Do Not Take for Granted! The Art of Elevating the Capsule in Hip Arthroscopy: A Stepwise Approach
Authors: Maldonado DR, Chen JW, Lall AC, Kyin C, Walker-Santiago R, Rosinsky PJ, Shapira J, Domb BG
DOI: 10.1016/j.eats.2019.04.003
Background
Capsular management is a critical technical aspect of hip arthroscopy, especially with increasing emphasis on capsular closure and plication to prevent postoperative instability. This article outlines a stepwise technique for safe and effective capsular elevation.
Methods
A detailed technical guide is provided to elevate the capsule while preserving its integrity. The approach ensures a reproducible capsulotomy and facilitates later closure or plication, reducing risk of iatrogenic damage.
Key Findings
- Proper capsule elevation enhances access to the joint while preserving tissue needed for secure capsular closure.
- Avoids complications like incomplete closures or excessive tissue loss.
- Reinforces the need to respect capsular tissue even in basic arthroscopic procedures.
Conclusions
Capsular preservation and careful elevation should be treated as essential surgical steps. A structured approach promotes technical efficiency, reduces risk, and enhances long-term outcomes.
What Does This Mean for Providers?
- Adopt a systematic capsular elevation technique to ensure surgical efficiency and enable optimal closure or plication.
- Essential for both novice and experienced hip arthroscopists to minimize instability risks.
- Improves joint access without compromising the ability to perform critical stabilizing procedures later in the surgery.