Theodor Fontane Brandenburg an der Havel Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roland","family":"Becker","sequence":"additional","affiliation":[{"name":"Center of Orthopaedics and Traumatology, Brandenburg Medical School University Hospital Brandenburg an der Havel Brandenburg an der Havel Germany"},{"name":"Faculty of Health Science Brandenburg, Brandenburg Medical School Theodor Fontane Brandenburg an der Havel Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ingo J.","family":"Banke","sequence":"additional","affiliation":[{"name":"Clinic of Orthopaedics and Sports Orthopaedics, School of Medicine and Health TUM University Hospital, Technical University of Munich Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,10,17]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/03635465211056082"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2023.06.045"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/jhps\/hnz025"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2019.158489"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/03635465211068109"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1177\/11207000211005762"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546519865919"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2020.09.046"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2019.01.033"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1177\/03635465241234937"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2023.12.019"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2022.11.013"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546517710008"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546519831291"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2018.10.142"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2017.01.037"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1177\/03635465241247287"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-022-06877-9"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546512445883"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm11154548"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546517702855"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546517739824"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-020-06147-6"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2018.02.029"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1177\/23259671231197435"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00590-021-02997-z"},{"issue":"4","key":"e_1_2_12_28_1","first-page":"92","article-title":"Capsular closure after hip arthroscopy: our experience","volume":"91","author":"Di Benedetto P","year":"2020","journal-title":"Acta Biomed"},{"key":"e_1_2_12_29_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-014-2885-9"},{"key":"e_1_2_12_30_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-022-06918-3"},{"key":"e_1_2_12_31_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546517743720"},{"key":"e_1_2_12_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2017.10.019"},{"key":"e_1_2_12_33_1","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.22.00340"},{"key":"e_1_2_12_34_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546513499154"},{"key":"e_1_2_12_35_1","doi-asserted-by":"publisher","DOI":"10.1177\/23259671221144056"},{"key":"e_1_2_12_36_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546519894301"},{"key":"e_1_2_12_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2017.03.008"},{"key":"e_1_2_12_38_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546520951202"},{"key":"e_1_2_12_39_1","doi-asserted-by":"publisher","DOI":"10.3390\/medicina60050738"},{"key":"e_1_2_12_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otsr.2022.103349"},{"key":"e_1_2_12_41_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546518795696"},{"key":"e_1_2_12_42_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546514548017"},{"key":"e_1_2_12_43_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2015.06.028"},{"key":"e_1_2_12_44_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13018-022-03208-z"},{"key":"e_1_2_12_45_1","doi-asserted-by":"publisher","DOI":"10.1177\/23259671241275661"},{"key":"e_1_2_12_46_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12178-023-09855-x"},{"key":"e_1_2_12_47_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546520936255"},{"key":"e_1_2_12_48_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546517730583"},{"key":"e_1_2_12_49_1","doi-asserted-by":"publisher","DOI":"10.3389\/fspor.2022.881054"},{"key":"e_1_2_12_50_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12891-021-04576-z"},{"key":"e_1_2_12_51_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11999-012-2499-9"},{"key":"e_1_2_12_52_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546513494173"},{"key":"e_1_2_12_53_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2012.07.011"},{"key":"e_1_2_12_54_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546514534181"},{"key":"e_1_2_12_55_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2024.05.035"},{"key":"e_1_2_12_56_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546516664883"},{"issue":"2","key":"e_1_2_12_57_1","first-page":"121","article-title":"[Clinical effects of tranexamic acid in arthroscope for femoroacetabular impingement]","volume":"34","author":"Li N","year":"2021","journal-title":"Zhongguo Gu Shang"},{"key":"e_1_2_12_58_1","doi-asserted-by":"publisher","DOI":"10.1111\/os.13132"},{"key":"e_1_2_12_59_1","doi-asserted-by":"publisher","DOI":"10.1177\/1120700019880818"},{"key":"e_1_2_12_60_1","doi-asserted-by":"publisher","DOI":"10.1111\/os.12717"},{"key":"e_1_2_12_61_1","doi-asserted-by":"publisher","DOI":"10.1002\/ksa.12205"},{"key":"e_1_2_12_62_1","doi-asserted-by":"publisher","DOI":"10.1177\/03635465211023508"},{"key":"e_1_2_12_63_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12891-024-07894-0"},{"key":"e_1_2_12_64_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546518808033"},{"key":"e_1_2_12_65_1","doi-asserted-by":"publisher","DOI":"10.1177\/03635465211073341"},{"key":"e_1_2_12_66_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546521990789"},{"issue":"1","key":"e_1_2_12_67_1","first-page":"E47","article-title":"Poorer arthroscopic outcomes of mild dysplasia with cam femoroacetabular impingement versus mixed femoroacetabular impingement in absence of capsular repair","volume":"46","author":"Matsuda DK","year":"2017","journal-title":"Am J Orthop (Belle Mead NJ)"},{"key":"e_1_2_12_68_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00264-020-04810-8"},{"key":"e_1_2_12_69_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-200212000-00014"},{"key":"e_1_2_12_70_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2020.08.004"},{"key":"e_1_2_12_71_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.asmr.2023.100816"},{"key":"e_1_2_12_72_1","doi-asserted-by":"publisher","DOI":"10.1093\/jhps\/hnaa033"},{"key":"e_1_2_12_73_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546515624682"},{"key":"e_1_2_12_74_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2021.05.012"},{"key":"e_1_2_12_75_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546511401900"},{"key":"e_1_2_12_76_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2017.06.030"},{"key":"e_1_2_12_77_1","doi-asserted-by":"publisher","DOI":"10.5152\/j.aott.2021.21174"},{"key":"e_1_2_12_78_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2012.04.154"},{"key":"e_1_2_12_79_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2025.02.032"},{"key":"e_1_2_12_80_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71"},{"key":"e_1_2_12_81_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546520987226"},{"key":"e_1_2_12_82_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2012.03.047"},{"key":"e_1_2_12_83_1","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.91B1.21329"},{"key":"e_1_2_12_84_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546509346393"},{"key":"e_1_2_12_85_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2024.11.080"},{"key":"e_1_2_12_86_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546516669325"},{"key":"e_1_2_12_87_1","doi-asserted-by":"publisher","DOI":"10.1093\/jhps\/hnv002"},{"key":"e_1_2_12_88_1","doi-asserted-by":"publisher","DOI":"10.1177\/03635465221145704"},{"key":"e_1_2_12_89_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546517705617"},{"key":"e_1_2_12_90_1","doi-asserted-by":"publisher","DOI":"10.1177\/03635465231161348"},{"key":"e_1_2_12_91_1","doi-asserted-by":"publisher","DOI":"10.1177\/23259671241251413"},{"key":"e_1_2_12_92_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546514526357"},{"key":"e_1_2_12_93_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.l4898"},{"key":"e_1_2_12_94_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.i4919"},{"key":"e_1_2_12_95_1","doi-asserted-by":"publisher","DOI":"10.1177\/2325967120963110"},{"key":"e_1_2_12_96_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-022-07266-y"},{"key":"e_1_2_12_97_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40634-021-00428-w"},{"key":"e_1_2_12_98_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-021-84345-z"},{"key":"e_1_2_12_99_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2023.03.025"},{"key":"e_1_2_12_100_1","doi-asserted-by":"publisher","DOI":"10.1177\/23259671241295755"},{"key":"e_1_2_12_101_1","doi-asserted-by":"publisher","DOI":"10.1111\/os.13042"},{"key":"e_1_2_12_102_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546515608162"},{"key":"e_1_2_12_103_1","doi-asserted-by":"publisher","DOI":"10.1111\/os.13839"},{"key":"e_1_2_12_104_1","doi-asserted-by":"publisher","DOI":"10.5371\/hp.2019.31.2.102"},{"key":"e_1_2_12_105_1","doi-asserted-by":"publisher","DOI":"10.1111\/os.13877"},{"key":"e_1_2_12_106_1","doi-asserted-by":"publisher","DOI":"10.1111\/jcpt.13755"}],"container-title":["Knee Surgery, Sports Traumatology, Arthroscopy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ksa.70094","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ksa.70094","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ksa.70094","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T14:43:09Z","timestamp":1772980989000},"score":1,"resource":{"primary":{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/10.1002\/ksa.70094"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,17]]},"references-count":105,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1002\/ksa.70094"],"URL":"https:\/\/doi.org\/10.1002\/ksa.70094","archive":["Portico"],"relation":{},"ISSN":["0942-2056","1433-7347"],"issn-type":[{"value":"0942-2056","type":"print"},{"value":"1433-7347","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,17]]},"assertion":[{"value":"2025-07-19","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-09-14","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-17","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}