Capsular repair vs capsulectomy in total hip arthroplasty

Abstract

Background A major complication of total hip arthroplasty is dislocation. The hip joint capsule can be incised and repaired, or can be excised. Sources of data We performed a systematic review of the literature following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines focusing on capsular repair and capsulectomy. Areas of agreement We identified 31 articles (17 272 patients). Capsular repair produced a lower blood loss (465.2 vs 709.2 ml), and the procedure lasted 102.5 vs 96.08 min in patients who underwent capsulectomy. The patients undergoing capsulectomy experienced a dislocation rate of 3.06%, whereas in the patients undergoing capsular repair, the dislocation rate was 0.65%. Areas of controversy Most studies are retrospective observational studies, with no prospective randomized trials. Growing points Capsular preservation is association with a lower dislocation rate and a lower blood loss. Capsular excision does take statistically less time, but it is uncertain how a 6 min difference is clinically relevant. Areas timely for developing research Appropriately powered randomized clinical trials should be conducted to better define the association between the chosen implants, approach and outcome.

Imageless navigation for primary total hip arthroplasty: a meta-analysis study

“…This may generate inconsistencies [ 8 , 14 , 46 ]. Muscular damage or detachment, capsular repair and capsulotomy may have an influence on the surgical outcome [ 47 – 49 ]; however, given the lack of available data, these points were not possible to analyse separately. Given the lack of available data, surgical exposure (minimally or standard invasive), type of implant, cementation and post-operative protocol were not considered for analysis [ 9 , 50 – 52 ].…”

Reliability and repeatability of 2021 ARCO classification and its guiding significance in treatment of nontraumatic osteonecrosis of the femoral head

“…ONFH is common in young adults, and its prevalence is reportedly increasing [ 3 ]. In addition, because the disease is more common in young people and the prosthesis has a certain lifespan, young patients are at risk of the need for multiple replacements [ 4 ]. Therefore, many scholars have focused on how to improve the success rate of preserving the femoral head in patients with early ONFH [ 5 – 7 ].…”

CORR Insights®: Small Random Angular Variations in Pelvic Tilt and Lower Extremity Can Cause Error In Static Image-based Preoperative Hip Arthroplasty Planning: A Computer Modeling Study

“…The etiology of dislocation is certainly multifactorial. Soft tissue management is related to the risk of dislocation [7], and clinical experience supports a role for muscle weakness and patient selection. Implant position also influences the risk of THA dislocation, but the best femoral and acetabular component position remains elusive and may not be the same for all patients.…”