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Capsulotomy with repair during THA yielded no anterior capsular defects

Orthopedics Today reports on the findings of a study led by HSS hip and knee surgeon, Alexander S. McLawhorn, MD, MBA, which found patients who underwent total hip arthroplasty (THA) through the direct anterior approach with capsulotomy and repair had no anterior capsular defects compared with patients who underwent capsulectomy only.

Dr. McLawhorn and colleagues collected metal artifact reduction sequence (MARS) MRI at discharge and one year follow-up for 32 patients who underwent THA through the direct anterior approach. Of these patients, 17 underwent capsulotomy and repair and 15 underwent capsulectomy, only. Each MARS MRI was scored by a radiologist blinded to intraoperative data, and researchers graded anterior capsular integrity, status of the piriformis and conjoint tendons, and muscle atrophy. Results showed 75 percent of piriformis tendons and 38 percent of conjoined tendons were intact immediately postoperatively. Researchers found intact piriformis and conjoined tendon in 97 percent of patients at one year. However, many of the intact piriformis and conjoined tendons were in continuity through scar with the capsule. All patients had direct contact between posterior capsule and bone.

“Thus, we can speculate that anterior capsular repair may improve anterior stability for [direct-anterior approach] DAA THA, as we have observed for posterior capsular repair and posterior stability for posterior approach THA,” said Dr. McLawhorn.

Read the full article at Healio.com.