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This improvement in outcomes also is attributed to the increased awareness of performing capsular closure after addressing intra\u2010articular hip pathology, to preserve the biomechanical properties of the hip. A number of biomechanical studies have demonstrated that the iliofemoral ligament is a critical component of hip biomechanics, providing stability and limiting joint translation, distraction, and rotation within the normal range of hip motion. The interportal and T\u2010capsulotomy are the most commonly used methods for accessing intra\u2010articular pathology; both techniques require transection of the iliofemoral ligament perpendicular to its fibers, which may lead to micro\u2010 and macroinstability if left unrepaired at the end of the procedure. Several clinical studies have been published in the recent literature demonstrating that patients who undergo hip arthroscopy for femoroacetabular impingement syndrome and have an unrepaired capsule have lower functional outcome scores, achievement of meaningful outcomes, success rates, as well as greater failure rates and reported pain when compared with patients who have complete capsular closure. Capsular plication of the vertical T\u2010limb and closure of the interporal limb via plication have been reported to improved outcomes. Degree of plication is dependent on dynamic, intraoperative assessment of hip range of motion. The senior author recommends reflecting of the medial and lateral leaflets after T\u2010capsulotomy with polyethylene sutures to provide better exposure of the peripheral compartment, which can be used for closure. The remainder of the closure is performed with a suture\u2010passing device and approximately 2 to 3 interrupted stitches per limb.<\/jats:p>","DOI":"10.1016\/j.arthro.2019.10.028","type":"journal-article","created":{"date-parts":[[2019,12,18]],"date-time":"2019-12-18T02:05:57Z","timestamp":1576634757000},"page":"9-11","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":32,"title":["The Role of Comprehensive Capsular Management in Hip Arthroscopy for the Treatment of Femoroacetabular Impingement Syndrome"],"prefix":"10.1002","volume":"36","author":[{"given":"Edward C.","family":"Beck","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery Wake Forest Baptist Health Winston\u2010Salem North Carolina U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sunikom","family":"Suppauksorn","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery Rush University Medical Center Chicago Illinois U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shane J.","family":"Nho","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery Rush University Medical Center Chicago Illinois U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,1,1]]},"reference":[{"key":"e_1_2_2_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2015.02.031"},{"key":"e_1_2_2_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/2325967118S00009"},{"key":"e_1_2_2_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546514548017"},{"key":"e_1_2_2_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2016.09.019"},{"key":"e_1_2_2_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546511412161"},{"key":"e_1_2_2_7_1","article-title":"Danish Hip Arthroscopy Registry: Capsular closing in patients with femoroacetabular impingement (FAI): Results of a Matched\u2010cohort controlled study","author":"Mygind\u2010Klavsen B.","year":"2016","journal-title":"J\u00a0Hip Preserv Surg."},{"key":"e_1_2_2_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2018.09.005"},{"key":"e_1_2_2_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2016.01.049"}],"container-title":["Arthroscopy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S074980631930934X?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S074980631930934X?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/arthroscopyjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1016\/j.arthro.2019.10.028","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/arthroscopyjournals.onlinelibrary.wiley.com\/doi\/full-xml\/10.1016\/j.arthro.2019.10.028","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/arthroscopyjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1016\/j.arthro.2019.10.028","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,15]],"date-time":"2026-03-15T09:30:06Z","timestamp":1773567006000},"score":1,"resource":{"primary":{"URL":"https:\/\/arthroscopyjournals.onlinelibrary.wiley.com\/doi\/10.1016\/j.arthro.2019.10.028"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,1]]},"references-count":8,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2020,1]]}},"alternative-id":["10.1016\/j.arthro.2019.10.028"],"URL":"https:\/\/doi.org\/10.1016\/j.arthro.2019.10.028","archive":["Portico"],"relation":{},"ISSN":["0749-8063","1526-3231"],"issn-type":[{"value":"0749-8063","type":"print"},{"value":"1526-3231","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,1]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"The Role of Comprehensive Capsular Management in Hip Arthroscopy for the Treatment of Femoroacetabular Impingement Syndrome","name":"articletitle","label":"Article Title"},{"value":"Arthroscopy: The Journal of Arthroscopic & Related Surgery","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.arthro.2019.10.028","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2019 by the Arthroscopy Association of North America","name":"copyright","label":"Copyright"}]}}