Arthroscopic Technique of Capsular Plication for the Treatment of Hip Instability

Self Cite

Femoroacetabular impingement describes a pathologic interaction between the bony femoral head/neck junction and acetabulum. Cam-type femoroacetabular impingement results from an aspherical femoral head architecture, which increases early contact along the acetabular surface during hip range of motion. Errant arthroscopic femoroplasty recently has been discussed within the literature to describe a preventable etiology of failed hip arthroscopy, most notably cam over-and under-resection. We present an arthroscopic surgical technique for achieving the perfectly spherical femoroplasty, meant to minimize complications and improve postoperative outcomes.

Section: Capsular Managementmentioning

confidence: 99%

Achieving a Perfectly Spherical Femoroplasty: Pearls, Pitfalls, and Optimal Surgical Technique

Lall

Annin

Chen

et al. 2020

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“…Capsular plication was performed at the conclusion of intracapsular procedures, as previously described. 21 Traction was released from the operative extremity, and the hip was flexed to 45 . A 7-mm disposable cannula (Arthrex) was introduced through the anterior and midanterior portals.…”

Section: Intraoperative Proceduresmentioning

confidence: 99%

Posterolateral Acetabuloplasty and Distal Femoral Neckplasty, Labral Repair, and Capsular Plication for Hip Reverse Contre-Coupe Lesion

Chandrasekaran

Walsh

Hartigan

et al. 2017

Self Cite

This article describes the arthroscopic approach and management of a "reverse contre-coup" injury to the hip labrum. The injury occurs in the setting of posterolateral acetabular rim over-coverage impinging on the distal femoral neck in extension causing the femoral head to lever out anteriorly against the labrum. Ligamentous laxity and associated loss of anterior capsular restraint allow increased femoral head translation, adding further insult to the anterior labrum. The arthroscopic approach entails not only a labral repair with correction of the osseous conflict but also restoration of soft-tissue stability to minimize anterior femoral translation.

“…Chandrasekaran and Domb proposed that capsular plication should be advocated when treating patients with hip instability. 5 In our practice, we have experienced cases of disruption of the suture site after a routine capsular closure with strong suture for treating hip instability. Thus, we devised a surgical technique for capsular closure or plication using smooth suture tape (Ultratape; Smith & Nephew, Andover, MA) (the shoelace technique).…”

mentioning

confidence: 99%

Arthroscopic Shoelace Capsular Closure Technique in the Hip Using Ultratape

Uchida

Pascual‐Garrido

Ohnishi

et al. 2017

Hip arthroscopy is promising tool for assessing and treating intra-articular pathologies including labral tears, cartilage injuries, and ligamentum teres tears of the hip. Interportal capsulotomy allows for better visualization and accessibility of the arthroscope and working instruments. The hip capsule has been defined as a crucial stabilizer of the hip joint. Thus, capsular closure is recognized as an important procedure to prevent postoperative instability after hip arthroscopic surgery. Despite the routine capsular closure during hip arthroscopy, there is a small subset of patients who complain of hip pain and dysfunction after surgery most likely because of disruption of hip closure site after routine complete capsular closure with strong suture for treating hip instability. This technical note describes the arthroscopic shoelace capsular suture technique using Ultratape for treating femoroacetabular impingement with capsular laxity and borderline hip dysplasia.