Biomechanical Evaluation of Capsulotomy, Capsulectomy, and Capsular Repair on Hip Rotation

Abrams, Geoffrey D.; Hart, Michael H.; Takami, Kaosu; Bayne, Christopher O.; Kelly, Bryan T.; Orías, Alejandro A. Espinoza; Nho, Shane J.

doi:10.1016/j.arthro.2015.02.031

Cited by 164 publications

(163 citation statements)

References 23 publications

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“…Biomechanical studies have shown altered hip kinematics after capsulotomy including excessive hip rotation and translation. [2][3][4] Capsule closure or plication has been reported to be an independent predictor of improved patient outcome in several series of revision hip arthroscopy. 5,6 Frank et al 7 showed improved functional outcomes and patient satisfaction as well as a decreased need for revision surgery after complete capsular closure compared with partial closure.…”

mentioning

confidence: 99%

Hip Arthroscopy Capsular Closure: The Figure of Eight Technique

Aoki

Karns

Hananouchi

et al. 2017

Arthroscopy Techniques

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Hip arthroscopy techniques have continued to evolve for femoroacetabular impingement and other intraarticular pathologies. However, there is still debate about the importance and technique of routine capsular closure. We present an efficient and reliable technique for creating a watertight capsular closure to prevent iatrogenic macro and microinstability. This Technical Note details our stepwise technique using figure of eight sutures to obtain a complete and secure capsular closure.

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mentioning

confidence: 99%

Hip Arthroscopy Capsular Closure: The Figure of Eight Technique

Aoki

Karns

Hananouchi

et al. 2017

Arthroscopy Techniques

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“…1,14 Given that treatment of the capsule during hip arthroscopy is variable among surgeons, 15 many biomechanical studies have aimed to better describe the properties of the hip capsule and their implications on hip arthroscopy. 15 Capsulectomy, the removal of the capsule, provides complete visualization without the need for tissue retraction. In this technique, standard arthroscopic portals are used to access the central compartment with the hip in traction.…”

Section: Surgical Management Of the Capsulementioning

confidence: 99%

“…When the surgeon addresses the peripheral compartment, the CAM deformity is identified with fluoroscopy and the capsule overlying the defect is resected. 15 An advantage of this method is the elimination of pathologic tissue as a potential pain generator, as observed in cases of capsular hypertrophy or stiffness. However, because the medial and lateral arms of the ILFL are released in this technique, excision permanently alters joint mechanics.…”

Section: Surgical Management Of the Capsulementioning

confidence: 99%

Hip Capsular Management

et al. 2018

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Due to both the currently available technology and anatomic constraints of the hip joint, capsulotomy is necessary to perform hip arthroscopy. Proper management of the hip capsule is a crucial component of hip arthroscopy that has evolved with increased awareness that capsular closure during hip arthroscopy reestablishes the normal anatomy of the iliofemoral ligament and thus restores the biomechanical characteristics of the hip joint. This article reviews the biomechanical rationale for hip access and closure, as well as recent clinical studies on patient-reported outcomes with regard to capsular closure. Additionally, capsulotomy techniques including capsulectomy as well as interportal and T-capsulotomy techniques are reviewed, and the authors' preferred technique for capsular management is described. While capsular closure is technically challenging and increases operative time, meticulous closure improves outcomes by reducing postoperative micro- and gross instability.

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“…47 In recent cadaveric studies, authors demonstrated that larger size capsulotomies significantly increase joint instability and hip external rotation while proper repair restored the normal range of motion and capsule stability. 48,49 …”

Section: Fai Managementmentioning

confidence: 99%

The current situation in hip arthroscopy

et al. 2017

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Hip arthroscopy is an evolving surgical technique that has recently increased in popularity.Although femoroacetabular impingement was an important launch pad for this technique, extra-articular pathology has been described through hip endoscopy.Good clinical results in the medium term will allow improvements in this technique and increase its indications.Cite this article: EFORT Open Rev 2017;2:58-65. DOI: 10.1302/2058-5241.2.150041

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Biomechanical Evaluation of Capsulotomy, Capsulectomy, and Capsular Repair on Hip Rotation

Cited by 164 publications

References 23 publications

Hip Arthroscopy Capsular Closure: The Figure of Eight Technique

Hip Arthroscopy Capsular Closure: The Figure of Eight Technique

Hip Capsular Management

The current situation in hip arthroscopy

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