Aside from direct capsular repair, capsular plication can also be performed in cases of hip instability in an effort to improve the stability of the hip. In this procedure, the capsule is tightened through the use of specialized instrumentation and suture placement that allows the surgeon to precisely control tensioning of the capsule. This directly affects the function of the capsule in providing ligamentous hip stability. 

A number of studies have evaluated the clinical outcomes for capsular plication. 

• A review of over 47 studies notes case reports of successful treatment using capsular plication during hip arthroscopy (Domb, Philippon, and Giordano; Arthroscopy; 2013).

• A recent review of contemporary capsule management during hip arthroscopy supports the use of capsular plication to reduce ligament volume and stabilize the hip joint (Nho et al., CRMM 2019).

• A retrospective study of 26 patients with femoroacetabular impingement and borderline hip dysplasia found that labral repair with simultaneous capsular plication significantly improved patient reported outcomes and pain with high satisfaction at a minimum of two year follow-up

• A case series of 32 patients with hip instability found that capsular plication significant improved patient reported outcomes over one year after surgery (Kalisvaart and Safran, KSSTA 2017)

The available evidence suggests that capsular plication is an effective treatment for hip instability. It is associated with a significant improvement in pain and function, a low risk of complications, and a good long-term outcome. Capsular plication has a moderate recommendation for the treatment of hip instability.