Domb BG, et al. - The authors aimed to clarify whether capsular closure during hip arthroscopy affected patient outcomes over midterm follow-up. Observations revealed a significant short-term improvement among patients undergoing hip arthroscopy and who had minimal or no arthritis, this was evident irrespective of the capsule closure. However, patients who had unrepaired capsules showed deterioration in mHHS as well as a higher rate of conversion to arthroplasty at midterm follow-up, even when controlling for various perioperative variables. Despite this, patients met the Minimal clinical important difference (MCID) and patient acceptable symptomatic state (PASS) criteria in both groups. Findings suggested that in patients undergoing hip arthroscopy, routine capsular closure could result in more consistently durable outcome, but also that individual patient pathology may dictate capsular management.