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

Journal of Orthopaedic Surgery and Research

Daisuke Chiba¹  Hiroaki Kurishima¹  Takayuki Suzuki¹  Yu Mori¹  Takehiro Sugaya¹  Soshi Hamada¹  Toshimi Aizawa¹  Kazuyoshi Baba¹  Atsushi Kogure¹  Itsuki Oizumi²  Kumi Kamata²  Yoshiyuki Kuwahara³  Eiji Itoi⁴ 

[1] Department of Orthopedic Surgery, Tohoku University School of Medicine, 1-1 Seiryo-machi, Aoba-ku, 980-8574, Sendai, Miyagi, Japan;Iwaki Medical Center, 16 Kusehara, Uchigo Mimayamachi, 973-8555, Fukushima, Iwaki, Japan;Sendai City Hospital, 1-1-1 Asuto Nagamachi, Taihaku-ku, 982-8502, Sendai, Miyagi, Japan;Tohoku Rosai Hospital, 4-3-21, Dainohara, Aoba-ku, 981-8563, Sendai, Miyagi, Japan;

关键词: External rotator;    Capsular ligament;    Dislocation;    Ischiofemoral ligament;    Total hip arthroplasty;    Cadaveric study;    Hip joint;   

DOI  :  10.1186/s13018-021-02873-w

来源: Springer

【 摘 要 】

BackgroundThis study examined the biomechanics of preventing excessive internal hip joint rotation related to the hip flexion angle.MethodAn intramedullary nail with a circular plate equipped with a protractor was installed in the femur of nine normal hips. The circular plate was pulled by 3.15 Nm of force in the internal rotation direction. The external rotators were individually resected, finally cutting the ischiofemoral ligament. The cutting order of the external rotators differed on each side to individually determine the internal rotation resistance. The external rotators were resected from the piriformis to the obturator externus in the right hips and the reverse order in the left hips. Traction was performed after excising each muscle and ischiofemoral ligament. Measurements were taken at 0°, 30°, and 60° of hip flexion, and the differences from baseline were calculated.ResultsFor the right hip measurements, the piriformis and ischiofemoral ligament resection significantly differed at 0° of flexion (p = 0.02), each external rotator and the ischiofemoral ligament resections significantly differed at 30° of flexion (p < 0.01), and the ischiofemoral ligament and piriformis and inferior gemellus resections significantly differed at 60° of flexion (p = 0.04 and p = 0.02, respectively). In the left hips, the ischiofemoral ligament and obturator externus, inferior gemellus, and obturator internus resections significantly differed at 0° of flexion (p < 0.01, p < 0.01, and p = 0.01, respectively), as did each external rotator and the ischiofemoral ligament resections at 30° of flexion (p < 0.01).ConclusionThe ischiofemoral ligament primarily restricted the internal rotation of the hip joint. The piriformis and obturator internus may restrict internal rotation at 0° and 60° of flexion.

【 授权许可】

CC BY