FP5.6 Quantifying Hip Axial Distraction Stability with the Periportal Capsulotomy Approach: A Cadaveric Analysis

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ID: 331275
2026
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Abstract
Abstract ICLB05 - The Art of Navigation: Foundations of Efficient and Complication-Free Hip Arthroscopy, Session Room 6 (BMCC Level 3), October 8, 2026, 14:00 - 16:00 Background Capsular disruption during hip arthroscopy has been linked to postoperative microinstability, with resistance to axial distraction providing a biomechanical measure of capsular integrity and joint stability. While complete capsular repair improves stability after interportal and T-cut capsulotomies, the extent to which periportal capsular repair restores axial distraction remains unclear, particularly when evaluating differences between unrepaired, partial closure, and complete closure. Hypothesis / Purpose This study compares distraction resistance across open, partial, and complete periportal states during hip arthroscopy to quantify biomechanical effects of graded capsular restoration. We hypothesized that complete periportal capsular repair would restore resistance to axial distraction closer to the native state than unrepaired or partial repair. Study Design Cadaveric Study, Level V Methods Nine fresh-frozen cadaveric hemi-pelvis specimens were mounted on an axial traction system and sequentially tested in native, open, partial, and complete repair states. Incremental axial traction (0–200 lbF) was applied under fluoroscopic guidance, and joint distraction distance was measured as the perpendicular separation between the acetabular sourcil and femoral head. Paired statistical analyses with Bonferroni correction compared distraction resistance across states, and percent restoration toward native was calculated. Results Nine cadaveric hemi-pelvises were sequentially tested across native, open, partial, and complete periportal repair states under incremental axial traction. Capsulotomy increased distraction compared with the native capsule beginning at 25 lbF and persisting through maximal loads, while both partial and complete repair restored axial resistance with traction. Capsulotomy resulted in greater axial distraction compared with the native capsule beginning at 50 lbF (8.39 ± 2.9 mm vs 4.37 ± 2.6 mm, p = 0.002) and persisting through maximal traction (200 lbF: 11.4 ± 2.3 vs 9.59 ± 2.2 mm, p < 0.001). Both partial and complete periportal repair restored resistance to axial distraction across traction loads. Complete repair outperformed partial repair in restoring native biomechanics at mid-range (62.5–112.5 lbF: 56–78% vs 40–58%) and high loads (137.5–200 lbF: 71–95% vs 40–57%). Absolute distraction distances were not significantly different between partial and complete repair across most traction loads (all p > 0.0167), although analyses demonstrated that complete repair more closely approximated native biomechanics, with convergence of distraction–load curves at higher traction loads. Conclusions Following periportal capsulotomy, complete capsular closure restores resistance to axial distraction more effectively than partial repair at mid-to-high traction loads and may be especially important when maximizing capsular stability.
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Authors Ashley L Matter, Sierra Levene, Benjamin T Johnson, Leah Henry, Steve Aoki, Elora Buscher
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Journal Journal of hip preservation surgery
Year 2026
DOI
10.1093/jhps/hnag043.038
URL
https://doi.org/10.1093/jhps/hnag043.038
Keywords Keywords not found

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