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Comparable Torque to Failure Using the Simple Stich Versus the Figure of Eight Configuration for Hip Capsular Closure Following An Interportal Capsulotomy. A Cadaveric Study

      Abstract

      Purpose

      To measure and compare the torque to failure and stiffness of the capsular repair construct consisting of four-suture simple stitches to a two-figure of eight stitches repair construct in external rotation following an interportal capsulotomy.

      Methods

      Six pairs of fresh-frozen cadaveric hemipelves were divided into two capsular repair groups. All hips underwent a 40 mm interportal capsulotomy from the 12 o’clock position to the 3 o’clock position. Capsular closure was performed using either the two stitches in a figure of eight or with four simple stitches. Afterward, each hemipelvis was securely fixed to the frame of a mechanical testing system with the hip in 10° of extension and externally rotated to failure. Significance was set at P < 0.05.

      Results

      The average failure torque was 86.2 ± 18.9 N·m and 81.5 ± 8.9 N·m (P = 0.57) for the two stitches in a figure of eight and the four simple stitches, respectively. Failure stiffness was also not statistically different between groups and both capsular closure techniques failed at similar degrees of rotation (P = 0.65).

      Conclusion

      Hip capsular repair using either the four simple stitch or two-figure of eight configurations following interportal capsulotomy demonstrated comparable failure torques and similar stiffness in a cadaveric model.
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      References

        • Kyin C.
        • Maldonado D.R.
        • Go C.C.
        • Shapira J.
        • Lall A.C.
        • Domb B.G.
        Mid To Long-term Outcomes Of Hip Arthroscopy: A Systematic Review.
        Arthroscopy. 2021 Mar; 37: 1011-1025
        • Menge T.J.
        • Briggs K.K.
        • Rahl M.D.
        • Philippon M.J.
        Hip Arthroscopy for Femoroacetabular Impingement in Adolescents: 10-Year Patient-Reported Outcomes.
        Am J Sports Med. 2021; 49: 76-81
        • Menge T.J.
        • Briggs K.K.
        • Dornan G.J.
        • McNamara S.C.
        • Philippon M.J.
        Survivorship and Outcomes 10 Years Following Hip Arthroscopy for Femoroacetabular Impingement: Labral Debridement Compared with Labral Repair.
        J Bone Joint Surg Am. 2017; 99: 997-1004
        • Byrd J.W.T.
        • Jones K.S.
        Prospective analysis of hip arthroscopy with 10-year followup.
        Clin Orthop. 2010; 468 (d): 741-746
        • Krych A.J.
        • Thompson M.
        • Knutson Z.
        • Scoon J.
        • Coleman S.H.
        Arthroscopic Labral Repair Versus Selective Labral Debridement in Female Patients With Femoroacetabular Impingement: A Prospective Randomized Study.
        Arthroscopy. 2013; 29: 46-53
        • Mansor Y.
        • Perets I.
        • Close M.R.
        • Mu B.H.
        • Domb B.G.
        In Search of the Spherical Femoroplasty: Cam Overresection Leads to Inferior Functional Scores Before and After Revision Hip Arthroscopic Surgery.
        Am J Sports Med. 2018; 46: 2061-2071
        • Shapira J.
        • Kyin C.
        • Go C.
        • et al.
        Indications and Outcomes of Secondary Hip Procedures After Failed Hip Arthroscopy. A Systematic Review.
        Arthrosc J Arthrosc Relat Surg Off Publ Arthrosc Assoc N Am Int Arthrosc Assoc. Published online March. 2020; 4
        • Nho S.J.
        • Beck E.C.
        • Kunze K.N.
        • Okoroha K.
        • Suppauksorn S.
        Contemporary Management of the Hip Capsule During Arthroscopic Hip Preservation Surgery.
        Curr Rev Musculoskelet Med. 2019; (Published online July 5): 260-270
        • Ortiz-Declet V.
        • Mu B.
        • Chen A.W.
        • et al.
        Should the Capsule Be Repaired or Plicated After Hip Arthroscopy for Labral Tears Associated With Femoroacetabular Impingement or Instability? A Systematic Review.
        Arthrosc J Arthrosc Relat Surg Off Publ Arthrosc Assoc N Am Int Arthrosc Assoc. 2018; 34: 303-318
        • Chahla J.
        • Sherman B.
        • Wydra F.
        • Gerhardt M.B.
        The Pie-Crusting Technique for Capsular Management During Hip Arthroscopy.
        Arthrosc Tech. 2019; 8: e93-e96
        • Chambers C.C.
        • Monroe E.J.
        • Flores S.E.
        • Borak K.R.
        • Zhang A.L.
        Periportal Capsulotomy: Technique and Outcomes for a Limited Capsulotomy During Hip Arthroscopy.
        Arthrosc J Arthrosc Relat Surg Off Publ Arthrosc Assoc N Am Int Arthrosc Assoc. 2019; 35: 1120-1127
        • Wydra F.B.
        • Al’Khafaji I.
        • Haruno L.
        • et al.
        Pie-Crusting Capsulotomy Provides Similar Visualization with Increased Repair Stiffness Compared to a T-Capsulotomy: A Biomechanical Study.
        Arthrosc J Arthrosc Relat Surg Off Publ Arthrosc Assoc N Am Int Arthrosc Assoc. March 31, 2021; (Published online)
        • Parvaresh K.
        • Rasio J.P.
        • Martin R.L.
        • et al.
        Achievement of Meaningful Clinical Outcomes Is Unaffected by Capsulotomy Type During Arthroscopic Treatment of Femoroacetabular Impingement Syndrome: Results From the Multicenter Arthroscopic Study of the Hip (MASH) Study Group.
        Am J Sports Med. 2021; 49: 713-720
        • Freeman K.L.
        • Nho S.J.
        • Suppauksorn S.
        • Chahla J.
        • Larson C.M.
        Capsular Management Techniques and Hip Arthroscopy.
        Sports Med Arthrosc Rev. 2021; 29: 22-27
        • Baha P.
        • Burkhart T.A.
        • Getgood A.
        • Degen R.M.
        Complete Capsular Repair Restores Native Kinematics After Interportal and T-Capsulotomy.
        Am J Sports Med. 2019; 47: 1451-1458
        • Chahla J.
        • Mikula J.
        • Schon J.
        • et al.
        Hip Capsular Closure: A Biomechanical Analysis of Failure Torque.
        Am J Sports Med. 2017; 45: 434-439
        • Aoki S.K.
        • Karns M.R.
        • Hananouchi T.
        • Todd D.C.
        Hip Arthroscopy Capsular Closure: The Figure of Eight Technique.
        Arthrosc Tech. 2017; 6: e505-e509
        • O’Neill D.C.
        • Tomasevich K.M.
        • Mortensen A.J.
        • Featherall J.
        • Ohlsen S.M.
        • Aoki S.K.
        Capsular Repair During Hip Arthroscopy Demonstrates Restoration of Axial Distraction Resistance in an in Vivo Intraoperative Testing Model.
        J Bone Joint Surg Am. July 27, 2021; (Published online)
        • Philippon M.J.
        • Michalski M.P.
        • Campbell K.J.
        • et al.
        A quantitative analysis of hip capsular thickness.
        Knee Surg Sports Traumatol Arthrosc Off J ESSKA. 2015; 23: 2548-2553
        • Domb B.G.
        • Philippon M.J.
        • Giordano B.D.
        Arthroscopic Capsulotomy, Capsular Repair, and Capsular Plication of the Hip: Relation to Atraumatic Instability.
        Arthrosc J Arthrosc Relat Surg. 2013; 29: 162-173
        • Philippon M.J.
        • Trindade C.A.C.
        • Goldsmith M.T.
        • et al.
        Biomechanical Assessment of Hip Capsular Repair and Reconstruction Procedures Using a 6 Degrees of Freedom Robotic System.
        Am J Sports Med. 2017; 45: 1745-1754
        • Jimenez A.E.
        • Owens J.S.
        • Shapira J.
        • et al.
        Hip Capsular Management in Patients with Femoroacetabular Impingement or Microinstability: A Systematic Review of Biomechanical Studies.
        Arthrosc J Arthrosc Relat Surg Off Publ Arthrosc Assoc N Am Int Arthrosc Assoc. Published online. April 30, 2021;
        • Telleria J.J.M.
        • 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 N Y N. 2014; 27: 489-497
        • Weber A.E.
        • Neal W.H.
        • Mayer E.N.
        • et al.
        Vertical Extension of the T-Capsulotomy Incision in Hip Arthroscopic Surgery Does Not Affect the Force Required for Hip Distraction: Effect of Capsulotomy Size, Type, and Subsequent Repair.
        Am J Sports Med. 2018; 46: 3127-3133
        • Paschos N.K.
        • Brand J.C.
        • Rossi M.J.
        • Lubowitz J.
        Methods to Improve Arthroscopic and Orthopaedic Biomechanical Investigations: A Few of Our Favorite Things.
        Arthrosc J Arthrosc Relat Surg Off Publ Arthrosc Assoc N Am Int Arthrosc Assoc. 2019; 35: 2967-2969