Capsular Closure
What is Hip Capsular Closure?
The hip capsule is a membranous fold consisting of three major ligaments enveloping the hip joint. It protects the joint and stabilizes it by keeping the joint in position.
Hip capsular closure is performed to repair the hip capsule at the end of a hip arthroscopy procedure.
Hip arthroscopy is a minimally-invasive surgical procedure performed through a very small incision to diagnose and treat a wide range of hip problems.
Why Do You Need Hip Capsular Closure?
During hip arthroscopy, the capsule is penetrated to improve access and achieve adequate visibility of the joint structures. Therefore, there is a risk of developing iatrogenic instability (the instability resulting from direct surgical or medical intervention) due to capsular insufficiency.
This situation can be avoided with effective closure of the hip capsule and must be performed to prevent future complications.
The procedure is usually recommended for young, active individuals
What if the Hip Capsule is not Closed?
If the hip capsule is not closed, you may:
- Experience deterioration in the functioning of the hip joint
- Require a further surgical procedure called arthroplasty
- Face medical conditions such as acetabular or femoral head Outerbridge
The Procedure
During hip arthroscopy, portals are created through the capsule to access the joint structures. For further access, the capsule is cut between two portal entry sites usually in the front of the joint extending towards the side. Once the joint structures have been repaired, the instruments are removed and capsule closure is performed
Adequate healthy capsular tissue is required for proper capsular closure. The procedure is usually performed with sutures using different techniques. A special suturing instrument is inserted through one portal with a camera in the other portal. Separate sutures are passed through the upper part of the capsular cut and then the lower part along the length of the capsular incision with care to avoid damage to the underlying joint structures such as the cartilage or labrum. The sutures are then tied closing the capsule. Three sutures are usually necessary but as many as eight may be needed to achieve a watertight capsular closure.
Benefits
Hip capsular closure helps to:
- Cut down the risk of iatrogenic instability
- Restore proper hip biomechanics
- Prevent anterior hip dislocations (total or partial)
- Maintain the stability of the hip
- Improve functional outcomes of the hip
- Provide a safe and effective option for non-arthritic patients
Contraindications
Hip capsular closure is not recommended in cases of stiff hips, borderline arthritic changes, and inflammatory hip disorders.