Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2015 Feb 16;4(1):e71-4.
doi: 10.1016/j.eats.2014.11.008. eCollection 2015 Feb.

Arthroscopic capsule reconstruction in the hip using iliotibial band allograft

Christiano A C Trindade  1 , Gregory A Sawyer  1 , Kiyokazu Fukui  1 , Karen K Briggs  1 , Marc J Philippon  1
Affiliations

Arthroscopic capsule reconstruction in the hip using iliotibial band allograft

Christiano A C Trindade et al. Arthrosc Tech. .

Abstract

The hip capsule has been identified as an important static stabilizer of the hip joint. Despite the intrinsic bony stability of the hip socket, the capsule plays a key role in hip stability, particularly at the extremes of motion, and the iliofemoral ligament is the most important stabilizer in extension and external rotation. Patients who do not undergo capsular closure or plication may continue to complain of hip pain and dysfunction postoperatively, likely because of microinstability or muscle invagination into the capsular defect, and high-resolution magnetic resonance imaging or magnetic resonance arthrography will identify the capsular defect. Seen primarily in the revision setting, capsular defects can cause recurrent stress at the chondrolabral junction. An attempt at secondary closure can be challenging because of capsular limb adherence to the surrounding soft tissues. Therefore reconstruction may be the only possible surgical solution for this problem. We describe our new surgical technique for arthroscopic hip capsular reconstruction using iliotibial band allograft.

PubMed Disclaimer

Figures

Fig 1
Fig 1
Magnetic resonance images showing (A) large capsular defect (arrow) on coronal view and (B) muscle herniation into capsular defect (arrow) on sagittal view.
Fig 2
Fig 2
(A) The edges of the folded graft are sutured with No. 2-0 absorbable, braided suture, making a quadrilateral shape. (B) The No. 2-0 suture runs in a figure-of-8 fashion to make a complete surrounding of the graft edges. (C) On each corner of the graft, loops are made using a No. 2 absorbable, braided suture.
Fig 3
Fig 3
Left hip capsule as seen from midanterior portal, with patient in modified supine position. After insertion into the joint, the graft must be adequately placed in position.
Fig 4
Fig 4
Left hip (subspinal region) seen from midanterior portal, with patient in modified supine position. The suture loops on each corner of the graft help achieve control inside the joint and adequate fixation to the subspinal region and native capsule. (FN, femoral neck; PL, proximal loop).
See this image and copyright information in PMC

References

    1. Telleria J.J., Lindsey D.P., Giori N.J., Safran M.R. A quantitative assessment of the insertional footprints of the hip joint capsular ligaments and their spanning fibers for reconstruction. Clin Anat. 2014;27:489–497. - PubMed
    1. Harris J.D., Slikker W., III, Gupta A.K., McCormick F.M., Nho S.J. Routine complete capsular closure during hip arthroscopy. Arthrosc Tech. 2013;2:e89–e94. - PMC - PubMed
    1. Domb B.G., Philippon M.J., Giordano B.D. Arthroscopic capsulotomy, capsular repair, and capsular plication of the hip: Relation to atraumatic instability. Arthroscopy. 2013;29:162–173. - PubMed
    1. Fujishiro T., Nishikawa T., Takikawa S., Saegusa Y., Yoshiya S., Kurosaka M. Reconstruction of the iliofemoral ligament with an artificial ligament for recurrent anterior dislocation of total hip arthroplasty. J Arthroplasty. 2003;18:524–527. - PubMed
    1. Martin H.D., Savage A., Braly B.A., Palmer I.J., Beall D.P., Kelly B. The function of the hip capsular ligaments: A quantitative report. Arthroscopy. 2008;24:188–195. - PubMed

LinkOut - more resources