Background: A major complication of total hip arthroplasty is dislocation. The hip joint capsule can be incised and repaired, or can be excised.
Sources Of Data: We performed a systematic review of the literature following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines focusing on capsular repair and capsulectomy.
Areas Of Agreement: We identified 31 articles (17 272 patients). Capsular repair produced a lower blood loss (465.2 vs 709.2 ml), and the procedure lasted 102.5 vs 96.08 min in patients who underwent capsulectomy. The patients undergoing capsulectomy experienced a dislocation rate of 3.06%, whereas in the patients undergoing capsular repair, the dislocation rate was 0.65%.
Areas Of Controversy: Most studies are retrospective observational studies, with no prospective randomized trials.
Growing Points: Capsular preservation is association with a lower dislocation rate and a lower blood loss. Capsular excision does take statistically less time, but it is uncertain how a 6 min difference is clinically relevant.
Areas Timely For Developing Research: Appropriately powered randomized clinical trials should be conducted to better define the association between the chosen implants, approach and outcome.
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The combination of hip arthroscopy and periacetabular osteotomy (PAO) has been proven safe and effective for addressing symptoms in patients with developmental dysplasia of the hip (DDH). As not every patient with dysplasia will require a hip arthroscopy to obtain desired clinical improvement in the setting of periacetabular osteotomy, a challenge is identifying which patients require adjacent procedures (either via arthroscopic or open) to fully treat their hip pathology. Even though labral repair is the most reported arthroscopic procedure in cases of hip dysplasia, I would suggest that labral treatment is the least likely helpful component of hip arthroscopy in these cases.
View Article and Find Full Text PDFClinical and radiological outcomes of arthroscopic bony Bankart repair using the 'door-locking' technique: excellent bone healing with a low complication rate.
J Shoulder Elbow Surg
January 2025
State Key Laboratory of Pharmaceutical Biotechnology, Division of Sports Medicine and Adult Reconstructive Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, 321 Zhongshan Road, Nanjing, 210008, Jiangsu, People's Republic of China; Branch of National Clinical Research Center for Orthopedics, Sports Medicine and Rehabilitation, Nanjing Jiangsu, 210008, People's Republic of China. Electronic address:
Background: Arthroscopic repair is recommended for patients with bony Bankart lesions to restore anterior shoulder stability and avoid recurrent glenohumeral instability. The aim of this study was to investigate the clinical and radiological outcomes of patients following arthroscopic bony Bankart repair using a single suture anchor fixation technique named the "door-locking" technique.
Methods: From January 2017 to February 2024, a consecutive series of 22 patients with acute bony Bankart lesions underwent shoulder arthroscopy.
With Proper Surgical Indications, Sex-Based Differences in Pathology Do Not Impact Hip Arthroscopy Outcomes or Complications: A Systematic Review.
Arthroscopy
January 2025
American Hip Institute Research Foundation, Chicago, IL 60018. Electronic address:
Purpose: To identify sex-based differences in pathology, outcomes, and complications after hip arthroscopy for femoroacetabular impingement (FAI), and to compare patient-reported outcomes (PRO) scores between males and females.
Methods: The PubMed and MEDLINE databases were searched in September 2024, according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Included studies had data stratified by sex, minimum 2-year patient reported outcome (PRO) scores for hip arthroscopy in the setting of FAI and labral pathology, and a 2014 or later publication date.
No difference in outcomes after remplissage or open Bankart repair plus inferior capsular shift in collision and contact athletes with subcritical glenoid bone loss ≤ 10 % and off-track Hill Sachs lesion.
Arthroscopy
December 2024
Sanatorio Allende. Avenida Hipólito Irigoyen 384, Nueva Córdoba, CP 5000, Córdoba, Argentina. Electronic address:
Purpose: To compare functional outcomes, recurrence rate, range of motion (ROM) and return to sport between arthroscopic Bankart repair with remplissage (BR) and open Bankart repair with inferior capsular shift (OBICS) in contact and collision athletes with recurrent anterior shoulder instability.
Methods: A prospective comparative cohort study of 90 patients separated into two study groups (OBICS and BR) of 45 collision and contact athletes each was conducted. All athletes had subcritical glenoid bone loss (SGBL) ≤ 10% and off-track Hill Sach lesions (HSLs).
In all aspects of orthopaedic surgery, restoring native patient anatomy has shown improved outcomes in comparison to nonanatomic reconstructions. Particular attention has been paid to the hip capsule, as the complex of the iliofemoral, pubofemoral, and ischiofemoral ligaments, as well as the zona orbicularis and iliocapsularis, all play an essential role in hip stability, mechanics, and maintenance of intra-articular pressures. An anatomic approach toward hip arthroscopy also includes labral repair or reconstruction with preservation of the chondrolabral junction and cam resection.
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