TY - JOUR
T1 - Effect of capsulotomy on hip stability-a consideration during hip arthroscopy
AU - Bayne, Christopher
AU - Stanley, Robert
AU - Simon, Peter
AU - Espinoza-Orias, Alejandro
AU - Salata, Michael J.
AU - Bush-Joseph, Charles A.
AU - Inoue, Nozomu
AU - Nho, Shane J.
PY - 2014/4/1
Y1 - 2014/4/1
N2 - We conducted a study to further understand the effect of capsulotomy on hip joint stability using an in vitro cadaver model. Thirteen fresh-frozen cadaveric hip specimens were subjected to an external rotation torque of 0.588 Nm. The experimental kinematics, post-process translation, and rotation data for each specimen were tested under 4 conditions: neutral flexion with capsule intact; neutral flexion with transverse capsulotomy; maximum flexion with capsule intact; and maximum flexion with transverse capsulotomy. A segmented 3-dimensional model of the femur was used to evaluate femoral head translation after application of external rotation torque. In maximum flexion, hips with intact capsules rotated less than hips with capsulotomy in the y (abduction) and z (external rotation) planes (y-plane, P = .01; z-plane, P = .02). After capsulotomy, there was a qualitative observation of increased distal, lateral, and anterior translation of the femoral head in neutral position, and a qualitative observation of increased medial, posterior, and distal translation of the femoral head in flexion. Qualitatively, after capsulotomy, hips tested in neutral position demonstrated more translation than rotation, whereas hips tested in flexion demonstrated more rotation than translation. Capsulotomy appears to permit increased rotation in maximum flexion. Hips tested in neutral trended toward more translation than rotation, whereas hips in flexion trended toward more rotation than translation. Judicious capsular management is indicated during arthroscopic hip procedures.
AB - We conducted a study to further understand the effect of capsulotomy on hip joint stability using an in vitro cadaver model. Thirteen fresh-frozen cadaveric hip specimens were subjected to an external rotation torque of 0.588 Nm. The experimental kinematics, post-process translation, and rotation data for each specimen were tested under 4 conditions: neutral flexion with capsule intact; neutral flexion with transverse capsulotomy; maximum flexion with capsule intact; and maximum flexion with transverse capsulotomy. A segmented 3-dimensional model of the femur was used to evaluate femoral head translation after application of external rotation torque. In maximum flexion, hips with intact capsules rotated less than hips with capsulotomy in the y (abduction) and z (external rotation) planes (y-plane, P = .01; z-plane, P = .02). After capsulotomy, there was a qualitative observation of increased distal, lateral, and anterior translation of the femoral head in neutral position, and a qualitative observation of increased medial, posterior, and distal translation of the femoral head in flexion. Qualitatively, after capsulotomy, hips tested in neutral position demonstrated more translation than rotation, whereas hips tested in flexion demonstrated more rotation than translation. Capsulotomy appears to permit increased rotation in maximum flexion. Hips tested in neutral trended toward more translation than rotation, whereas hips in flexion trended toward more rotation than translation. Judicious capsular management is indicated during arthroscopic hip procedures.
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M3 - Article
C2 - 24730000
AN - SCOPUS:84921920901
VL - 43
SP - 160
EP - 165
JO - American Journal of Orthopedics
JF - American Journal of Orthopedics
SN - 1078-4519
IS - 4
ER -