A Method for Capsular Management and Avoidance of Iatrogenic Instability: Minimally Invasive Capsulotomy in Hip Arthroscopy

Most surgeons create a T-shaped or interportal capsulotomy to ensure good visibility when performing hip arthroscopy. This entails transecting the iliofemoral ligament, which may or may not be repaired at the end of the procedure. Cases of iatrogenic hip instability and pain after hip arthroscopy suggest that the iliofemoral ligament plays a crucial role in the stability of the hip joint, and thus preservation should be a goal in hip arthroscopy. We describe a minimally invasive iliofemoral ligament-sparing capsulotomy, guided by the reflected head of the rectus tendon, that can be easily repaired after arthroscopic rim trimming, labral refixation, and offset correction.