The Pie-Crusting Technique for Capsular Management During Hip Arthroscopy Jorge Chahla, M.D., Ph.D., Benjamin Sherman, D.O., Frank Wydra, M.D., Michael.

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Presentation transcript:

The Pie-Crusting Technique for Capsular Management During Hip Arthroscopy Jorge Chahla, M.D., Ph.D., Benjamin Sherman, D.O., Frank Wydra, M.D., Michael B. Gerhardt, M.D. Arthroscopy Techniques Volume 8, Issue 1, Pages e93-e96 (January 2019) DOI: 10.1016/j.eats.2018.09.005 Copyright © 2018 Arthroscopy Association of North America Terms and Conditions

Fig 1 Illustration of the pie-crusting technique as viewed from anterior of the left hip. A standard interportal capsulotomy is performed, and the radiofrequency ablator is used to create small perforations in the capsule. (RF, radiofrequency.) Arthroscopy Techniques 2019 8, e93-e96DOI: (10.1016/j.eats.2018.09.005) Copyright © 2018 Arthroscopy Association of North America Terms and Conditions

Fig 2 View of the femoral neck and capsule as seen from the anterolateral portal of the right hip using a 70° arthroscope. (A) An interportal capsulotomy has been made, and the radiofrequency ablator is seen pulling traction to test excursion of the capsule. (B) Demonstration of the first full-thickness capsule perforation using the ablator approximately 1 cm distal to the interportal capsulotomy. (C) Demonstration of the increase in capsular excursion after the first capsular perforation. Arthroscopy Techniques 2019 8, e93-e96DOI: (10.1016/j.eats.2018.09.005) Copyright © 2018 Arthroscopy Association of North America Terms and Conditions

Fig 3 View of the femoral neck and capsule as seen from the anterolateral portal of the right hip using a 70° arthroscope. The radiofrequency ablator (RF) is seen pulling traction on the anterior hip capsule to check for adequate excursion. Arthroscopy Techniques 2019 8, e93-e96DOI: (10.1016/j.eats.2018.09.005) Copyright © 2018 Arthroscopy Association of North America Terms and Conditions

Fig 4 View of the right hip from the anterolateral portal. Repair of the interportal capsulotomy is performed using a suture shuttling device (Pivot Injector; Stryker) to place 3 No. 1 vicryl sutures from anterior to posterior. Arthroscopy Techniques 2019 8, e93-e96DOI: (10.1016/j.eats.2018.09.005) Copyright © 2018 Arthroscopy Association of North America Terms and Conditions