Iliopectineal Ligament as an Important Landmark in Ilioinguinal Approach of the Anterior Acetabulum: A Cadaveric Morphologic Study

Abstract

Background:The iliopectineal ligament is the most stout anterior part of the iliopectineal membrane. It separates "lacuna musculorum" laterally from "lacuna vasorum" medially. This ligament is an important guide in the safe anterior approach to the acetabulum. Aim of the work:To study the detailed anatomy of the iliopectineal ligament demonstrating its importance as a surgical landmark in the anterior approach to the acetabulum. Material and methods:The material of this work included eight adult formalin preserved cadavers. Dissection of the groin was done for each cadaver in supine position with exposure of the inguinal ligament. The iliopectineal ligament and the three surgical windows in the anterior approach to the acetabulum were revealed.Results: Results described the detailed morphological anatomy of the iliopectineal ligament as regard its thickness, attachments and variations in its thickness. The study also revealed important anatomical measurements in relation to the inguinal ligament. The distance between the anterior superior iliac spine (ASIS) to the pubic tubercle ranged from 6.7 to 10.1 cm with a mean value of 8.31±1.3. The distance between the anterior superior iliac spine (ASIS) to the blending point of the iliopectineal ligament to the inguinal ligament ranged from 1.55 to 1.92 cm with a mean value of 1.78±0.15. Conclusion:The iliopectineal ligament detailed morphology and attachments are crucial when planning to do anterior approach of the acetabulum to decrease incidence of iatrogenic injury to the femoral vessels.