title: Biomechanical Evaluation of Capsulotomy, Capsulectomy, and Capsular Repair on Hip Rotation.
abstract: OBJECTIVE
  To determine the effect of different types of capsulotomies on hip rotational biomechanical characteristics.
  
  
  METHODS
  Seven fresh-frozen cadaveric hip specimens were thawed and dissected, leaving the hip capsule and labrum intact. The femur was transected and potted, and each specimen was placed in a custom loading apparatus that allowed for adjustment of flexion, extension, and axial rotation of the femur. Six reflective infrared markers were attached to the specimens to track the motion of the femoral head with respect to the acetabulum in real time, and external rotation was produced by applying a torque of 10 Nm to the hip specimens. Data analysis was performed using the 3-dimensional position of the markers in space. The specimens were tested in neutral flexion and 40° of flexion in the following capsular states: intact, interportal capsulotomy, T-capsulotomy, repaired capsulotomy, and capsulectomy. Paired t tests and analysis of variance were used with an α value of .05 set as significant.
  
  
  RESULTS
  With the hip in neutral flexion, there was increased external rotation with a T-capsulotomy (91.1° ± 20.3°, P = .029) and capsulectomy (91.9° ± 19.6°, P = .015) compared with the intact hip (83.2° ± 20.5°). After complete repair of the T-capsulotomy (87.4° ± 20.6°), there was no significant difference in external rotation compared with the intact hip. No significant differences were seen between groups at 40° of hip flexion.
  
  
  CONCLUSIONS
  A T-capsulotomy showed significantly increased external rotation versus the intact and interportal capsulotomy states. The repaired T-capsulotomy restored the rotational profile back to the native state.
  
  
  CONCLUSIONS
  Many methods of capsular treatment during hip arthroscopy exist. Capsulotomy and capsulectomy do not restore the external rotation restraint of the hip back to its native state.
authors.affiliation: Department of Orthopedic Surgery, Stanford University School of Medicine and VA Palo Alto, Palo Alto, California, U.S.A.; Veterans Administration Hospital-Palo Alto, Palo Alto, California, U.S.A.. Electronic address: gabrams@stanford.edu.
authors.forename: Geoffrey D
authors.initials: GD
authors.lastname: Abrams
authors.affiliation: Hip Preservation Center, Division of Sports Medicine, Department of Orthopedic Surgery, Rush University Medical Center, Chicago, Illinois, U.S.A.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Hart
authors.affiliation: Hip Preservation Center, Division of Sports Medicine, Department of Orthopedic Surgery, Rush University Medical Center, Chicago, Illinois, U.S.A.
authors.forename: Kaosu
authors.initials: K
authors.lastname: Takami
authors.affiliation: Hip Preservation Center, Division of Sports Medicine, Department of Orthopedic Surgery, Rush University Medical Center, Chicago, Illinois, U.S.A.
authors.forename: Christopher O
authors.initials: CO
authors.lastname: Bayne
authors.affiliation: Center for Hip Pain and Preservation, Hospital for Special Surgery, New York, New York, U.S.A.
authors.forename: Bryan T
authors.initials: BT
authors.lastname: Kelly
authors.affiliation: Hip Preservation Center, Division of Sports Medicine, Department of Orthopedic Surgery, Rush University Medical Center, Chicago, Illinois, U.S.A.
authors.forename: Alejandro A
authors.initials: AA
authors.lastname: Espinoza Orías
authors.affiliation: Hip Preservation Center, Division of Sports Medicine, Department of Orthopedic Surgery, Rush University Medical Center, Chicago, Illinois, U.S.A.
authors.forename: Shane J
authors.initials: SJ
authors.lastname: Nho
mesh_terms: D000077:Acetabulum / Q000601:surgery; D000368:Aged; D001182:Arthroscopy / Q000379:methods*; D001696:Biomechanical Phenomena; D002102:Cadaver; D005260:Female; D005270:Femur Head / Q000503:physiopathology; D006621:Hip Joint / Q000503:physiopathology* / Q000601:surgery*; D006801:Humans; D008297:Male; D016059:Range of Motion, Articular; D012399:Rotation; D019415:Torque; D014945:Wound Healing