Evidence of capsular defect following hip arthroscopy

  • Frank McCormickEmail author
  • William SlikkerIII
  • Joshua D. Harris
  • Anil K. Gupta
  • Geoffrey D. Abrams
  • Jonathan Frank
  • Bernard R. BachJr
  • Shane J. Nho



The purpose of this study is to identify the incidence of capsular defects in patients undergoing revision hip arthroscopy.


A radiographic and anatomical analysis of MR arthrograms of patients undergoing revision arthroscopy was performed to assess for the presence of capsular defect. Intra-operative images and findings were reviewed. Patients with persistent cam and pincer lesions were excluded.


From October 2011 to October 2012, 25 patients underwent revision hip arthroscopy surgery, and 9 patients met our inclusion criteria. Within this series, all patients had post-surgical capsular irregularities and seven patients (78 %) had radiographic evidence of capsule and iliofemoral defects on MR arthrogram. Gross capsular defects were confirmed at revision surgery in two patients.


The findings of this study demonstrate post-surgical radiographic and anatomical evidence of capsular defects in a select group of patients following hip arthroscopy.

Level of evidence



Hip arthroscopy Capsulectomy Hip micro-instability Femoral acetabular impingement 


  1. 1.
    Bedi A, Galano G, Walsh C, Kelly BT (2011) Capsular management during hip arthroscopy: from femoroacetabular impingement to instability. Arthroscopy 27(12):1720–1731PubMedCrossRefGoogle Scholar
  2. 2.
    Bedi A, Kelly BT, Khanduja V (2013) Arthroscopic hip preservation surgery: current concepts and perspective. J Bone Joint Surg Brl 95-B(1):10–19Google Scholar
  3. 3.
    Benali Y, Katthagen BD (2009) Hip subluxation as a complication of arthroscopic debridement. Arthroscopy 25(4):405–407PubMedCrossRefGoogle Scholar
  4. 4.
    Blakey CM, Field MH, Singh PJ, Tayar R, Field RE (2010) Secondary capsular laxity of the hip. Hip Int 20(4):497–504PubMedGoogle Scholar
  5. 5.
    Boykin RE, Anz AW, Bushnell BD, Kocher MS, Stubbs AJ, Philippon MJ (2011) Hip instability. J Am Acad Orthop Surg 19(6):340–349PubMedGoogle Scholar
  6. 6.
    Colvin AC, Harrast J, Harner C (2012) Trends in hip arthroscopy. J Bone Joint Surg Am 94(4):e23PubMedCrossRefGoogle Scholar
  7. 7.
    Domb BG, Philippon MJ, Giordano BD (2013) Arthroscopic capsulotomy, capsular repair, and capsular plication of the hip: relation to atraumatic instability. Arthroscopy 29(1):162–173PubMedCrossRefGoogle Scholar
  8. 8.
    Dudda M, Mamisch TC, Krueger A, Werlen S, Siebenrock KA, Beck M (2011) Hip arthroscopy after surgical hip dislocation: is predictive imaging possible? Arthroscopy 27(4):486–492PubMedCrossRefGoogle Scholar
  9. 9.
    Martin HD, Savage A, Braly BA, Palmer IJ, Beall DP, Kelly B (2008) The function of the hip capsular ligaments: a quantitative report. Arthroscopy 24(2):188–195PubMedCrossRefGoogle Scholar
  10. 10.
    Matsuda DK (2009) Acute iatrogenic dislocation following hip impingement arthroscopic surgery. Arthroscopy 25(4):400–404PubMedCrossRefGoogle Scholar
  11. 11.
    Mei-Dan O, McConkey MO, Brick M (2012) Catastrophic failure of hip arthroscopy due to iatrogenic instability: can partial division of the ligamentum teres and iliofemoral ligament cause subluxation? Arthroscopy 28(3):440–445PubMedCrossRefGoogle Scholar
  12. 12.
    Montgomery SR, Ngo SS, Hobson T, Nguyen S, Alluri R, Wang JC, Hame SL (2013) Trends and demographics in hip arthroscopy in the United States. Arthroscopy 29(4):661–665PubMedCrossRefGoogle Scholar
  13. 13.
    Ranawat AS, McClincy M, Sekiya JK (2009) Anterior dislocation of the hip after arthroscopy in a patient with capsular laxity of the hip. A case report. J Bone Joint Surg Am 91(1):192–197PubMedCrossRefGoogle Scholar
  14. 14.
    Sansone M, Ahlden M, Jonasson P, Sward L, Eriksson T, Karlsson J (2013) Total dislocation of the hip joint after arthroscopy and ileopsoas tenotomy. Knee Surg Sports Traumatol Arthrosc 21(2):420–423PubMedCrossRefGoogle Scholar
  15. 15.
    Shu B, Safran MR (2011) Hip instability: anatomic and clinical considerations of traumatic and atraumatic instability. Clin Sport Med 30(2):349–367CrossRefGoogle Scholar
  16. 16.
    Smith MV, Panchal HB, Ruberte Thiele RA, Sekiya JK (2011) Effect of acetabular labrum tears on hip stability and labral strain in a joint compression model. Am J Sport Med 39(Suppl):103S–110SCrossRefGoogle Scholar
  17. 17.
    Smith MV, Sekiya JK (2010) Hip instability. Sports Med Arthrosc 18(2):108–112PubMedCrossRefGoogle Scholar
  18. 18.
    Wagner FV, Negrao JR, Campos J, Ward SR, Haghighi P, Trudell DJ, Resnick D (2012) Capsular ligaments of the hip: anatomic, histologic, and positional study in cadaveric specimens with MR arthrography. Radiology 263(1):189–198PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Frank McCormick
    • 1
    • 2
    Email author
  • William SlikkerIII
    • 1
  • Joshua D. Harris
    • 1
  • Anil K. Gupta
    • 1
  • Geoffrey D. Abrams
    • 1
  • Jonathan Frank
    • 1
  • Bernard R. BachJr
    • 1
  • Shane J. Nho
    • 1
  1. 1.Hip Preservation Center, Division of Sports Medicine, Department of Orthopaedic Surgery, Rush University Medical Center, Rush Medical CollegeRush UniversityChicagoUSA
  2. 2.Midwest Orthopaedics at RushChicagoUSA

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