Dr. Bose

The NCP (Neck Capsule Preserving) Approach which is increasingly being adopted by surgeons world wide was developed at ARCH by Dr. Bose. This facilitates a faster recovery due to the repair of the capsule.  The vascularity of the critical regions of the head and neck is also preserved in the NCP Approach.

Dr. De Smet

Do you preserve the hip capsule during your hip resurfacing surgeries?

[Koen De Smet ANSWER/]  YES AND I THINK YOU SHOULD

Dr. Rubinstein

Saving the capsule is good with a THR because it may decrease the rate of dislocation. In regular THR it can go either way saving or not. Due to the technical needs of the resurf procedure the
capsule must be fully opened and partially removed. There is no way to do a resurf and fully preserve the capsule. This is not a problem though because the resurfs are more stable then a THR and dislocations are very unlikely. I certainly wouldn’t let the need to sacrifice the capsule turn you off to resurfacing. The anatomy of the resurf makes the capsule less necessary then in a THR

The capsule is the membrane connecting the rim of the acetabulum and the base of the femoral neck. It helps stabilize the hip and provides some of the blood supply to the femoral head. I may not have been clear regarding how it is handled in a resurf. It is cut all the way around to allow the head to be dislocated enough to expose the head to resurface it. A small portion around the neck is left to preserve the blood supply. The part near the side of approach (posterior for most surgeons) is sometimes removed. At the end the part that is assessable is usually repaired and the rest scars back in. As for motion it is likely that a good therapy program and activity does more to keep the hip mobile then how much capsule is removed. That said I try to retain as much as possible and still be able to do the job.

Scott Rubinstein M.D.