Editorial Commentary: Capsular Repair May Not Be Required for All Patients Undergoing Hip Arthroscopy, Though Should Be Considered in At-Risk Populations as the Downside of Repair Is Minimal.

Abstract

Hip arthroscopy femoroacetabular impingement syndrome continues to evolve, changing trends and constant pendulum swinging. While hip arthroscopy initially was performed with a capsulectomy, fastidious capsular management has became the norm over the last decade. Recently, the utility of routine capsular closure has again been called into question, with several studies finding minimal differences between repaired and unrepaired cohorts. Like most controversies in orthopaedics, the answer is likely nuanced, and a one-size-fits-all approach should be spurned in favor of patient-specific and capsulotomy technique-specific considerations. However, while capsule repair may not be required in every patient, the downside of closure is minimal and our understanding of the hip imperfect. Select patients that receive interporal capsulotomies may do well with an unrepaired capsule, but a high degree of caution should be used if considering this.