What is capsular reconstruction surgery?
The hip capsule is a fibrous soft tissue structure that surrounds the hip joint and acts to protect and stabilize the joint. Disruption of the capsule is common during hip arthroscopic procedures and can create microinstability leading to pain and dysfunction if not repaired adequately during surgery. If not addressed, the instability may lead to detrimental cartilage and labral damage. Capsular reconstruction surgery is a procedure that replaces the damaged capsule with a graft from another part of the body (autograft) or a donor (allograft). The goal of this procedure is to restore stability and the biomechanical properties of the hip joint.
The difference between capsular repair and reconstruction is that repair consists of cleaning the frayed capsular tissue and reattaching the torn edges together, whereas, reconstruction involves removing the deficient capsule segment and replacing it with a graft.
Who is a good candidate for capsular reconstruction?
Capsular reconstruction is indicated for patients who have symptoms of hip instability, weakness, or pain due to a deficient joint capsule, have failed conservative management, and who are not candidates for repair. Most commonly, patients will present with microinstability after previous arthroscopic surgery when the capsule was not restored.
Capsular repair is not an option in patients that do not have adequate amount of remaining capsular tissue. Inadequate tissue makes it impossible to restore the dynamic stability of the hip joint by repair.
What does the procedure entail?
Capsular reconstruction of the hip may be performed arthroscopically. This is a minimally invasive procedure that utilizes small incisions with thin instruments and a small camera to see inside the joint. The defect in the hip capsule is measured and an appropriately sized graft is prepared. The new graft is laid over the defect and attached to the rim of the hip socket and as well as the healthy segment of the native capsule.
This procedure is performed in an outpatient surgery center. This means the patient will go home the same day of surgery once they have recovered from anesthesia. Patients will wear a brace for 8 weeks postoperatively that will prevent extending the operated leg.