Role of the Acetabular Labrum and the Iliofemoral Ligament in Hip Stability

2011 ◽  
Vol 39 (1_suppl) ◽  
pp. 85-91 ◽  
Author(s):  
Casey A. Myers ◽  
Bradley C. Register ◽  
Pisit Lertwanich ◽  
Leandro Ejnisman ◽  
W. Wes Pennington ◽  
...  
Keyword(s):  
Acetabular Labrum ◽  
Hip Stability ◽  
Iliofemoral Ligament

scholarly journals Portal enlargement in hip arthroscopy preserving the iliofemoral ligament: a novel access technique protecting soft tissue restraints

2020 ◽  
Vol 7 (2) ◽  
pp. 313-321 ◽  
Author(s):  
Victor M Ilizaliturri ◽  
Ruben Arriaga Sánchez ◽  
Rafael Zepeda Mora ◽  
Carlos Suarez-Ahedo
Keyword(s):  
Soft Tissue ◽  
Hip Joint ◽  
Hip Arthroscopy ◽  
Central Compartment ◽  
Peripheral Compartment ◽  
Hip Instability ◽  
Hip Stability ◽  
Relevant Role ◽  
Iliofemoral Ligament

Abstract Capsulotomy in different modalities has been used to provide adequate exposure to access both the central and peripheral compartment in hip arthroscopy. Even though the hip joint has inherent bony stability, soft tissue restraints may be important in patients with ligaments hyperlaxity or in some cases with diminished bony stability. Biomechanical studies and clinical outcomes have shown the relevant role of the capsule in hip stability, mainly the role of the iliofemoral ligament. Although is not very common, iatrogenic post-arthroscopy subluxation and dislocation have been reported and many surgeons are concerned about the role aggressive capsulotomy or capsulectomy in this situation, thus capsule repair has become very popular. We present a novel technique to access the hip without cutting the iliofemoral ligament. With this technique we can obtain adequate arthroscopic access to the hip joint in order to treat adequately the central compartment pathologies reducing the risk of iatrogenic post-operative hip instability.

scholarly journals The role of the iliofemoral ligament as a stabilizer of the hip joint

2021 ◽  
Vol 6 (7) ◽  
pp. 545-555
Author(s):  
Riccardo D’Ambrosi ◽  
Nicola Ursino ◽  
Carmelo Messina ◽  
Federico Della Rocca ◽  
Michael Tobias Hirschmann
Keyword(s):  
Hip Joint ◽  
External Rotation ◽  
Hip Dislocation ◽  
Primary Role ◽  
Hip Instability ◽  
Hip Stability ◽  
Current Systematic Review ◽  
Iliofemoral Ligament ◽  
And Function

The purpose of this systematic literature review is to analyse the role of the iliofemoral ligament (ILFL) as a hip joint stabilizer in the current literature. A total of 26 articles were included in the review. The ILFL is the largest hip ligament consisting of two distinct arms and is highly variable, both in its location and overall size, and plays a primary role in hip stability; in the case of hip dislocation, the iliofemoral ligament tear does not heal, resulting in a persistent anterior capsule defect. Clinically, the ILFL is felt to limit external rotation in flexion and both internal and external rotation in extension. The abduction–hyperextension–external rotation (AB-HEER) test is overall the most accurate test to detect ILFL lesions. Injuries of the ILFL could be iatrogenic or a consequence of traumatic hip instability, and can be accurately studied with magnetic resonance imaging. Different arthroscopic and open techniques have been described in order to preserve the ILFL during surgery and, in case of lesions, several procedures with good to excellent results have been reported in the existing literature. The current systematic review, focusing only on the ILFL of the hip, summarizes the existing knowledge on anatomy, imaging and function and contributes to the further understanding of the ILFL, confirming its key role in anterior hip stability. Future studies will have to develop clinical tests to evaluate the functionality and stability of the ILFL. Cite this article: EFORT Open Rev 2021;6:545-555. DOI: 10.1302/2058-5241.6.200112

The Role of the Acetabular Labrum and the Transverse Acetabular Ligament in Load Transmission in the Hip*

1998 ◽  
Vol 80 (12) ◽  
pp. 1781-8 ◽  
Author(s):  
GREGORY A. KONRATH ◽  
ANDREW J. HAMEL ◽  
STEVE A. OLSON ◽  
BRIAN BAY ◽  
NEIL A. SHARKEY
Keyword(s):  
Acetabular Labrum ◽  
Load Transmission ◽  
Transverse Acetabular Ligament

The Hip Suction Seal, Part I: The Role of Acetabular Labral Height on Hip Distractive Stability

2020 ◽  
Vol 48 (11) ◽  
pp. 2726-2732 ◽  
Author(s):  
Hunter W. Storaci ◽  
Hajime Utsunomiya ◽  
Bryson R. Kemler ◽  
Samuel I. Rosenberg ◽  
Grant J. Dornan ◽  
...  
Keyword(s):  
Negative Pressure ◽  
Clinical Effects ◽  
Acetabular Labrum ◽  
Peak Negative Pressure ◽  
Hip Stability ◽  
New Strategy ◽  
Fresh Frozen ◽  
Articular Pathology ◽  
Distraction Force ◽  
Suction Seal

Background: The acetabular labrum has been found to provide a significant contribution to the distractive stability of the hip. However, the influence of labral height on hip suction seal biomechanics is not known. Hypothesis: The smaller height of acetabular labrum is associated with decreased distractive stability. Study Design: Descriptive laboratory study. Methods: A total of 23 fresh-frozen cadaveric hemipelvises were used in this study. Hips with acetabular dysplasia or femoroacetabular impingement–related bony morphologic features, intra-articular pathology, or no measurable suction seal were excluded. Before testing, each specimen’s hip capsule was removed, a pressure sensor was placed intra-articularly, and the hip was fixed in a heated saline bath. Labral size was measured by use of a digital caliper. Maximum distraction force, distance to suction seal rupture, and peak negative pressure were recorded while the hip underwent distraction at a rate of 0.5 mm/s. Correlations between factors were analyzed using the Spearman rho, and differences between groups were detected using Mann-Whitney U test. Results: Of 23 hips, 12 satisfied inclusion criteria. The maximum distraction force and peak negative pressure were significantly correlated ( R = −0.83; P = .001). Labral height was largely correlated with all suction seal parameters (maximum distraction force, R = 0.69, P = .013; distance to suction seal rupture, R = 0.55, P = .063; peak negative pressure, R = −0.62, P = .031). Labral height less than 6 mm was observed in 5 hips, with a mean height of 6.48 mm (SD, 2.65 mm; range, 2.62-11.90 mm; 95% CI, 4.80-8.17 mm). Compared with the 7 hips with larger labra (>6 mm), the hips with smaller labra had significantly shorter distance to suction seal rupture (median, 2.3 vs 7.2 mm; P = .010) and significantly decreased peak negative pressure (median, −59.3 vs −66.9 kPa; P = .048). Conclusion: Smaller height (<6 mm) of the acetabular labrum was significantly associated with decreased distance to suction seal rupture and decreased peak negative pressure. A new strategy to increase the size of the labrum, such as labral augmentation, could be justified for patients with smaller labra in order to optimize the hip suction seal. Clinical Relevance: The height of the acetabular labrum is correlated with hip suction seal biomechanics. Further studies are required to identify the clinical effects of labral height on hip stability.

Biomechanical evaluation contribution of the acetabular labrum to hip stability

2015 ◽  
Vol 24 (7) ◽  
pp. 2338-2345 ◽  
Author(s):  
Pisit Lertwanich ◽  
Anton Plakseychuk ◽  
Scott Kramer ◽  
Monica Linde-Rosen ◽  
Akira Maeyama ◽  
...  
Keyword(s):  
Acetabular Labrum ◽  
Hip Stability ◽  
Biomechanical Evaluation

scholarly journals Role of the acetabular labrum in load support across the hip joint

2011 ◽  
Vol 44 (12) ◽  
pp. 2201-2206 ◽  
Author(s):  
Corinne R. Henak ◽  
Benjamin J. Ellis ◽  
Michael D. Harris ◽  
Andrew E. Anderson ◽  
Christopher L. Peters ◽  
...  
Keyword(s):  
Hip Joint ◽  
Acetabular Labrum

Paper # 43: Contributions of the Iliofemoral Ligaments and the Acetabular Labrum in Hip Stability

2011 ◽  
Vol 27 (10) ◽  
pp. e96-e97 ◽  
Author(s):  
Marc J. Philippon ◽  
Casey A. Myers ◽  
W. Wesley Pennington ◽  
Pisit Lertwanich ◽  
Leandro Ejnisman ◽  
...  
Keyword(s):  
Acetabular Labrum ◽  
Hip Stability

Vertical Extension of the T-Capsulotomy Incision in Hip Arthroscopic Surgery Does Not Affect the Force Required for Hip Distraction: Effect of Capsulotomy Size, Type, and Subsequent Repair

2018 ◽  
Vol 46 (13) ◽  
pp. 3127-3133 ◽  
Author(s):  
Alexander E. Weber ◽  
William H. Neal ◽  
Erik N. Mayer ◽  
Benjamin D. Kuhns ◽  
Elizabeth Shewman ◽  
...  
Keyword(s):  
Arthroscopic Surgery ◽  
Materials Testing ◽  
Distraction Effect ◽  
Intact State ◽  
Capsular Repair ◽  
Complete Repair ◽  
Hip Stability ◽  
Hip Distraction ◽  
Iliofemoral Ligament ◽  
Distraction Force

Background: Interportal and T-capsulotomies are popular techniques for exposing femoroacetabular impingement deformities. The difference between techniques with regard to the force required to distract the hip is currently unknown. Purpose: To quantify how increasing interportal capsulotomy size, conversion to T-capsulotomy, and subsequent repair affect the force required to distract the hip. Study Design: Controlled laboratory study. Methods: Eight fresh-frozen cadaveric hip specimens were dissected and fixed in a materials testing system, such that pure axial distraction of the iliofemoral ligament could be achieved. The primary outcome measure was the load required to distract the hip to a distance of 6 mm at a rate of 0.5 mm/s. Each hip was tested in the intact state and then sequentially under varying capsulotomy conditions: 2-cm interportal, 4-cm interportal, half-T (4-cm interportal and 2-cm T-capsulotomy), and full-T (4-cm interportal and 4-cm T-capsulotomy). After serial testing, isolated T-limb repair and then subsequent complete repair were performed. Repaired specimens underwent distraction testing as previously stated to assess the ability to restore hip stability to the native profile. Distraction force as well as the relative distraction force (percentage normalized to the intact capsule) were compared between all capsulotomy and repair conditions. Results: Increasing interportal capsulotomy size from 2 to 4 cm resulted in significantly less force required to distract the hip ( P < .001). The largest relative decrease in force was seen between the intact state (274.6 ± 71.2 N; 100%) and 2-cm interportal (209.7 ± 73.2 N; 76.4% ± 15.6%; P = .0008). There was no significant mean difference in distraction force when 4-cm interportal (160.4 ± 79.8 N) was converted to half-T (140.7 ± 73.5 N; P = .270) and then full-T (112.0 ± 70.2 N; P = .204). When compared with the intact state, isolated T-limb repair partially restored stability (177.3 ± 86.3 N; 63.5% ± 19.8%; P < .0001), while complete repair exceeded native values (331.7 ± 103.7 N; 122.7% ± 15.1%; P = .0008). Conclusion: The conversion of interportal capsulotomy to T-capsulotomy did not significantly affect the force required to distract the hip in a cadaveric model. However, larger interportal capsulotomies resulted in significant stepwise decreases in distraction force. When performing interportal or T-capsulotomy, the iliofemoral ligament strength is significantly decreased, but complete capsular repair demonstrated the ability to restore joint stability to the native, intact hip. Clinical Relevance: Increasing interportal capsulotomy size decreases the force required to distract the hip. In an effort to maximize visualization and minimize the magnitude of iliofemoral ligament fibers cut, many surgeons have moved from extended interportal capsulotomy to T-capsulotomy. Interportal and T-capsulotomies result in equivalent hip distraction, partial capsular repair marginally improves hip stability, and only complete repair has the ability to restore the hip to its native biomechanical profile.

scholarly journals The role of the acetabular labrum in hip dysplasia

2013 ◽  
Vol 84 (1) ◽  
pp. 60-64 ◽  
Author(s):  
Charlotte Hartig-Andreasen ◽  
Kjeld Søballe ◽  
Anders Troelsen
Keyword(s):  
Hip Dysplasia ◽  
Acetabular Labrum
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