Arthroscopic Hip Capsular Plication With Augmentation Using a Bioinductive Collagen Implant

Abstract

With advancements in arthroscopic techniques and instrumentation, hip arthroscopy has become an increasingly used technique to treat soft-tissue and osseous pathologies about the hip. Patient predisposition to labral and capsular injuries can present as femoroacetabular impingement or hip dysplasia, sometimes in combination. Capsular management continues to be a topic of debate, with capsular repair becoming the standard of care in most cases. Furthermore, in cases of borderline dysplasia and microinstability, considerations for not only capsular repair but with plication has shown significant clinical success. Although plication in this setting has shown promise, given a 20% failure rate, we suggest capsular augmentation to bolster the repair. We present a technique of capsular augmentation using a bioinductive collagen implant (Smith & Nephew) to improve the capsular integrity following repair and plication. The benefits of this implant are easy delivery through standard arthroscopic portals and secure fixation to the capsular tissue. These implants have a proven track record in the shoulder and serve as a scaffold for improved tissue quality, and their application in hip arthroscopy has potential by increasing the integrity of the capsular repair. Future studies are needed to address the clinical outcomes of this technique.