Hip Capsular Closure in Distraction: A Technique to Allow Easier Closure of T and Interportal Capsulotomies

Abstract

Capsule closure during hip arthroscopy is increasingly being shown to optimize outcomes and minimize complications. Although various techniques and suture configurations have been described, closure of the hip capsule remains a technically challenging step for many hip arthroscopists. The purpose of this Technical Note is to summarize capsular management in arthroscopic hip-preservation surgery and to outline a technique of passing capsule sutures under hip traction. This technique is useful, as it facilitates adequate visualization of the vertical limb of the T capsulotomy and interportal capsulotomy, which is difficult when attempted with the hip out of traction and flexed. Our technique also helps to reduce the risk of iatrogenic cartilage injury during suture passage by increasing the distance between the femoral head and capsule leaflets, or the functional working area for capsule closure.