Hip Capsular Plication

What is Capsular Plication?

Capsular plication is a surgical procedure used to tighten or reshape the fibrous capsule of the hip joint. This capsule, along with ligaments, muscles, and tendons, helps stabilize the hip. In some cases, the capsule can become loose or weak, leading to hip instability. This instability can cause the joint to feel like it is “giving out,” especially during movements like hip extension or external rotation. Capsular plication addresses this instability by folding and suturing the capsule, restoring its strength and function.

Why Do You Close the Capsule?

The hip capsule acts as an important stabilizing structure. When it becomes lax or damaged, it compromises the overall stability of the hip joint, increasing the risk of dislocation or persistent pain. By closing and tightening the capsule through plication, surgeons aim to restore normal hip mechanics, reduce symptoms of instability, and prevent further joint issues. The procedure reorients the fibers of the capsule, promoting a secure joint structure that can better handle movement and load.

How is Capsular Plication Performed?

Capsular plication is typically performed arthroscopically. During the procedure, small incisions are made around the hip, and specialized instruments are inserted to access the joint. The capsule is then carefully incised to visualize the inside of the joint. The surgeon will repair any damaged tissues before folding and suturing the capsule to tighten it. This process strengthens the joint capsule, helping prevent further instability and improving overall hip function.

What are the Risks of Capsular Plication?

As with any surgical procedure, capsular plication comes with certain risks, including:

• Infection: Though rare, infections can occur at the surgical site or deeper within the joint.
• Stiffness: Excessive tightening of the capsule could lead to limited range of motion in the hip joint.
• Nerve Damage: The proximity of nerves to the hip joint means there is a slight risk of nerve injury, which can result in numbness or weakness.
• Failure to Resolve Instability: In some cases, the procedure may not fully resolve hip instability or may require further treatment.

Who is a Candidate for Capsular Plication?

Patients who experience recurrent hip instability or have damage to the joint capsule or ligaments are potential candidates for capsular plication. Those who have failed conservative treatment options such as physical therapy or activity modification may benefit from this surgical intervention.

What to Expect During Recovery

Recovery from capsular plication typically involves a period of restricted movement to allow the hip capsule to heal properly. Patients are often advised to use crutches for a few weeks and avoid activities that place stress on the joint. Physical therapy is usually recommended to gradually restore strength and flexibility to the hip. Full recovery can take several months, depending on the extent of the procedure and individual healing rates.

Dr. Shane J. Nho is a board-certified fellowship-trained sports medicine orthopedic surgeon who specializes in the treatment of hip labral tears. For more information on hip capsular plication or to schedule a consultation, contact our orthopedic team today.