Capsular Suspension Technique for Hip Arthroscopy

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Presentation transcript:

Capsular Suspension Technique for Hip Arthroscopy Andrew E. Federer, M.D., Vasili Karas, M.D., M.S., Shane Nho, M.D., Struan H. Coleman, M.D., Ph.D., Richard C. Mather, M.D., M.B.A. Arthroscopy Techniques Volume 4, Issue 4, Pages e317-e322 (August 2015) DOI: 10.1016/j.eats.2015.03.004 Copyright © 2015 Arthroscopy Association of North America Terms and Conditions

Fig 1 (A) Central-compartment capsulotomy in a left hip, showing the reflected head of the rectus femoris in the medial aspect of the capsulotomy. Visualization is performed through the anterior portal (AP) and working through the anterolateral portal (ALP). (B) Portal and suspension clamp setup in a left hip with the patient in the supine position. The cephalad (H) aspect of the patient is on the right, and the caudad (T) aspect is on the left. The camera is viewing from the AP with a clamp suspending the medial capsule (MC). Another clamp is on the ALP suspending the lateral capsule (LC), and the distal anterolateral (DALA) portal is the most distal portal. (C) Visualization of the central compartment with the ALP as the viewing portal, showing a clear view of the labrum (L) with a retracted medial capsule; the lateral capsule is outside the viewing field. (D) Visualization of subspine (SS) from ALP with the medial capsule suspended and the labrum inferiorly. (FH, femoral head; RF, rectus muscle.) Arthroscopy Techniques 2015 4, e317-e322DOI: (10.1016/j.eats.2015.03.004) Copyright © 2015 Arthroscopy Association of North America Terms and Conditions

Fig 2 (A) Peripheral compartment in a left hip viewed through the anterolateral portal (ALP) after labral repair and before osteochondroplasty within this compartment. The femoral head (FH) is inferior, the medial capsule (MC) is suspended, and the labrum (L) has been repaired. (B) Proximal portion of the lateral leaflet of the peripheral-compartment obstructing visualization after placement of 1 medial and 1 lateral suspension suture, with visualization through the anterior portal (AP). (C) Placement of the second stitch in the lateral capsule, viewing from the AP. (D) Suspension of the lateral capsule with visualization of a cam lesion, as well as the lateral synovial folds about the lateral limb of the capsule. (FN, femoral neck; LL, lateral limb.) Arthroscopy Techniques 2015 4, e317-e322DOI: (10.1016/j.eats.2015.03.004) Copyright © 2015 Arthroscopy Association of North America Terms and Conditions

Fig 3 Peripheral compartment in a left femur viewed through the anterolateral portal (ALP) with initiation of osteochondroplasty, with excellent visualization of the cam lesion, as well as the medial (M) and lateral (L) base of the femoral neck (FN). Arthroscopy Techniques 2015 4, e317-e322DOI: (10.1016/j.eats.2015.03.004) Copyright © 2015 Arthroscopy Association of North America Terms and Conditions