Should the Capsule Be Repaired or Plicated After Hip Arthroscopy for Labral Tears Associated With Femoroacetabular Impingement or Instability? A Systematic Review
Authors
Ortiz-Declet V, Mu B, Chen AW, Litrenta J, Perets I, Yuen LC, Domb BG
Journal: Arthroscopy. 2018 Jan;34(1):303–318
DOI: 10.1016/j.arthro.2017.06.030
Background
There is ongoing debate about whether to repair the hip capsule after arthroscopy for FAI or instability.
Methods
This systematic review included 34 studies (biomechanical, case reports, and clinical outcomes) examining the role of the capsule in hip stability and outcomes after capsular repair vs non-repair.
Key Findings
Biomechanical studies showed clear support for capsule repair in maintaining joint stability. Clinical studies and case reports found better outcomes and fewer complications with repair or plication. Capsular closure showed superior outcomes to unrepaired capsulotomy in non-arthritic patients.
Conclusions
Routine capsular repair is supported by biomechanical and clinical evidence, particularly in patients with instability or borderline dysplasia. Capsular release may be appropriate for stiff or inflamed hips.
What Does This Mean for Patients
Reconstructing the hip capsule during surgery can enhance joint stability and improve outcomes—especially in patients at risk of instability.