Creating and Closing the T-Capsulotomy for Improved Visualization During Arthroscopic Treatment of Femoroacetabular Impingement

Treatment of femoroacetabular impingement through an arthroscopic approach has gained widespread popularity in recent years. Although outcomes are generally favorable, one of the most common reasons for failure is incomplete resection of cam lesions of the femoral neck. As a result, the T-capsulotomy has been introduced as a method for improving access to the femoral head-neck junction, which is not always visible through a standard interportal capsulotomy. The T-capsulotomy has the benefits of improving arthroscopic visualization of the femoral neck, reducing overall fluoroscopy exposure for the patient and surgeon, and facilitating capsular plication. We present a reliable and efficient method for creating and repairing the T-capsulotomy. We routinely perform this technique in patients with cam lesions that are too large or too distal to safely visualize and decompress through an interportal capsulotomy.