An Anatomical Study of the Anterosuperior Capsular Attachment Site on the Acetabulum
An Anatomical Study of the Anterosuperior Capsular Attachment Site on the Acetabulum
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DOI：
10.2106/jbjs.19.00034
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发表时间：
2019-09-04
影响因子：
5.3
通讯作者：
Akita, Keiichi
中科院分区：
文献类型：
--
作者：
Tsutsumi, Masahiro;Nimura, Akimoto;Akita, Keiichi
背景资料：尽管许多外科医生在髋关节镜手术中从髋臼前上方进行部分关节囊脱离以矫正髋臼畸形，但很少有研究关注这些关节囊脱离是否影响髋关节稳定性。本研究的目的是探讨髋臼前上方的关节囊附着。我们假设，附件的髂前下棘（AIIS）的下方面是广泛的和纤维软骨，可能有很大的作用，在髋关节stability.Methods：15髋关节9具尸体的日本捐助者进行了分析。对11个髋关节进行了肉眼分析，对另外4个髋关节进行了组织学分析。结果：大体观察显示，髋臼囊附着体的宽度随位置的不同而不同，髋臼囊附着体下缘的宽度明显大于髋臼前上缘。此外，AIIS下缘的囊附着与显微CT识别的印模相对应。组织学分析显示，AIIS下缘的髋关节囊附着于髋臼，邻近盂唇近端边缘。结论：髋关节囊附着于AIIS下缘的特点是附着面呈骨性压迹，附着面宽度大，纤维软骨分布均匀。
Background: Despite the fact that many surgeons perform partial capsular detachment from the anterosuperior aspect of the acetabulum to correct acetabular deformities during hip arthroscopy, few studies have focused on whether these detachments influence hip joint stability. The aim of this study was to investigate the capsular attachment on the anterosuperior aspect of the acetabulum. We hypothesized that the attachment on the inferior aspect of the anterior inferior iliac spine (AIIS) is wide and fibrocartilaginous and might have a substantial role in hip joint stability.Methods: Fifteen hips from 9 cadavers of Japanese donors were analyzed. Eleven hips were analyzed macroscopically, and the other 4 were analyzed histologically. In all specimens, the 3-dimensional morphology of the acetabulum and AIIS was examined using micro-computed tomography (micro-CT).Results: Macroscopic analysis showed that the widths of the capsular attachments varied according to the location, and the attachment width on the inferior edge of the AIIS was significantly larger than that on the anterosuperior aspect of the acetabulum. Moreover, the capsular attachment on the inferior edge of the AIIS corresponded with the impression, which was identified by micro-CT. Histological analysis revealed that the hip joint capsule on the inferior edge of the AIIS attached to the acetabulum adjacent to the proximal margin of the labrum. In addition, the hip joint capsule attached to the inferior edge of the AIIS via the fibrocartilage.Conclusions: The capsular attachment on the inferior edge of the AIIS was characterized by an osseous impression, large attachment width, and distributed fibrocartilage.