Comparative effects of hip capsule repair and cam lesion excision on capsulotomy healing: An in vivo biomechanical and histological analysis

IF 2 Q2 ORTHOPEDICS

Journal of Experimental Orthopaedics Pub Date : 2025-05-19 DOI:10.1002/jeo2.70267

Abbas Aghayev, Burak Duymaz, Selahaddin Aydemir, Pınar Akokay Yılmaz, Gurhan Tukel, Resit Bugra Husemoglu, Onur Gürsan, Onur Hapa

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Abstract

Purpose

This study evaluates the effects of hip capsule repair and cam lesion excision on capsular healing by assessing biomechanical strength and histological integrity in an in vivo rabbit model.

Methods

An in vivo rabbit model with 80 rabbits was used, where capsulotomy was performed on the right hip of each subject. The rabbits were assigned into four groups: Group 1 (capsulotomy without repair), Group 2 (capsulotomy with capsule repair), Group 3 (capsulotomy + cam resection without repair), Group 4 (capsulotomy + cam resection + capsule repair). Each group was stratified into 4-week and 8-week follow-up subgroups. Biomechanical testing assessed maximum tensile strength, while histological evaluation included semiquantitative grading of collagen arrangement, inflammatory response, osteogenesis, and angiogenesis.

Results

Histological analysis revealed superior healing in the capsule repair + cam resection group (Group 4) compared to the unrepaired capsulotomy group (Group 1) (p = 0.01). Biomechanical testing demonstrated that capsule repair (Group 2) improved strength over unrepaired capsulotomy (135.2 N vs. 111.9 N, p = 0.03). Cam resection alone (Group 3) resulted in significantly higher strength than unrepaired capsulotomy (163.2 N vs. 111.9 N, p = 0.01). The combination of cam resection and capsule repair (Group 4) demonstrated superior strength, outperforming capsule repair alone (176 N vs. 135.2 N, p = 0.01). At 8 weeks, the capsule repair + cam resection group (Group 4a) showed significantly enhanced biomechanical strength compared to the unrepaired capsulotomy group (Group 1a) (181.6 N vs. 120.9 N, p = 0.001) and capsule repair alone (Group 2a) (181.6 N vs. 125.8 N, p = 0.01).

Conclusion

Our findings indicate that cam resection, particularly when combined with capsule repair, significantly improves biomechanical strength and enhances the healing process of the capsule. These findings offer practical guidance for optimising surgical strategies to enhance patient outcomes and long-term joint function.

Level of Evidence

Level III, experimental therapeutic study (prospective and controlled).

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髋关节囊修复与切除对囊切开术愈合的比较效果：体内生物力学和组织学分析

目的本研究通过评估兔体内模型的生物力学强度和组织完整性，评估髋关节囊修复和切除对囊愈合的影响。方法80只家兔在体模型，每只兔右髋关节切开囊膜。将家兔分为4组：1组（囊膜切开不修复）、2组（囊膜切开加囊膜修复）、3组（囊膜切开+囊膜切除不修复）、4组（囊膜切开+囊膜切除+囊膜修复）。各组分为随访4周和8周亚组。生物力学测试评估最大抗拉强度，而组织学评估包括胶原排列、炎症反应、成骨和血管生成的半定量分级。结果组织学分析显示，囊膜修复+ cam切除组（4组）的愈合优于未修复的囊膜切除组（1组）（p = 0.01）。生物力学测试表明，囊膜修复（第二组）比未修复的囊膜切开术提高了强度（135.2 N比111.9 N, p = 0.03）。单独Cam切除术（第3组）的强度明显高于未修复的囊膜切除术（163.2 N比111.9 N, p = 0.01）。cam切除联合包膜修复（第4组）表现出更强的强度，优于单独包膜修复（176 N比135.2 N, p = 0.01）。8周时，与未修复的囊膜切开组（1a组）（181.6 N vs. 120.9 N, p = 0.001）和单独进行囊膜修复组（2a组）（181.6 N vs. 125.8 N, p = 0.01）相比，囊膜修复+ cam切除组（4a组）的生物力学强度显著增强。结论我们的研究结果表明，凸轮切除，特别是与包膜修复相结合，可以显著提高生物力学强度，促进包膜的愈合过程。这些发现为优化手术策略以提高患者预后和长期关节功能提供了实用指导。证据等级：III级，实验性治疗性研究（前瞻性和对照）。

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