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The Pie-Crusting Technique for Capsular Management During Hip Arthroscopy.

Jorge Chahla¹, Benjamin Sherman², Frank Wydra¹

¹Cedars Sinai Kerlan Jobe Institute, Santa Monica, California, U.S.A.

Arthroscopy Techniques

|March 23, 2019

Summary

This study introduces a pie crusting technique for hip arthroscopy, improving visualization during femoroplasty. This method avoids extensive capsulotomy, potentially reducing instability risks associated with femoroacetabular impingement surgery.

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Area of Science:

Orthopedic Surgery
Arthroscopy Techniques

Background:

Hip arthroscopy is a common procedure for femoroacetabular impingement (FAI) and labral tears.
Standard T capsulotomy during FAI arthroscopy can lead to iliofemoral ligament transection and potential hip instability.
Improved visualization is crucial for effective femoroplasty in FAI treatment.

Purpose of the Study:

To present an alternative capsulotomy technique for hip arthroscopy.
To describe the pie crusting technique as a modification to the standard T capsulotomy.
To highlight the benefits of this technique in FAI surgery.

Main Methods:

Description of a novel pie crusting capsulotomy technique for hip arthroscopy.
Application of the technique during femoroplasty for femoroacetabular impingement.
Comparison with standard extended interportal or T capsulotomy.

Main Results:

The pie crusting technique provides enhanced visualization of the femoral head-neck junction.
This method obviates the need for an extended capsulotomy, preserving the iliofemoral ligament.
The technique can also create necessary venting holes to prevent capsular hematoma.

Conclusions:

The pie crusting capsulotomy is a viable alternative for hip arthroscopy in FAI.
It offers improved visualization and may mitigate risks of hip instability.
This technique enhances surgical safety and efficacy in FAI procedures.