Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
Share the Article
Liu CJ, He YH, Peng Q, Jiang CC, Chen TZ. Conceptual evolution in arthroscopic capsulotomy techniques and capsular management strategies for the hip. World J Orthop 2026; 17(11): 125447 [DOI: 10.5312/wjo.125447]
Chu-Jie Liu, Can-Cai Jiang, Tie-Zhu Chen, Department of Osteoarthritis and Sports Medicine, Hunan Provincial People’s Hospital (The First Affiliated Hospital of Hunan Normal University), Changsha 410005, Hunan Province, China
Yin-Hao He, Department of Osteoarthritis and Sports Medicine, The First Affiliated Hospital of Hunan Medical College, Huaihua 418000, Hunan Province, China
Qiang Peng, Department of Orthopedics, Joints, and Sports Medicine, The Central Hospital of Shaoyang, Shaoyang 422000, Hunan Province, China
Author contributions: Liu CJ and Chen TZ conceived and designed the study; Liu CJ, He YH, Peng Q, and Jiang CC performed the literature search and data extraction; Liu CJ drafted the manuscript; He YH, Peng Q, and Jiang CC revised the manuscript critically for important intellectual content; Chen TZ supervised the study and gave final approval. All authors have read and approved the final version.
AI contribution statement: The authors declare that DeepSeek-V3 was used solely for language polishing. All authors have verified all AI-assisted content and accept full responsibility for the manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Corresponding author: Tie-Zhu Chen, Associate Professor, Department of Osteoarthritis and Sports Medicine, Hunan Provincial People’s Hospital (The First Affiliated Hospital of Hunan Normal University), No. 61 Jiefang West Road, Furong District, Changsha 410005, Hunan Province, China. ctzmz11@163.com
Received: July 7, 2026 Revised: September 13, 2026 Accepted: October 28, 2026 Published online: November 18, 2026 Processing time: 126 Days and 11.9 Hours
Abstract
The narrative review is conducted based on the literature on the hip joint capsule anatomy, biomechanics and arthroscopy capsular management to summarize the evolution of capsulotomy concepts and practice. Traditional transverse capsulotomy and T-shaped capsulotomy provide a good surgical visualization but affect the stability of joint. This has led to the adoption of modified transverse capsulotomy techniques and capsular closure; longitudinal capsulotomy techniques preserve joint stability and ensure a clear visualization, and the publication of expert consensus guidance has contributed to their ongoing standardization and normalization, but there are still certain limitations. However, evidence for the outside-in longitudinal capsulotomy techniques remains limited and largely indirect, derived mainly from technique descriptions and early case series. Hip arthroscopy capsular management has improved over time. This shows how modern surgical philosophy is gradually developed from just repairing anatomy. And it now pays more attention to rebuilding and protecting the capsular function. Besides, evidence of the outside-in longitudinal capsulotomy is still limited and largely indirect, so further comparative studies are needed.
Core Tip: This narrative review summarizes the development of hip arthroscopic capsulotomy from inside-out techniques to outside-in techniques. It describes the progression from maximizing exposure to preserving capsular function. And it also discusses the evidence on capsular closure, current challenges, and future directions.
