The “capsular noose”: A new capsular repair technique to diminish dislocation risk after the posterior approach total hip arthroplasty

Post-operative hip dislocation has been commonly associated with primary THA as a troublesome complication after posterior approach. Although several other risk factors have been implicated, techniques of capsular repair and closure have also been described. A new technique for repair of the capsule...

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Bibliographic Details
Published in:International journal of surgery open 2019, Vol.17, p.8-14
Main Authors: Swanson, Todd V., Kukreja, Mohit M., Ballard, James C., Calleja, Henry G.M., Brown, Jonathon M.
Format: Article
Language:English
Subjects:
Capsular noose
Capsular repair
Capsule
Dislocation
Posterior approach
Total hip arthroplasty
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Summary:Post-operative hip dislocation has been commonly associated with primary THA as a troublesome complication after posterior approach. Although several other risk factors have been implicated, techniques of capsular repair and closure have also been described. A new technique for repair of the capsule after posterior, minimally invasive, total hip arthroplasty is described. In Part A of this two-part study, 133 classic repairs of the capsule and external rotators to the greater trochanter (Group 1) were retrospectively compared to 144 capsular noose repairs (Group 2). After minimum 24-month follow up, dislocation was more common in Group 1 than in Group 2 (5.3% vs. 0.69%, p = 0.02). In Part B, 20 consecutive patients were tested intra-operatively for torque and internal rotation to dislocation using three capsular repair techniques. The capsular noose repair provided greater resistance to dislocation than no repair (p 
ISSN:2405-8572
2405-8572
DOI:10.1016/j.ijso.2018.12.005