Hip Capsular Preservation When Treating Femoroacetabular Impingement Syndrome Should Remain Universal and Some Hip Phenotypes Necessitate Maximum Surgical Stability.

Hip capsular preservation literature shows varying outcome. Capsular preservation is most common in the United States. Different surgeons prefer, and different patients require simple periportal capsulotomies versus wider exposure with T-type capsulotomy and traction stitches. Revision cases require wider expose. Paramount is adequate bony decompression in patients with FAI, but capsular preservation may also be universally recommended. Finally, in addition to revision indications, some hip phenotypes may require more aggressive capsular management. Patients with borderline hip dysplasia, acetabular retroversion, increased femoral anteversion, and higher Beighton scores necessitate more hip stability, thus capsular preservation and closure is paramount. Patients with "tight" hips, thicker capsules, and larger cam lesions may need less stringent capsular care.