Impacts of external rotators and the ischiofemoral ligament on preventing excessive internal hip rotation: a cadaveric study

Baba, Kazuyoshi; Chiba, Daisuke; Mori, Yu; Kuwahara, Yoshiyuki; Kogure, Atsushi; Sugaya, Takehiro; Kamata, Kumi; Oizumi, Itsuki; Suzuki, Takayuki; Kurishima, Hiroaki; Hamada, Soshi; Itoi, Eiji; Aizawa, Tadanori

doi:10.1186/s13018-021-02873-w

Cited by 3 publications

(1 citation statement)

References 23 publications

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“…A short taper stem was used in most cases, and there was no significant difference between the stem shape and gemellus inferior muscle damage. The 38 hips (22.4%) with partial gemellus inferior muscle damage had no postoperative dislocation, and the intact posterior capsule, ischiofemoral ligament, and internal obturator tendon seemed to be highly resistant to posterior dislocation [ 28 ]. The final condition of hips with partial gemellus inferior muscle damage was nearly equal to the condition of ERP, which preserves muscles from the piriformis to the internal obturator muscle [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

Clinical Outcomes of Bipolar Hemiarthroplasty with a Conjoined Tendon-Preserving Posterior Approach for Femoral Neck Fractures

Tanaka,

Mori,

Noro

et al. 2024

Medicina

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Background and Objectives: The conventional posterior approach in the lateral decubitus position is widely used for femoral neck fractures in femoral hemiarthroplasty. Postoperative dislocation is the major problem with this approach. The conjoined tendon-preserving posterior (CPP) approach is a less invasive surgical approach than the conventional posterior approach to the hip, maintains posterior stability, and preserves short external rotators and joint capsules. However, the mention was required to avoid muscle damage and whether muscle damage affects postoperative dislocation or not. The current study aimed to evaluate the clinical results of the CPP approach in hemiarthroplasty for femoral neck fractures and identify muscle damage risk factors. Materials and Methods: This study was a retrospective cohort study and included 170 hips in 168 patients. The mean age at the operation was 81.2 years. The preservation rate of the internal obturator muscle and gemellus inferior muscle and factors related to intraoperative short rotator muscle injury were investigated retrospectively. The postoperative complications and the relation between muscle damage and postoperative dislocation were investigated. Results: In the four hips (2.3%) with the obturator internus muscle damage, thirty-eight hips (22.4%) with gemellus inferior muscle damage were detected; in the muscle-damaged cases, the high body mass index (BMI) was significantly higher. The complication occurred in four hips (2.3%), including postoperative posterior dislocation in one hip without muscle damage (0.6%). Postoperative infection occurred in one hip (0.6%), and peroneal or sciatic nerve paralysis was suspected in two hips (1.1%). Conclusions: Compared to the conventional posterior approach in previous reports, the CPP approach reduces postoperative dislocation. A higher BMI is a risk factor for muscle damage, and the gemellus inferior muscle damage has no effect on postoperative dislocation. The CPP approach for BHA appeared to be an effective treatment method.

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Section: Discussionmentioning

confidence: 99%

Clinical Outcomes of Bipolar Hemiarthroplasty with a Conjoined Tendon-Preserving Posterior Approach for Femoral Neck Fractures

Tanaka,

Mori,

Noro

et al. 2024

Medicina

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Role of the Conjoined Tendon in Hip Stability Post-Total Hip Arthroplasty: Insights From a Direct Anterior Approach Cadaver Study

Zhao,

Bao

et al. 2024

Arthroplasty Today

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The predominant insertion of the ischiofemoral ligament is a merging to the iliofemoral ligament as demonstrated on magnetic resonance arthrogram studies

Hatem,

Badejo,

McCarroll

et al. 2024

Acta Radiol

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Background The capsular ligaments at the hip joint work in synchrony with the acetabulum and femoral head for articular stability. There is a lack of understanding about ischiofemoral ligament (ISFL) anatomy and function. Purpose To assess the insertion of the ISFL in non-arthritic adult hips. Material and Methods A retrospective analysis was performed in 72 patients who underwent magnetic resonance arthrogram (MRA) for the assessment of hip pain. The distribution of the ISFL components, the thickness, and the insertion site were assessed by concomitantly using the axial oblique, coronal, and sagittal MRA images. Results Two insertions of the ISFL anterior to the center of the femoral head were identified in 71 (99%) hips: (i) predominant anterior merging with the iliofemoral ligament as continuation of zona orbicularis, observed in all hips; and (ii) anterolateral junction of femoral neck and greater trochanter. Two ISFL parts (proximal and distal) were identified in 70 (97%) of the 72 studied hips. The proximal part was always thinner (mean 2.6 ± 0.7 mm) and originated from the ischium at the acetabular rim. The distal part was a continuation of the zona orbicularis, and the mean thickness was 6.7 ± 1.6 mm. Both parts merged as they coursed over the superior portion of the femoral head. Conclusion The predominant insertion of the ischiofemoral ligament is a merging to the iliofemoral ligament anteriorly. Surgical procedures such as hip arthroscopy involving the ISFL will affect the function of the iliofemoral ligament, and vice versa.

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Impacts of external rotators and the ischiofemoral ligament on preventing excessive internal hip rotation: a cadaveric study

Cited by 3 publications

References 23 publications

Clinical Outcomes of Bipolar Hemiarthroplasty with a Conjoined Tendon-Preserving Posterior Approach for Femoral Neck Fractures

Clinical Outcomes of Bipolar Hemiarthroplasty with a Conjoined Tendon-Preserving Posterior Approach for Femoral Neck Fractures

Role of the Conjoined Tendon in Hip Stability Post-Total Hip Arthroplasty: Insights From a Direct Anterior Approach Cadaver Study

The predominant insertion of the ischiofemoral ligament is a merging to the iliofemoral ligament as demonstrated on magnetic resonance arthrogram studies

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