Comparative effects of hip capsule repair and cam lesion excision on capsulotomy healing: An in vivo biomechanical and histological analysis

ABSTRACT Purpose This study evaluates the effects of hip capsule repair and cam lesion excision on capsular healing by assessing biomechanical strength and histological integrity in an in vivo rabbit model. Methods An in vivo rabbit model with 80 rabbits was used, where capsulotomy was performed on...

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Main Authors: Abbas Aghayev, Burak Duymaz, Selahaddin Aydemir, Pınar Akokay Yılmaz, Gurhan Tukel, Resit Bugra Husemoglu, Onur Gürsan, Onur Hapa
Format: Article
Language:English
Published: Wiley 2025-04-01
Series:Journal of Experimental Orthopaedics
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Online Access:https://doi.org/10.1002/jeo2.70267
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author Abbas Aghayev
Burak Duymaz
Selahaddin Aydemir
Pınar Akokay Yılmaz
Gurhan Tukel
Resit Bugra Husemoglu
Onur Gürsan
Onur Hapa
author_facet Abbas Aghayev
Burak Duymaz
Selahaddin Aydemir
Pınar Akokay Yılmaz
Gurhan Tukel
Resit Bugra Husemoglu
Onur Gürsan
Onur Hapa
author_sort Abbas Aghayev
collection DOAJ
description ABSTRACT Purpose This study evaluates the effects of hip capsule repair and cam lesion excision on capsular healing by assessing biomechanical strength and histological integrity in an in vivo rabbit model. Methods An in vivo rabbit model with 80 rabbits was used, where capsulotomy was performed on the right hip of each subject. The rabbits were assigned into four groups: Group 1 (capsulotomy without repair), Group 2 (capsulotomy with capsule repair), Group 3 (capsulotomy + cam resection without repair), Group 4 (capsulotomy + cam resection + capsule repair). Each group was stratified into 4‐week and 8‐week follow‐up subgroups. Biomechanical testing assessed maximum tensile strength, while histological evaluation included semiquantitative grading of collagen arrangement, inflammatory response, osteogenesis, and angiogenesis. Results Histological analysis revealed superior healing in the capsule repair + cam resection group (Group 4) compared to the unrepaired capsulotomy group (Group 1) (p = 0.01). Biomechanical testing demonstrated that capsule repair (Group 2) improved strength over unrepaired capsulotomy (135.2 N vs. 111.9 N, p = 0.03). Cam resection alone (Group 3) resulted in significantly higher strength than unrepaired capsulotomy (163.2 N vs. 111.9 N, p = 0.01). The combination of cam resection and capsule repair (Group 4) demonstrated superior strength, outperforming capsule repair alone (176 N vs. 135.2 N, p = 0.01). At 8 weeks, the capsule repair + cam resection group (Group 4a) showed significantly enhanced biomechanical strength compared to the unrepaired capsulotomy group (Group 1a) (181.6 N vs. 120.9 N, p = 0.001) and capsule repair alone (Group 2a) (181.6 N vs. 125.8 N, p = 0.01). Conclusion Our findings indicate that cam resection, particularly when combined with capsule repair, significantly improves biomechanical strength and enhances the healing process of the capsule. These findings offer practical guidance for optimising surgical strategies to enhance patient outcomes and long‐term joint function. Level of Evidence Level III, experimental therapeutic study (prospective and controlled).
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spelling doaj-art-3ae21624d2db44abbe99d5633c24ae292025-08-20T03:44:05ZengWileyJournal of Experimental Orthopaedics2197-11532025-04-01122n/an/a10.1002/jeo2.70267Comparative effects of hip capsule repair and cam lesion excision on capsulotomy healing: An in vivo biomechanical and histological analysisAbbas Aghayev0Burak Duymaz1Selahaddin Aydemir2Pınar Akokay Yılmaz3Gurhan Tukel4Resit Bugra Husemoglu5Onur Gürsan6Onur Hapa7Department of Orthopedics and Traumatology Dokuz Eylul University Faculty of Medicine İzmir TurkeyDepartment of Orthopedics and Traumatology Dokuz Eylul University Faculty of Medicine İzmir TurkeyDepartment of Orthopedics and Traumatology Kastamonu Research and Training Hospital Kastamonu TurkeyDepartment of Medical Laboratory Techniques Izmır Kavram Vocational School Izmir TurkeyDepartment of Orthopedics and Traumatology Dokuz Eylul University Faculty of Medicine İzmir TurkeyDepartment of Biomechanics Dokuz Eylul University Izmir TurkeyDepartment of Orthopedics and Traumatology Dokuz Eylul University Faculty of Medicine İzmir TurkeyDepartment of Orthopedics and Traumatology Dokuz Eylul University Faculty of Medicine İzmir TurkeyABSTRACT Purpose This study evaluates the effects of hip capsule repair and cam lesion excision on capsular healing by assessing biomechanical strength and histological integrity in an in vivo rabbit model. Methods An in vivo rabbit model with 80 rabbits was used, where capsulotomy was performed on the right hip of each subject. The rabbits were assigned into four groups: Group 1 (capsulotomy without repair), Group 2 (capsulotomy with capsule repair), Group 3 (capsulotomy + cam resection without repair), Group 4 (capsulotomy + cam resection + capsule repair). Each group was stratified into 4‐week and 8‐week follow‐up subgroups. Biomechanical testing assessed maximum tensile strength, while histological evaluation included semiquantitative grading of collagen arrangement, inflammatory response, osteogenesis, and angiogenesis. Results Histological analysis revealed superior healing in the capsule repair + cam resection group (Group 4) compared to the unrepaired capsulotomy group (Group 1) (p = 0.01). Biomechanical testing demonstrated that capsule repair (Group 2) improved strength over unrepaired capsulotomy (135.2 N vs. 111.9 N, p = 0.03). Cam resection alone (Group 3) resulted in significantly higher strength than unrepaired capsulotomy (163.2 N vs. 111.9 N, p = 0.01). The combination of cam resection and capsule repair (Group 4) demonstrated superior strength, outperforming capsule repair alone (176 N vs. 135.2 N, p = 0.01). At 8 weeks, the capsule repair + cam resection group (Group 4a) showed significantly enhanced biomechanical strength compared to the unrepaired capsulotomy group (Group 1a) (181.6 N vs. 120.9 N, p = 0.001) and capsule repair alone (Group 2a) (181.6 N vs. 125.8 N, p = 0.01). Conclusion Our findings indicate that cam resection, particularly when combined with capsule repair, significantly improves biomechanical strength and enhances the healing process of the capsule. These findings offer practical guidance for optimising surgical strategies to enhance patient outcomes and long‐term joint function. Level of Evidence Level III, experimental therapeutic study (prospective and controlled).https://doi.org/10.1002/jeo2.70267biomechanical analysiscam excisioncapsular managementcapsule repairfemoroacetabular impingement (FAI)histological healing
spellingShingle Abbas Aghayev
Burak Duymaz
Selahaddin Aydemir
Pınar Akokay Yılmaz
Gurhan Tukel
Resit Bugra Husemoglu
Onur Gürsan
Onur Hapa
Comparative effects of hip capsule repair and cam lesion excision on capsulotomy healing: An in vivo biomechanical and histological analysis
Journal of Experimental Orthopaedics
biomechanical analysis
cam excision
capsular management
capsule repair
femoroacetabular impingement (FAI)
histological healing
title Comparative effects of hip capsule repair and cam lesion excision on capsulotomy healing: An in vivo biomechanical and histological analysis
title_full Comparative effects of hip capsule repair and cam lesion excision on capsulotomy healing: An in vivo biomechanical and histological analysis
title_fullStr Comparative effects of hip capsule repair and cam lesion excision on capsulotomy healing: An in vivo biomechanical and histological analysis
title_full_unstemmed Comparative effects of hip capsule repair and cam lesion excision on capsulotomy healing: An in vivo biomechanical and histological analysis
title_short Comparative effects of hip capsule repair and cam lesion excision on capsulotomy healing: An in vivo biomechanical and histological analysis
title_sort comparative effects of hip capsule repair and cam lesion excision on capsulotomy healing an in vivo biomechanical and histological analysis
topic biomechanical analysis
cam excision
capsular management
capsule repair
femoroacetabular impingement (FAI)
histological healing
url https://doi.org/10.1002/jeo2.70267
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