L‐Capsulotomy and Anatomic Repair of Zona Orbicularis: Hip Arthroscopy Capsular Management for Femoroacetabular Impingement Syndrome

Abstract As an increasingly recognized technique, the longitudinal outside‐in capsulotomy (LOIC) has the advantages of reducing damage to the iliofemoral ligament and decreasing the impact on hip joint stability. However, it has limitations in exposing and addressing acetabular‐sided lesions, particularly in femoroacetabular impingement syndrome cases with posterior pathologies. In this report, we describe a modified capsulotomy technique based on LOIC to obtain a balance between reducing damage to the iliofemoral ligament and achieving adequate visualization of acetabular‐sided pathologies. Furthermore, the LOIC usually requires transecting the zona orbicularis to expose and address femoral‐sided lesions, but standard repair techniques may be insufficient to adequately restore its anatomic continuity and mechanical strength. In this report, we describe an anatomic suture technique specifically designed for the anatomic repair of the zona orbicularis during LOIC.