Hip Capsular Management

William H. Neal; Kyle N. Kunze; Natalie L. Leong; Shane J. Nho

doi:10.1055/s-0038-1642007

The Journal of Hip Surgery, Table of Contents

The Journal of Hip Surgery 2018; 02(03): 111-116
DOI: 10.1055/s-0038-1642007

Special Section Article

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Hip Capsular Management

William H. Neal

¹Section of Young Adult Hip Surgery, Division of Sports Medicine, Department of Orthopedic Surgery, Rush University Medical Center, Rush Medical College of Rush University, Chicago, Illinois

,

Kyle N. Kunze

¹Section of Young Adult Hip Surgery, Division of Sports Medicine, Department of Orthopedic Surgery, Rush University Medical Center, Rush Medical College of Rush University, Chicago, Illinois

,

Natalie L. Leong

¹Section of Young Adult Hip Surgery, Division of Sports Medicine, Department of Orthopedic Surgery, Rush University Medical Center, Rush Medical College of Rush University, Chicago, Illinois

,

Shane J. Nho

¹Section of Young Adult Hip Surgery, Division of Sports Medicine, Department of Orthopedic Surgery, Rush University Medical Center, Rush Medical College of Rush University, Chicago, Illinois

› Author Affiliations

Abstract

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.

Keywords

arthroscopy - hip - capsule - management - femoroacetabular impingement

Full Text

References

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