Table 3.

Technical Pearls and Benefits to Capsular Suspension Technique

Technical pearls

The surgeon should leave adequate proximal capsule with the interportal capsulotomy for repair (5-8 mm distal to labrum).

Using untied mattress stitches for capsular suspension will reduce the total number of sutures used.

For interportal capsulotomy repair, the surgeon must ensure that the ALP cannula is inserted at the interval between the ICM and the gluteus minimus to avoid incorporating the gluteus minimus in the stitch and to allow access to the entire interportal capsulotomy from the ALP.

Developing the plane between the rectus femoris and capsule will prevent incorporation of muscle and/or tendon into capsule repair.

Benefits of technique

Offers improved visualization of the central and peripheral compartments

Enables preservation of the clean, native capsule edge, decreasing the need for excessive debridement and incidence of iatrogenic damage

Helps prevent over-tightening and subsequent stiffness by protecting the native edges of the capsule and removing them from the working area during treatment of central- and peripheral-compartment pathology

Allows exposure of the acetabular rim and subspinous region—as a result of suspension and retraction of the proximal capsule—while preserving the capsule for repair

Avoids the potential problem of an inadequate capsule for repair due to debridement for visualization or iatrogenic damage

Allows for peripheral-compartment access without the need for an assistant

ALP, anterolateral portal; ICM, iliocapsularis muscle.