Minimally Invasive Hip Arthroscopy for Femoroacetabular Impingement Using Iliofemoral Ligament–Preserving Skip Capsulotomy for Cam Resection

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Interportal capsulotomy is the standard approach for treating femoroacetabular impingement during hip arthroscopy. However, this method carries a substantial risk of injuring the iliofemoral ligament, which may result in joint instability and persistent pain. We describe a modified "skip capsulotomy" technique, which preserves iliofemoral ligament integrity while enabling adequate access for cam resection. This technique employs a small longitudinal capsulotomy (∼5 mm) aligned with the mid-anterior portal and a short transverse incision (∼1.5-2 cm) extending posteriorly from the anterolateral portal, without connecting the 2 portals. The iliofemoral ligament is preserved by avoiding an interportal incision. This minimally invasive approach allows sufficient visualization and instrument maneuverability while preserving capsular stability, which is particularly advantageous in patients with hip instability.

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