Capsular Reconstruction of the Hip Using Modified Kite Technique: A Technical Guide for Efficient Graft Management and Fixation

Preserving capsular integrity has become an important principle of hip preservation surgery given the increasingly recognized deleterious effects of instability in cases of capsular insufficiency. When capsular tissue is deficient, capsular reconstruction may be indicated to restore function of the iliofemoral ligament and improve hip biomechanics. To date, few studies have presented technical guidance on performing arthroscopic capsular reconstruction of the hip. In this Technical Note, we introduce a modified kite technique for arthroscopic entry, control, and fixation of a capsular reconstruction graft. Similar to flying a kite with multiple fly lines, and to the previously described kite technique for hip labral reconstruction, the principles of this method are founded on the belief that control sutures within a pulley system facilitate safe and efficient graft management during capsular reconstruction procedures.