Capsule Repair After Arthroscopic Surgery of the Hip

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Hip arthroscopy is a surgical technique used to address intra-articular cartilage and labral pathologies. Hip joint stability is determined by static (osseous, labral, and capsuloligamentous) and dynamic (neuromuscular and adhesional forces) factors. Understanding of the hip capsuloligamentous complex and its importance to hip stability, post operative function level, and pain continues to grow. Capsulotomy is commonly used in hip arthroscopy to allow visualization and instrument navigation however the optimal technique, amount of resection, and indications for capsular repair remain unknown. As the arthroscopic treatment of FAI has rapidly developed over the past 10 years, leaving the capsule open has been the common standard. Lately, capsular repair is increasingly considered, as concerns are raised regarding long term effects of extensive capsulotomies and occasional reports of devastating post operative side effects, such as post arthroscopy dislocation or subtle instability resulting in rapid osteoarthritis, are being published. It should be noted that these complications have only been seen in patients with a shallow hip socket or hyperlaxity, both of which are exclusion criteria for this study. Our hypothesis is that capsular repair, after cam FAI surgery, requiring moderate capsulotomy, would result in better patient outcomes, in the short, mid ad long term, both clinically and radiographically.

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