Hip Capsular Management in Patients With Femoroacetabular Impingement or Microinstability: A Systematic Review of Biomechanical Studies
Authors: Jimenez AE, Owens JS, Shapira J, Saks BR, Ankem HK, Sabetian PW, Lall AC, Domb BG
DOI: 10.1016/j.arthro.2021.04.004
Background
Hip microinstability is characterized by excessive joint motion, leading to pain and dysfunction. The hip capsule is critical for joint stability, and surgical management of the capsule may influence postoperative outcomes.
Methods
This systematic review analyzed biomechanical studies assessing how hip capsular management techniques—repair, release, or reconstruction—affect joint stability and range of motion in surgeries for femoroacetabular impingement (FAI) or microinstability.
Key Findings
- Capsular repair or reconstruction restores joint stability and optimizes motion.
- Capsular release without repair increases joint instability.
- Repair and reconstruction correlate with improved biomechanical stability.
Conclusions
Biomechanical evidence favors capsular repair or reconstruction to maintain hip joint stability postoperatively, especially in patients with microinstability or FAI.
What Does This Mean for Providers?
- Prioritize capsular repair or reconstruction during hip arthroscopy to optimize biomechanical stability and patient outcomes.
- Avoid indiscriminate capsular release, particularly in patients with microinstability.
- Consider patient-specific factors such as joint laxity and instability when deciding on capsular management.
- Integrate biomechanical principles into surgical planning to minimize postoperative instability and improve functional recovery.