Accessing the Hip Capsular Management: Outside-In and Inside-Out Including Periportal, Intraportal, T-Capsulotomy

The hip joint is a ball and socket joint supported by static and dynamic stabilizers. The hip capsule and its constituent ligaments provide support during weight-bearing activities. Hip arthroscopy requires capsulotomy for visualization and instrumentation and a thorough understanding of the anatomy and biomechanics of the hip capsule allows surgeons to select the appropriate capsulotomy technique for each procedure. This chapter describes capsular access techniques including periportal, interportal, and T-capsulotomy, as well as puncture and extracapsular access techniques. Capsular closure techniques are reviewed and outcomes after varying capsular management techniques are summarized.