Background

Hip capsulotomies, performed routinely during hip arthroscopy, can contribute to adverse joint kinematics. Direct repair is not always feasible. Therefore, the aim of this study was to evaluate the biomechanics of a conventional all-suture repair versus a hybrid suture and anchor-based capsular repair.

Methods

Nine paired (n = 18) hips were tested on a joint-motion simulator, utilizing optical trackers to capture kinematic data. Pairs were randomly allocated to capsular repair type and tested as (1) intact, (2) after T-capsulotomy, and (3) repair each at 0°, 45°, and 90° flexion. Internal and external rotation torques and abduction/adduction torques of 3 N·m were applied and rotational range of motion and joint translations recorded.

Findings

At 0°, following repair there were no significant differences in joint rotation or translations between repairs (p > 0.134).

At 45°, both repair types restored motion to near intact values, with no significant differences between groups. Similarly, there were no significant differences in joint translations between repairs.

At 90°, both types of capsular repair failed to restore rotational range of motion, with persistent increases in motion (47.0 ± 16.7°) compared to the intact condition (44.1 ± 15.8°, p = 0.006); however, there were no significant differences between repair groups. There were no significant differences in joint translations between repairs.

Interpretation

Use of a hybrid repair produced comparable joint rotation and translation under all testing conditions as an all-suture repair. As such, this technique represents a viable option for capsular repair where proximal capsular tissue is deficient.

中文翻译：

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混合缝合和基于锚的髋关节囊修补术的生物力学评估

背景

在髋关节镜检查期间常规进行的髋关节囊切开术可能会导致不利的关节运动学。直接维修并非总是可行的。因此，本研究的目的是评估常规全缝合修复与混合缝合和基于锚钉的囊膜修复的生物力学。

方法

 在关节运动模拟器上测试了九对成对（n = 18）的髋关节，利用光学跟踪器捕获运动学数据。对随机分配为囊修复类型，并进行以下测试：（1）完整，（2）T囊切开术后，（3）分别在0°，45°和90°屈曲下修复。施加3 N·m的内部和外部旋转扭矩以及外展/内收扭矩，并记录运动的旋转范围和关节平移。

发现

在0°时，修复后的关节旋转或修复之间的平移没有显着差异（p  > 0.134）。

在45°时，两种修复类型都将运动恢复到接近完整的值，各组之间没有显着差异。同样，修复之间的联合翻译也没有显着差异。

在90°时，两种类型的囊膜修复均无法恢复运动的旋转范围，与完整状态（44.1±15.8°，p  = 0.006）相比，运动持续增加（47.0±16.7° ）；但是，修复组之间没有显着差异。修复之间的联合翻译没有显着差异。

解释

使用混合修复可以在所有测试条件下产生与全缝合修复相当的关节旋转和平移。这样，该技术代表了在近端囊组织不足的情况下进行囊修复的可行选择。