Conceptual evolution in arthroscopic capsulotomy techniques and capsular management strategies for the hip

The narrative review is conducted based on the literature on the hip joint capsule anatomy, biomechanics and arthroscopy capsular management to summarize the evolution of capsulotomy concepts and practice.Traditional transverse capsulotomy and T-shaped capsulotomy provide a good surgical visualization but affect the stability of joint.This has led to the adoption of modified transverse capsulotomy techniques and capsular closure; longitudinal capsulotomy techniques preserve joint stability and ensure a clear visualization, and the publication of expert consensus guidance has contributed to their ongoing standardization and normalization, but there are still certain limitations.However, evidence for the outside-in longitudinal capsulotomy techniques remains limited and largely indirect, derived mainly from technique descriptions and early case series.Hip arthroscopy capsular management has improved over time.This shows how modern surgical philosophy is gradually developed from just repairing anatomy.And it now pays more attention to rebuilding and protecting the capsular function.Besides, evidence of the outside-in longitudinal capsulotomy is still limited and largely indirect, so further comparative studies are needed.