Outside-In Inverted L-Shaped Capsulotomy in Hip Arthroscopy

Hip arthroscopy has become the mainstream surgical treatment for femoroacetabular impingement syndrome, with approximately 88.75% of patients returning to sports postoperatively. Capsulotomy is a critical step in arthroscopic labral repair; however, various reported techniques possess inherent limitations. This technique employs an outside-in longitudinal capsulotomy along the femoral neck, followed by a transverse capsular release from its acetabular attachment along the path of the labral tear, creating an inverted "L"-shaped opening. On completion of the repair, the hip capsule is closed and retensioned using the remaining sutures from the labral repair anchors. This article summarizes the advantages, disadvantages, pearls, and pitfalls of this technique.