Surgical Technique: Arthroscopic Capsular Plication

Despite the inherent stability provided to the hip joint through its bony constraints, the surrounding capsuloligamentous structures comprising the hip capsule are vital to maintain native hip function. During hip arthroscopy, a capsulotomy is essential to allow for adequate visualization and instrument navigation to address intracapsular pathology within the hip joint. Failure to close the capsule may result in iatrogenic hip instability or microinstability, leading to persistent pain, disability, and the need for revision surgery. As a result, arthroscopic capsular plication may be indicated in cases of ligamentous laxity or microinstability during primary or revision hip arthroscopy to reduce capsular redundancy, decrease intracapsular volume, and tighten capsuloligamentous structures. This chapter describes our technique for arthroscopic capsular plication using either an interportal or T-capsulotomy, while providing a concise overview of the literature regarding capsular closure.