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Hip Aspiration / Anterior Hip Capsulotomy

- See: hip capsule

- Discussion:
    - femoral neck frx may increase intracapsular pressure and capsular distention;
    - this may decrease perfusion through the capsular vessels and contribute to development of osteonecrosis;
    - immediate joint aspiration following femoral neck frx may reverse intracapsular pressure and AVN;

- Capsulotomy Technique:
    - straight lateral incision is made from the top of the trochanter to point 1 cm distal to the lesser trochanter;
    - fascia lata is incised longitudinally & vastus lateralalis either split or lifted anteriorly;
    - capsular attachements at trochanteric ridge/vastus tubercle can be exposed with anterior retraction and the capsule incised in line w/ neck of the femur and released proximally and distally from intertrochanteric ridge to produce a T shaped capsulotomy

Intracapsular pressure and caput circulation in nondisplaced femoral neck fractures.

Intraosseous pO2 in femoral neck fracture. Restoration of blood flow after aspiration of hemarthrosis in undisplaced fractures.

Hip Joint Tamponade - an etiologic factor in the osteonecrosis of Legg Calve Perthes Disease. Gershuni PH, Hargens AR, Greenberg EN, et al. Trans Orthop Rec Soc. Las Vegas, Feb 1981.