Research progress on the capsulorrhaphy in hip arthroscopy
10.3760/cma.j.cn121113-20250507-00441
- VernacularTitle:髋关节镜术中关节囊缝合的研究现状
- Author:
Zhanyi SUN
1
;
Jin ZHANG
1
Author Information
1. 首都医科大学附属北京积水潭医院，北京 100035
- Publication Type:Journal Article
- Keywords:
Hip;
Arthroscopy;
Joint capsule;
Indications
- From:
Chinese Journal of Orthopaedics
2025;45(17):1154-1160
- CountryChina
- Language:Chinese
-
Abstract:
The hip joint capsule is a fibrous connective tissue sheath that encases the hip joint, enclosing the acetabulum and femoral neck as a sealed articular cavity. It plays an important role in maintaining joint stability by restricting excessive motion. Capsulotomy is an essential step in hip arthroscopy, as it provides adequate exposure of intra-articular pathology and creates the working space for surgical instrument. Commonly employed techniques include interportal capsulotomy, "T" -shaped capsulotomy, and periportal capsulotomy. For patients with proximal abnormal structures such as pincer-type acetabulum, an interportal capsulotomy is recommended. In patients with distal Cam-type deformities at the femoral head-neck junction, a "T" -shaped capsulotomy combined with periportal capsulotomy is advised. When preservation of the iliofemoral ligament is preferred, a periportal capsulotomy may be considered. The necessity of postoperative capsulorrhaphy, as well as the choice of repair technique, are key determinants of surgical success and functional recovery. Current evidence suggests that capsulorrhaphy during arthroscopy contributes to restoring normal anatomy, promoting wound healing, and facilitating postoperative functional outcomes, though it also places technical and experiential demands on the surgeon. Periportal capsulotomy, which preserves the iliofemoral ligament and involves smaller incisions, generally does not require routine closure. By contrast, interportal and "T" -shaped capsulotomies partially disrupt the iliofemoral ligament and cause greater capsular injury, making capsulorrhaphy advisable. Furthermore, capsular closure may be essential in certain populations, including obese patients, females, and patients with borderline developmental dysplasia of the hip, generalized ligamentous laxity, or high athletic demands. This review summarizes the anatomy and biomechanics of the hip capsule, surgical techniques, clinical outcomes, and indications for capsular repair, with the aim of guiding surgical planning and postoperative rehabilitation.
