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

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Abstract Background 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… Click to show full abstract

Abstract Background 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. Methods 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. Results The capsular noose repair provided greater resistance to dislocation than no repair (p  Conclusion The capsular noose repair may reduce dislocation risk after posterior approach total hip arthroplasty.

Keywords: posterior approach; capsular noose; dislocation; capsular repair; hip; repair

Journal Title: International Journal of Surgery Open
Year Published: 2019

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