Fig 9.

Surgical step 5. The capsule imbrication is an augmentation to the procedure. A superolateral to inferomedial cut in the capsule is made with a new No. 15 scalpel and the femoral head is exposed (left). When performing the capsulotomy, heavy pickups are used to lift the capsule off the surface of the femoral head to avoid iatrogenic damage to the underlying cartilage. The capsule is imbricated with a pants over vest technique using #1 Vicryl suture (right). The figures depicting the surgical procedure are in a supine position, on a left hip. Proximal, distal, medial, and lateral are the top, bottom, left, and right of the image, respectively.