The Pie-Crusting Technique for Capsular Management During Hip Arthroscopy

Hip arthroscopy is commonly performed for the treatment of femoroacetabular impingement and labral pathology. When arthroscopy for femoroacetabular impingement is performed, a capsulotomy is often utilized to maximize access and allow for improved visualization. When an extended interportal or T capsulotomy is performed, the iliofemoral ligament is transected, which can lead to micro or gross instability. The purpose of this Technical Note is to describe an alternative approach to the standard T capsulotomy using a pie crusting technique, which provides improved visualization of the femoral head–neck junction during the femoroplasty without the need for an extended capsulotomy and can also serve to create venting holes that prevent hematoma formation within the capsule.