Arthroscopic Hip Capsular Reconstruction: A Step-by-Step Guide With Rectus Overlay

The hip capsule is the primary stabilizer of the hip joint. At the time of hip arthroscopy, the capsule is disrupted to obtain intra-articular access and proper joint visualization. With the number of patients undergoing primary and revision hip arthroscopy continuing to increase, it is not uncommon for surgeons to encounter patients with iatrogenic capsular deficiency from prior hip arthroscopy. In cases where substantial capsular defects beyond the scope of capsular repair are visualized, reconstruction may be required to obtain satisfactory closure and restore hip stability. We present a step-by-step workflow for efficient hip capsular reconstruction with rectus overlay while allowing for facile incorporation of other revision procedures such as labral repair and femoral osteochondroplasty.