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Routine Complete Capsular Closure During Hip Arthroscopy
Joshua D. Harris, M.D., William Slikker, M.D., Anil K. Gupta, M.D., M.B.A., Frank M. McCormick, M.D., Shane J. Nho, M.D., M.S. Arthroscopy Techniques Volume 2, Issue 2, Pages e89-e94 (May 2013) DOI: /j.eats Copyright © 2013 Arthroscopy Association of North America Terms and Conditions
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Fig 1 Coronal magnetic resonance arthrogram of right hip. One should note the normal appearance of the left hip and the capsular opening from the acetabular rim with arthrography dye extrusion, after prior hip arthroscopy and capsulotomy left open. Arthroscopy Techniques 2013 2, e89-e94DOI: ( /j.eats ) Copyright © 2013 Arthroscopy Association of North America Terms and Conditions
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Fig 2 (A) Interportal capsulotomy may be made 5 to 8 mm from the labrum with an arthroscopic scalpel (Samurai Blade). A right hip is shown in the supine position with traction, viewing from the AL portal. (B) T capsulotomy with an arthroscopic scalpel (Samurai Blade) made over the femoral neck, with pull from the iliocapsularis and gluteus minimus at each capsular edge. The T capsulotomy allows for a 180° view of the peripheral compartment, affording the ability to address the cam lesion through osteochondroplasty, as well as with open surgical hip dislocation. A right hip is shown in the supine position with traction, viewing from the AL portal. (C) After the T capsulotomy has been made, the femoral cam lesion can easily be visualized. A left hip is shown in the supine position with traction, viewing from the anterior portal. (D) Completed femoral osteochondroplasty from 12 o'clock to 6 o'clock (180° bony resection), shown in a left hip in the supine position with traction, viewing from the anterior portal. Arthroscopy Techniques 2013 2, e89-e94DOI: ( /j.eats ) Copyright © 2013 Arthroscopy Association of North America Terms and Conditions
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Fig 3 (A) Crescent suture lasso placed through AL portal and passed through lateral leaflet of IFL. Nitinol wire is shuttled out of the lasso. A left hip is shown in the supine position without traction, viewing from the anterior portal. (B) A tissue penetrator-passer retrieves the shuttle for side-to-side suture placement. A left hip is shown in the supine position without traction, viewing from the anterior portal. (C) Side-to-side high-strength nonabsorbable suture in each capsular limb before tying. (D) Side-to-side high-strength nonabsorbable suture in the interportal and vertical “T” capsulotomy limbs demonstrating the extra-articular appearance of complete capsular closure. A left hip is shown in the supine position without traction, viewing from the anterior portal. Arthroscopy Techniques 2013 2, e89-e94DOI: ( /j.eats ) Copyright © 2013 Arthroscopy Association of North America Terms and Conditions
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Fig 4 Capsular closure device that grasps and passes high-strength nonabsorbable suture in (A) acetabular side of IFL and (B) femoral side of IFL. A left hip is shown in the supine position without traction, viewing from the anterior portal. Arthroscopy Techniques 2013 2, e89-e94DOI: ( /j.eats ) Copyright © 2013 Arthroscopy Association of North America Terms and Conditions
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