Biomechanical evaluation of capsulotomy, capsulectomy, and capsular repair on hip rotation

Geoffrey D. Abrams, Michael A. Hart, Kaosu Takami, Christopher Bayne, Bryan T. Kelly, Alejandro A. Espinoza Orías, Shane J. Nho

Research output: Contribution to journalArticle

68 Scopus citations

Abstract

Purpose To determine the effect of different types of capsulotomies on hip rotational biomechanical characteristics. Methods Seven fresh-frozen cadaveric hip specimens were thawed and dissected, leaving the hip capsule and labrum intact. The femur was transected and potted, and each specimen was placed in a custom loading apparatus that allowed for adjustment of flexion, extension, and axial rotation of the femur. Six reflective infrared markers were attached to the specimens to track the motion of the femoral head with respect to the acetabulum in real time, and external rotation was produced by applying a torque of 10 Nm to the hip specimens. Data analysis was performed using the 3-dimensional position of the markers in space. The specimens were tested in neutral flexion and 40° of flexion in the following capsular states: intact, interportal capsulotomy, T-capsulotomy, repaired capsulotomy, and capsulectomy. Paired t tests and analysis of variance were used with an α value of.05 set as significant. Results With the hip in neutral flexion, there was increased external rotation with a T-capsulotomy (91.1° ± 20.3°, P =.029) and capsulectomy (91.9° ± 19.6°, P =.015) compared with the intact hip (83.2° ± 20.5°). After complete repair of the T-capsulotomy (87.4° ± 20.6°), there was no significant difference in external rotation compared with the intact hip. No significant differences were seen between groups at 40° of hip flexion. Conclusions A T-capsulotomy showed significantly increased external rotation versus the intact and interportal capsulotomy states. The repaired T-capsulotomy restored the rotational profile back to the native state. Clinical Relevance Many methods of capsular treatment during hip arthroscopy exist. Capsulotomy and capsulectomy do not restore the external rotation restraint of the hip back to its native state.

Original languageEnglish (US)
Pages (from-to)1511-1517
Number of pages7
JournalArthroscopy - Journal of Arthroscopic and Related Surgery
Volume31
Issue number8
DOIs
StatePublished - Jan 1 2015
Externally publishedYes

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine

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